〔Abstract〕 Objective To compare the value of the old and new schemes of glucose loading combined with intravenous insulin in myocardial metabolism imaging of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with coronary heart disease (CHD). Methods The clinical data of myocardial metabolism imaging in 160 patients with CHD admitted to Guangdong Provincial People's Hospital from April 16, 2018 to April 2, 2021 were retrospectively analyzed, and the image quality of the old and new glucose-regulating schemes and the adverse reactions of the two schemes were compared. Results (1) Among 38 cases of the old schemes had diabetes mellitus (DM) or abnormal glucose tolerance of patients (A1), 29 patients had good image quality and 9 patients had poor image quality, among which 8 patients could be diagnosed by delayed image for 1 h. 29 cases of the new scheme had DM or patients (B2) with abnormal glucose tolerance, 23 patients had good image quality and 6 patients had poor image quality, all of which could be diagnosed by delaying images for 1 h. The proportion of good image quality in A1 scheme was 76.3 % (29/38), and that in B1 scheme was 79.3 % (23/29). There was no statistical significance between the two schemes (P > 0.05). (2) In the old scheme without DM or abnormal glucose tolerance of patients (A2), the proportion of good image quality was 67.9 % (38/56), while the new scheme without DM or abnormal glucose tolerance of patients B2, the proportion of good image quality was 86.5 % (32/37), and all the images could be diagnosed. (3) There were 3 patients with hypoglycemia in the old scheme, and no patients with adverse reactions of hypoglycemia in the new scheme. There was no statistical significance in the incidence of adverse reactions between the two schemes (P > 0.05). Conclusion In the ¹⁸F-FDG PET/CT myocardial metabolism imaging of CHD patients, it is feasible to adopt the new glucose-regulating regimen, and the image quality is no different from the old schemes, and no adverse reactions such as hypoglycemia appear.