Abstract: Objective To investigate the effect of statins in the treatment of atherosclerotic cardiovascular (ASCVD) in elderly patients. Methods Clinical data about aged patients with ASCVD admitted to the second medical center of Chinese PLA General Hospital,including physical examination data,medical history,drug use during hospital-stay,were collected in the follow-up study since 2008,and the patients were divided into statin group and non-statin group according to the medication conditions,their follow-up ending events and relevant test results were recorded,and the relationship between statins and all-cause death and MACE events was analyzed by survival analysis and Cox proportional risk model. Results In this study,the follow-up period was 7.92±0.24 years in the statin group and 7.03±0.34 years in the non-statin group.During the follow-up period,all-cause mortality in the statin group was significantly lower than that in the non-statin group (32.0% vs 52.8%),with statistically significant difference (HR=0.629,P=0.033).While the incidence of MACE events in statin group was lower than that in the non-statin group (18.3% vs 37.7%),with statistically significant difference (HR=0.503,P=0.012).The incidence rate of nonfatal myocardial infarction in statin group was significantly lower than that in the non-statin group (3.5% vs 13.0%,HR=0.268,P=0.011).However,there was no significant difference in unstable angina,coronary revascularization,stroke,and the incidence of cardiac death between the two groups.LDL-C in the statin group was significantly lower than that in the non-statin group (2.11±0.67 mmol/L vs 2.50±0.64 mmol/L,P=0.000).Multivariate correlation analysis showed that age had statistically significant influence on all-cause deaths (HR=3.006,P=0.000).After correcting for age,sex,ARB,beta blockers,and antiplatelet agents,statin therapy showed significant influence on the incidence of MACE events (HR=0.509,P=0.016). Conclusion Statins can significantly reduce LDL-C levels,thus reducing the all-cause mortality,the incidence of MACE events,and non-fatal myocardial infarction in elderly ASCVD patients.Aging is the most important factor leading to all-cause death,and statin therapy is an important factor for the occurrence of MACE events.