【Abstract】 Objective To investigate the protective effects of atorvastatin with different doses on myocardial injury and vascular endothelial function in elderly patients with acute coronary syndrome (ACS) during perioperative period of PCI. Methods 72 elderly patients with ACS underwent selective PCI in our hospital from April 2017 to November 2017 were divided into group A and group B by random sampling, 36 in each group. In group A, regular dose of atorvastatin (20 mg/ once a day) was taken at admission. In group B, high dose of atorvastatin(80mg/ once a day) was taken at admission and another 20mg atorvastatin was added at 2 hours before PCI. The parameter of myocardial injury and vascular endothelial function before and after PCI, the incidence of contrast-induced nephropathy and side effects of drugs in perioperative period were compared between the two groups. Results There was no significant difference in the levels of CK- MB, LDH, cTnl and NT-proBNP between the two groups on admission(P〉0.05). At 6 hour and 24 hour after PCI, the levels of CK-MB, LDH, cTnl and NT-proBNP in group B were significantly lower than those in group A (P<0.05). At 24 hours after PCI, the serum levels of VEGF and NO in group B were significantly higher than those in group A(P<0.05) , while ET-1 was significantly lower than those in group A (PV0. 05). The incidence of contrast-induced nephropathy in group B was significantly lower than that in group A (P<0.05) , and there was no significant difference in the incidence of adverse drug reactions such as abnormal liver function, muscle pain, limb weakness, gastrointestinal discomfort between the two groups (P〉0.05). Conclusion High-dose of atorvastatin during perioperative period of PCI in elderly patients with ACS can significantly reduce myocardial injury, improve vascular endothelial function, and reduce the incidence of contrast-induced nephropathy after PCI.