OBJECTIVE：To observe the efficacy and safety of atorvastatin combined with recombinant human brain natriuretic peptide （rhBNP） in the treatment of acute myocardial infarction （AMI） with heart failure. METHODS：160 AMI patients with heart failure were randomly divided into group A and group B. Group A was given heparin， aspirin， clopidogrel， sodium intake was limited， diuretics and β-blockers were used for anti-heart failure， dyspnea patients were given oxygen masks， and lung infection patients were given antibiotics， and other conventional treatment； group B was additionally given loading dose 1.5 μg/kg rhBNP by intravenous injection within 3 min，and maintained with 0.007 5 μg/（kg·min） for 24 h， for 7 d+40 mg atorvastatin before bed， once a day， for continuous 14 d. The treatment course for both groups was 14 d. Clinical efficacy， serum procollagen amino-terminal peptide （PⅢNP）， high-sensitivity C-reactive protein （hs-CRP）， norepinephrine （NE）， serum creatinine （Cr）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic volume （LVEDV）， left ventricular end-systolic volume （LVESV） before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in group B was significantly higher than group A， the difference was statistically significant（P＜0.05）. Before treatment， there were no significant differences in the PⅢNP， hs-CRP， NE， Cr， LVEF， LVEDV and LVESV between 2 groups（P＞0.05）. after treatment， PⅢNP， hs-CRP， NE， Cr， LVEDV and LVESV in 2 groups were significantly lower than before， and group B was group A， LVEF was significantly higher than before， and group B was higher than group A， the differences were statistically significant （P＜0.05）. And there was no significant difference in the incidence of adverse reactions between 2 groups（P＞0.05）. CONCLUSIONS： Based on the conventional treatment， atorvastatin combined with rhBNP has certain efficacy in the treatment of AMI with heart failure， it can effectively improve cardiac output and ventricular remodeling， with similar safety.