Abstract: Objective To observe the effects of different loading doses of atorvastatin calcium on the outcomes of percutaneous
coronary intervention (PCI) in elderly patients with coronary heart disease (CHD). Methods A total of 120 CHD patients aged
over 80 years were randomly assigned into 3 equal groups to receive intensive pretreatment with statin at the doses of 20, 40,
or 60 mg prior to PCI performed within 48 to 72 h after admission. The changes of postoperative cardiac biochemical markers
including creatine kinase isoenzyme (CKMB), troponin I (cTNI) and high-sensitivity c-reactive protein (hs-CRP) were observed
and the incidence of major adverse cardiac events (MACE, including cardiac death, myocardial infarction, and target vessel
revascularization) were recorded within 30 days after PCI. Results Thirty-four patients in 20 mg statin group, 40 in 40 mg
statin group, and 38 in 60 mg statin group completed this study. In all the 3 groups, hs-CRP level significantly increased at 12
and 24 h after PCI compared with the preoperative levels (P<0.05). The patients in 60 mg statin group showed significantly
lower levels of CKMB, cTNI, and hs-CRP at 24 h after PCI than those in 20 mg statin group (P<0.05), and had also a
significantly lower incidence of total MACE within 30 days after PCI (2.6% vs 26.5% , P=0.003) resulting primarily from
significantly reduced myocardial infarction associated with PCI (2.6% vs 20.6%, P=0.016). The adverse drug reactions were
comparable among the 3 groups (P>0.05). Conclusions Intensive pretreatment with 60 mg/day atorvastatin calcium can
significantly reduce myocardial infarction related to PCI with good safety in elderly patients with CHD.