Aim To investigate the effect of intensive dose atorvastatin therapy on B7-H3, B7-H4 in peripheral blood monocytes of patients with unstable angina pectoris undergoing percutaneous coronary intervention (PCI). Methods The patients with unstable angina pectoris were randomly divided into conventional dose group (atorvastatin 20 mg/d, n=40) and intensive dose group (atorvastatin 80 mg/d, n=40), peripheral blood were collected before and 18 h ~ 24 h after PCI. Enzyme-linked immunosorbent assay was used to detect peripheral blood IL-4, IL-10, IFN-γ and sB7-H3, sB7-H4, fluorescence-based quantitive real-time PCR was used to measure B7-H3 and B7-H4 mRNA. Results The levels of IL-10, sB7-H3, sB7-H4 and the expression of B7-H3 and B7-H4 mRNA in the two groups after PCI were higher than those before PCI, and the increase of the intensive dose group was more significant than that of the conventional dose group (P＜0.05). On the contrary, the levels of IL-4 and IFN-γ in the two groups after PCI were decreased, and the decrease of the intensive dose group was more obvious than that of the conventional dose group (P＜0.05). Conclusion Intensive dose atorvastatin may promote the expression of B7-H3 and B7-H4, thereby reducing the immune inflammation in patients with unstable angina pectoris after PCI.