Objective To explore the correlation of serum uric acid (SUA) / high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and the prevalence of atrial fibrillation (AF) in patients suffering from coronary heart disease (CHD). Methods A total of 705 patients with CHD of Wujin People's Hospital affiliated to Jiangsu University from 2021 01 to 2022 12 were enrolled in this study, and they were divided into non-AF (n=626) and AF (n=79) based on the electrocardiogram results and past history. General data, physical examination indicators and blood biochemical tests were collected and the study subject UHR were calculated. UHR levels were divided into four groups to study the association between UHR and the prevalence of AF in CHD patients. Pearson correlation method was used to examine the relationship between UHR and indicators such as left atrial diameter (LAD). Multivariate logistic regression analysis was used to explore the association between UHR and the risk of AF in CHD patients. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) was evaluated for the predictive performance of UHR for AF.Results SUA, UHR, left atrial diameter (LAD), age, body weight, height, body mass index (BMI), alcohol consumption, history of smoking, hypertension and diabetes were significantly higher than the non-AF group. However, the high-density lipoprotein-cholesterol (HDL-C) levels were significantly lower than those in the non-AF group. With the increase of UHR level, the AF detection rate of Q1-Q4 group increased. Pearson's correlation analysis showed that UHR was positively associated with SUA, LAD, serum creatinine (SCr), height, weight, BMI, diastolic blood pressure (DBP), and negatively correlated with HDL-C. The results of multivariate logistic regression analysis showed that UHR was an independent risk factor for AF in CHD patients (OR=1.006, 95%CI: 1.003-1.009, P<0.001). ROC curve was drawn and it was found that the AUC of UHR to identify the occurrence of AF was 0.733. Conclusion High UHR levels may participate in left atrial remodeling leading to the development of AF. In CHD patients, UHR levels had a significant correlation with the occurrence of AF and was a risk factor for the occurrence of AF. This index can be used as a simple evaluation index for the early screening of AF in CHD patients