This study aims to understand the current status of fear of disease progression (FoP) in patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI), and to explore the relationship between FoP levels, perceived control, and medical coping strategies in these patients. A total of 360 CHD patients who underwent PCI at Xijing Hospital in Shaanxi Province between June and November 2024 were selected using a convenience sampling method. Surveys included a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the revised Control Attitudes Scale (CAS-R), and the Medical Coping Modes Questionnaire (MCMQ). Pearson correlation analysis was used to examine the relationships between disease perception, positive coping strategies, and FoP. A total of 360 patients completed the study. The average score for FoP in patients with CHD after PCI was 31.64 ± 4.61. FoP was negatively correlated with perceived control (r = -0.106, P < 0.01) and medical coping (r = -0.194, P < 0.01). Multivariate regression analysis showed that the type of intervention, family history of CHD, smoking status, perceived control, and total medical coping score were significant factors influencing FoP (P < 0.01). Enhancing perceived control and identifying positive coping strategies can improve FoP levels in patients with CHD after PCI. Therefore, clinicians should focus on perceived control and medical coping levels in patients and develop targeted interventions to alleviate negative emotions related to FoP.