Abstract: AIM To investigate the effects of atorvastatin and rosiglitazone on the synthesis of tumor necrosis factor-alpha in peripheral blood monocytes from patients with acute coronary syndrome without diabetes mellitus. METHODS Monocytes were isolated from patients with acute coronary syndrome without diabetes mellitus and cultured with dimethyl sulphoxide (as the control), atorvastatin (1 μmol/L), and rosiglitazone (1 μmol/L), or atorvastain (1 μmol/L) plus rosiglitazone (1 μmol/L) for up to 24 hours. Tumor necrosis factor-alpha antigens in supernatant were measured by enzyme-linked immunosorbent assay and their mRNA levels were assessed by reverse-transcriptase polymerase chain reaction. RESULTS Compared with the control, atorvastatin (1 μmol/L), and rosiglitazone (1 μmol/L), or atorvastain (1 μmol/L) plus rosiglitazone (1 μmol/L) decreased the levels of tumor necrosis factor-alpha protein ［(229±24)ng/L, (236±28)ng/L, (159±29)ng/L, vs (306±40)ng/L, respectively, all P<0.05］, and their mRNA (0.35±0.12, 0.39±0.11, 0.26±0.06 vs 0.78±0.14, respectively, all P<0.05) in peripheral blood monocytes from patients with acute coronary syndrome without diabetes mellitus. Furthermore, Compared with the groups of atorvastatin (1μmol/L) or rosiglitazone (1μmol/L), the groups of atorvastain plus rosiglitazone resulted in more significant reduction (P<0.05). CONCLUSION Both atorvastatin and roiglitazone, assuage inflammation through reducing tumor necrosis factor-alpha in peripheral blood monocytes from patients with acute coronary syndrome. Synergistic administration of atorvastatin and roiglitazone exerts better preventive and therapeutic effects on acute coronary syndrome.