Coronary heart disease (CHD) remains a leading cause of cardiovascular morbidity and mortality worldwide, posing a global health threat. In recent years, angiotensin-like proteins (ANGPTLs) have emerged as a research focus in CHD because of their critical role in regulating lipid metabolism and inflammation. ANGPTLs are a class of secreted glycoproteins that primarily regulate lipid metabolism by influencing lipoprotein lipase activity. Dysfunction of these proteins leads to dyslipidemia, thereby promoting the formation of atherosclerotic plaques. In addition, ANGPTLs act as proinflammatory factors, accelerating the development of endotheliitis. Current ANGPTL-targeted therapeutic strategies (monoclonal antibodies, small interfering RNA) have advanced to clinical trial stages, demonstrating favorable safety, tolerability, and lipid-lowering effects in humans. These approaches hold promise as novel preventive and therapeutic measures for CHD. This article aims to elucidate the multifaceted role of ANGPTLs in CHD, summarize existing drug research, and outline future research directions, emphasizing the broad prospects of ANGPTL-targeted therapies in CHD prevention and treatment.