Objective To explore the therapeutic effect of irbesartan combined with dobutamine in patients with coronary heart disease (CHD) and heart failure (HF). Methods 124 patients with CHD and HF treated in our hospital from April 2018 to April 2019 were randomly divided into dobutamine group (62 cases) and combined treatment group (62 cases). Dobutamine group was treated with dobutamine, and irbesartan combined with dobutamine was used in the combined treatment group. The cardiac function of the two groups was evaluated. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), glutathione peroxidase (GSHPx), lipid peroxide (LPO), malondialdehyde (MDA) were detected by enzymelinked immunosorbent assay, and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry. The levels of protective hormone (OPG) and insulinlike growth factor-1 (IGF-1) were compared between the two groups. Results After treatment, the left ventricular posterior wall thickness (LVPWd) level in the combined treatment group was lower than that in the dobutamine group, and the levels of left ventricular ejection fraction (LVEF) and stroke cardiac output (SV) were higher than those in the dobutamine group (P＜0.05). After treatment, the levels of TNFα, IL1β, IL6, LPO, MDA, CD8+, OPG in the combined treatment group were lower than those in the dobutamine group (P＜0.05). After treatment, the levels of GSHPx, CD4+, CD3+, IGF-1 in the combined treatment group were higher than those in the dobutamine group (P＜0.05). The total effective rate in the combined treatment group was higher than that in the dobutamine group (P＜0.05). The incidence of adverse reactions in the combined treatment group was slightly higher than that in the dobutamine group, but there was no statistical difference (P＞0.05). Conclusion Irbesartan combined with dobutamine can improve the cardiac function and immune function of patients with CHD and heart failure, reduce the severity of inflammation and oxidative stress injury,regulate the levels of OPG and IGF1, and have significant therapeutic effect and certain safety.