To examine effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI) in vitro, and the IL-6 concentration in supeatant was also examined. Methods Patients with AMI (n = 40) and with stable coronary heart disease (CHD) (n = 18) were registered. Peripheral blood monocytes from all participants were isolated and cultured for 24 hrs, but those from patients with AMI were randomly exposed to various concentration of atorvastatin (0, 0. 1, 1, 10 μmol/L) during the cultivation. COX-2 mRNA expression in monocytes was analyzed by reverse transcription polymerase chain reaction (RTPCR). Concentration of IL-6 in supeatant was measured by enzyme-linked immunosorbent assay (ELISA). Results COX-2 expression and IL-6 secretion by peripheral blood monocytes from patients with AMI (0.92 ± 0.13,205 ± 46pg/ml) were higher than that from controls (0.19±0.08, 41 ± 8 pg/ml ) ( both P ＜ 0. 05 ), and COX-2 expression was dramatically reduced up to 52% by atorvastatin ( P ＜ 0.05 ), in a concentration-dependent manner respectively.The expression of COX-2 from patients with AMI was obviously correlated with the secretion of IL-6 ( r = 0.636, P ＜0.05 ). COX-2 expression in the monocytes after intervention of atorvastatin was also positively correlated with IL-6 secretion by these cells ( r = 0.783, P ＜ 0.05 ). Conclusions COX-2 involves inflammatory respond in early-stage of AMI. Atorvastatin may decrease COX-2 expression in peripheral blood monocytes from patients with AMI and cyclooxygenase-dependent pathway might be correlated with the anti-inflammation mechanism of statin.