Abstract: AIM: To investigate the incidence and degree of atorvastatin-induced fatigue in patients with coronary heart disease (CHD) and to study the impact of fatigue on medication compliance. METHODS: The incidence and degree of atorvastatin-induced fatigue and the impact of fatigue on medication compliance were investigated in 477 percutaneous coronary intervention (PCI)-treated CHD patients (group A) and 312 drug-treated CHD patients (group B). The effect of drug dosage adjustment on fatigue alleviation was studied and the levels of creatine kinase (CK), alanine aminotransferase (ALT) and low-density lipoprotein (LDL) after taking atorvastatin were measured. RESULTS: The incidence of atorvastatin-induced fatigue in group A was higher than in group B and fatigue mainly occurred within 0-3 months after medication in group A. Fatigue-related drug dosage adjustment was observed in both groups and the incidence of drug dosage adjustment due to mild fatigue was higher in group B. Dosage adjustment of atorvastatin alleviated the fatigue in some but not all patients. No significant difference was found in CK, ALT and LDL levels between groups, but CK level was higher in patients with severe fatigue than in patients with moderate or mild fatigue. CONCLUSION: Atorvastatin-induced fatigue is mainly mild and the incidence of fatigue was higher in patients with PCI.