Objective: To analysis the values of microvolt T-wave alternans(MTWA) and maximum T-wave alternans(max-MTWA)in patients with low or moderate risk coronary artery disease(CAD),and assess the risk of sudden cardiac death(SCD). Methods:One hundred and twelve CAD patients were enrolled for this study,and sixty-six non-CAD patients as the control group. Based on the Duke treadmill test scores(DTS),CAD patients were divided into 2 groups:the low-risk CAD group(with scores ranging from 5 to 15)and the moderate-risk CAD group(with scores ranging from-10 to 5). All participants performed treadmill exercise stress tests and MTWA,max-MTWA and the heart rates(HR) at max-MTWA were recorded by the time-domain modified moving average beat analysis(MMA)method,then the ratio of max-MTWA/HR was calculated. Results:There were significant differences in max-MTWA,max-MTWA/HR ratio and MTWA values between the control group and the CAD group(all P<0.05). Furthermore,subgroup analysis showed that the max-MTWA and max-MTWA/HR ratio in the moderate-risk CAD group were higher than those in the low-risk CAD group,and the parameters in the low-risk CAD group were higher than those in the control group(all P<0.05). There was no significant difference in MTWA between the low-risk CAD group and the control group(P>0.05). However,MTWA in the moderate-risk CAD group were significantly higher than those in the low-risk CAD group and the control group(all P<0.05). Conclusion:max-MTWA and max-MTWA/HR ratio were significantly increased in patients with severe CAD. The risk of SCD in low-risk CAD patients was the low as the control group,while moderate-risk CAD patients have a higher risk of SCD.