| Objective This follow-up study was designed to observe the anti-imflammatory effect of atorvastatin 40mg/d and 10mg/d on patients with acute coronary artery syndromes (ACS) after PCI, And the lipoprotein regulation effect and the adverse reactions of aniso-dosage.Methods 90 ACS patients who were finally diagnosed and performed PCI (PTCA and/or STENT), excluded other imflammatory diseases and renal and liver dysfunction, were divided into two groups randomly, atorvastatin 10mg/d (group A) and atorvastatin 40mg/d (group B). We collectted the blood serum of the patients before and after 4, 12, 24 week's treatment, Then detected the ultrasensitive C-Reactive Protein (us-CRP) and Matrix Metalloprotease 9 (MMP-9) with ELISA together, To analysize its difference between groups and the bivariate correlation with the lipoprotein regulation effect, And observed Alanine aminotransferase ( ALT ) , Creatinine (Cr), Creatinine Kinase(CK) and conorary artery events.Results The missed follow-up rate in group A and B was 6.7% vs 8.9%. (1) The ALT peak of both group was at week 1-4, there were 20.0%(A) and 44.4%(B) ALT abnormality at week 1(x~2=6. 402, P=0. 010<0. 0);But only 6.7%(A) and 5%(B) were more than 3 fold of normal ALT, which needed discontinuation, All ALT elevated were recovered within weeks; There was 1 case renal function abnormality in group B might correlated to drug; no rhabdomyolysis. (2)The decrease of lipoprotein was statistically significant difference between group A and B respectively, at 12 weeks TC 12.3% vs 21.7% (t value 2.065,P=0.042<0.05), and at 24 weeks TC 11.1% vs 23.4% (t value 2.893,P=0.005<0.05), LDL 10.0% vs 29.5%(t value 3.635,P=0.000<0.05); There was also statistically significant difference on the percentage of LDL≤1.80mmol/L (21.4% vs 51.2%,x~2=7.978, P=0.005<0.05) at 24 weeks after administration between groups. (3)The serum concentration of us-CRP in group A and B decreased respectively by 30.5% vs 21.8% at 4 weeks, 46.8% vs 64.3% at 12 weeks, and 55.5% vs 71.7% (t value 2.467,P=0.0170.05) at 24 weeks; The serum concentration of MMP-9 in group A and B decreased respectively by 49.1% vs 50.0% at 4 weeks, 72.7% vs 84.2% (t value 2.334,P=0.023<0.05) at 12 weeks, and 64.7% vs 75.1% at 24 weeks; The Bivariate correlation analysis showed, there were linear dependence between the decline of serum concentration of us-CRP and TC (R=0.863,P=0.006<0.05), and LDL(R=0.879,P=0.004<0.05);It also had linear dependence between the decline of serum concentration of MMP-9 and TC (R=0.893,P=0.003<0.05),andLDL(R=0.916,P=0.001 <0.05). (4) The patients with recurrent coronary artery events were no statistical significant difference between groups within 24 weeks.Conclusion (1) Atorvastatin 40mg/d is safe on Chinese patients.(2) Atorvastatin 40mg/d is statistically significant increased the rate of reaching the lipoprotein regulation goal, especially for LDL^1.8mmol/L on CAD secondary prevention. (3) There were linear dependence between the decline of serum concentration of us-CRP, MMP-9 and the level of TC , LDL; It demonstrated that Atorvastatin 40mg/d could stabilize thevulnerable plaque.
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