BACKGROUND:A single, high(80 mg) loading(within 6 h) dose of atorvastatin reduces the incidence of periprocedural MI in elective PCI in the statin-naïve patients.But it is unknown whether single, high (80mg) loading dose of atorvastatin may lead to a decrease of the rate of periporcefuarl MI in real world including statin-user and statin naïver.METHODS: The day of the elective PCI, 522 patients were randomly assigned to atorvastatin 80 mg (atorvastatin group; n = 264) or no statin treatment(control group; n = 258) within 6 hr before PCI.Creatine kinase-MB(CK-MB)(upper limit of normal [ULN] 6.3 ng/ml)and cardiac troponin I(TnI)(ULN 0.1 ng/ml) were assessed before, 8 and 24 h after the PCI.Periprocedural MI was defined as a CK-MB elevation >3x ULN alone or associated with chest pain or ST-segment or T-wave abnormalities Subgroup analsys of incidence of CK-MB increase >3x ULN in the patients with statin user and statin naïver was also done.RESULTS: There was no significant difference in the incidence of a periprocedural MI between the control group and the atorvastatin group(11.2% vs 11.9% ; p =0.871).Median CK-MB peak after PCI was 2.2 ng/ml(interquartile range 0.75 to 61.04 ng/ml) in the atorvastatin group and 2.1 ng/ml (interquartile range 1.00 to 57.81ng/ml) in the control group(p = 0.913). The incidence of cardiac troponin I elevation >3x ULN was 26.9% in the atorvastatin group and 24% in the control group(p =0.293). Among patients, statin pre-user was 59.9%(n=313).Subgroup analysis showed that in the control group, the incidence of periprocedural MI was higher in statin naïver(18.6% in statin naïver vs 9.1% in statin user p=0.029) but in the atorvastatin group, there was no significant difference(12.9% in statin naïver vs 9.4% in statin user p=0.758). CONCLUSIONS: A single, high dose of atorvastatin before eletive PCI has no beneficial effect on reduction of the periprocedural MI in real world, but reduces the periprocedural MI in patients with statin naïver