Abstract: AIM To observe the effect of atorvastatin on cardiac function and serum cystatin (Cys)-C in patients with dilated cardiomyopathy (DCM). METHODS Forty-eight patients with DCM (NYHA cardiac function grade:Ⅱ-IV) were chosen to evaluate echocardiography parameters, plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP), serum Cys-C, and other serum biochemical indexes from October 2011 to January 2015. Patients were randomly divided into a routine treatment group (control group, n=27) and an auxiliary atorvastatin treatment group (treatment group, n=21),and the treatment group received atorvastatin 20 mg/d plus routine therapy, the other received routine therapy only. 12 months later, echocardiography parameters, Cys-C, and other serum biochemical indexes were measured and compared. RESULTS After 12 months of treatment, the heart function of the treatment group were significantly improved when compared to the control group (P<0.01). Left ventricular end diastolic diameter (LVEDD), serum NT-proBNP, and Cys-C levels were lower than the control group (P<0.05, P<0.01); The serum Cys-C levels were strongly correlated with left ventricular ejection fraction (LVEF), serum creatinine (SCr), NT-proBNP, and glomerular filtration rate (GFR) in patients with DCM (P<0.01). CONCLUSION Long term treatment with atorvastatin calcium in routine doses improved heart function and reversed myocardial remodeling in patients with DCM. This beneficial effect may be related to reduction of serum levels of Cys-C.