Background and Objectives: Elevation of cardiac enzyme, especially creatine kinase-MB (CK-MB), after percutaneous coronary intervention (PCI) has been associated with early and late cardiac events and mortality. The aim of our study is to assess whether pretreatment with rosuvastatin before PCI in patients with stable angina can reduce periprocedural myocardial infarction (MI) after PCI in a randomized study. Subjects and Methods: Sixty-three patients with stable angina without previous statin treatment were enrolled. Patients scheduled for elective PCI were randomized to rosuvastatin (n=31, 20 mg/d) or control (n=32) group 7 days before PCI. CK-MB (upper normal limit [UNL] 4.0 ng/ ml) and cardiac troponin I (cTnI, UNL 0.2 ng/ ml) levels were measured at baseline and at 6, 12, and 24 hours after PCI. Primary end-point of this study is to compare the incidence of periprocedural MI, defined as any CK-MB elevation above UNL after PCI. Results: There was no difference in clinical and angiographic characteristics between both groups. After rosuvastatin pretreatment for 7 days, there were no patients with abnormal elevation of CK or liver enzyme. The incidence of CK-MB elevation above UNL was significantly lower in the rosuvastatin group (6.5%) than the control group (28.1%) (p=0.041). cTnI elevation above UNL was detected in 34.5% in the rosuvastatin and 43.8% in the control group (p=0.601). The incidence of CK-MB elevation > 2 times UNL was 6.5% in the rosuvastatin group and 12.5% in the control group (p=0.672). By logistic regression analysis, the only independent predictor of any CK-MB elevation after PCI was rosuvastatin pretreatment (OR=0.075; 95% CI=0.006-0.878; p=0.039). Conclusion: This randomized trial suggests that pretreatment with rosuvastatin 20mg/d for 7 days can reduce the incidence of periprocedural MI after elective PCI in patients with stable angina.