BACKGROUND: This study was aimed to evaluate the effects of high dose stain therapy on ventricular remodeling in patients who underwent primary percutaneous coronary intervention(PCI) due to acute ST-segment elevation myocardial infarction(ASTEMI). METHOD: Between June 2006 and January 2007, 83 patients who underwent primary PCI due to ASTEMI were registered and followed up prospectively. They were devided to two groups [Group I(n=41); atorvastatin 10 mg/day and Group II(n=42); atorvastatin 40 mg/day] after PCI. Baseline and follow up echocardiographic parameters were determined. Serum markers of inflammation and lipid level were also measured. RESULTS: The baseline clinical and angiographic characteristics, echocardiographic parameters and laboratory result were not significantly different between two groups. The use of ACE inhibitor, Angiotensin receptor blocker and beta blocker were not significantly different. And the rate of In stent restenosis was not significantly different between the two groups. In follow-up echocardiographic parameters, Group II showed significantly higher left ventricular(LV) ejection fraction(EF) (46.3짹7.67 vs 53.5짹7.92, p=0.006), significantly lower end diastolic dimension(EDD)( 52.5짹4.63 vs 47.9짹3.53, p=0.001), and significantly lower LV wall motion score(24.78짹4.92 vs 19.09짹3.01, p<0.001). The change of LVEDD (1.20짹1.21 vs -3.93짹2.98, p<0.001) and LV wall motion score (-3.61짹2.27 vs -7.18짹3.75, p=0.032) were significantly higher in Group II. CONCLUSIONS: High dose atorvastatin therapy in patients who underwent primary PCI due to ASTEMI improves LVEF and attenuates adverse LV remodeling. This result may explain the beneficial effects of high dose statin therapy in ischemic heart failure.