Abstract: Objective To evaluate the efficacy of trimetazidine on insulin resistance in patients with coronary heart disease (CHD). Methods A cohort of 119 CHD patients were randomly divided into groups A and B receiving the same basic therapy, and the patients in group B were given additional trimetazidine 20 mg 3 times daily for 8 weeks. Before and after treatment, the changes in blood glucose, insulin levels and insulin sensitivity index were evaluated. Results The patients in group B showed better outcome than those in group A. After 8 weeks’ trimetazidine therapy, the fasting insulin and that at 2 h after oral glucose were decreased (P<0.01), and the insulin sensitivity index was improved (P<0.01). Conclusion Trimetazidine may produce obvious therapeutic effect on insulin resistance in CHD patients.