A study showed that intensive lipid-lowering treatment with atorvastatin for 6 months significantly reversed coronary plaque in patients. 70 patients who underwent successful percutaneous coronary intervention (PCI) were randomized to the intensive treatment group (atorvastatin 20 mg/day) and the control group and were examined at baseline and 6 months of treatment. The results showed that LDL levels decreased by 41.7% and plaque volume decreased by 13% in the atorvastatin intensive treatment group, whereas plaque volume increased by 8% in the control group, and the percentage change in plaque volume was positively correlated with the percentage decrease in LDL, a trend that was independent of baseline LDL levels. Thus the intensive lipid-lowering reversal of plaque by statin is closely related to its acute effect in the treatment of acute coronary syndromes and is not dependent on baseline levels of LDL. In fact, patients on statin started to benefit before significant lipid reduction, suggesting the existence of pleiotropic effects of statin. These effects include anti-inflammation, improvement of endothelial function, reduction of oxidative stress, and inhibition of thrombogenic responses. Pre-treatment with atorvastatin before intervention reduces the extent of myocardial infarction in patients with both stable and unstable angina who have not been on statins. Studies have shown that even in patients with stable angina or low to intermediate risk unstable angina who are normally taking statins, reloading with atorvastatin reduces perioperative myocardial infarction. Therefore, even in patients normally taking statins, high-intensity statin reload therapy should be given before intervention.