Background: Many evidences suggest that atherosclerosis is an inflammatory disease and inflammatory markers could be an important prognostic factors in acute coronary syndrome. Hydroxymethylglutaryl (HMG-CoA) reductase inhibitors (statins) have been shown anti-inflammatory property that are independent of lipid-lowering effects. Methods and Results:We evaluated the effects of 2-month treatment with simvastatin (40 mg/d, n=20) on plasma levels of circulating high-sensitivity C-reactive protein (hsCRP), inflammatory cytokines [tumor necrosis factor (TNF)-慣, interleukin (IL)-1棺, IL-6], and adhesion molecules [p-selectin and monocyte chemotactic peptide (MCP)-1] with placebo group (n=20) in 40 normocholesterol emic patients (LDL<130 mg/dL) with acute coronary syndrome. Baseline clinical and coronary angiographic parameters were not different significantly between the groups. Simvastatin therapy significantly reduced plasma levels of total cholesterol and LDL-cholesterol (p=0.05, p=0.02, respectively) compared with placebo group. Simvastatin therapy also significantly reduced plasma levels of hsCRP and IL-6 (p=0.03, p=0.03, respectively) compared with placebo group. But, the reduction of hsCRP and IL-6 levels with simvastatin was unrelated to the degree of LDL-cholesterol���s reduction. Conclusion: The effects of simvastatin on the reduction of hsCRP and IL-6 have potential implications in the management of acute coronary syndrome with normocholesterolemia.