Objective To investigate the effects of Trimetazidine hydrochloride combined with Atorvastatin calcium in the treatment of coronary heart disease on the levels of left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF), so as to provide reference for clinical treatment. Methods According to the random number table method, 67 patients with coronary heart disease admitted to Harbin The First Hospital from May to October 2020 were divided into two groups. The patients in the control group (33 cases) were treated with conventional therapy + Atorvastatin calcium, the patients in the experimental group (34 cases) were treated with Atorvastatin calcium + Trimetazidine hydrochloride, both patients were treated for 3 months. Clinical efficacy after treatment, LVESD, LVEDD, LVEF, serum cardiac troponin I (cTnI), creatine kinase isoenzyme-MB (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) levels before and after treatment were compared between the two groups. Results After treatment, the clinical total effective rate of patients in the experimental group was higher than that in the control group; compared with before treatment, the levels of LVESD, LVEDD, serum cTnI, CK-MB, NT-proBNP, TC, TG and LDL-C in the two groups decreased after treatment, the experimental group was lower than the control group, the levels of LVEF, HDL-C increased, the experimental group was higher than the control group (all P<0.05). Conclusion Trimetazidine hydrochloride combined with Atorvastatin calcium in the treatment of coronary heart disease can improve cardiac function, promote myocardial cell metabolism, improve vascular endothelial function, regulate blood lipid levels, and improve clinical therapeutic effects.