Abstract: OBJECTIVE To study the significance of ABCA1 gene mutation of pravastatin therapy on the patients with heart disease. METHODS Two hundred and thirty six cases of coronary heart disease(CHD) patients and 267 cases of healthy subjects were selected. CHD patients were divided into CHD-conventional treatment group and CHD-ravastatin group. CHD-conventional treatment got aspirin 0.1 g·d^-1, CHD-ravastatin got pravastatin 35 g·d^-1 plus aspirin 0.1 g·d^-1. The level of TC, HDL-C, apoA-I, LDL-C, apoB, TG in blood samples were tested before and after treated for 8, 16 weeks. Control group also adopted 6 biochemical index of blood testing, and DNA in two groups was extracted by Taqman probe method for genotype analysis. RESULTS The number of smoking in CHD group(139 cases) was significantly higher than that of control group (116 cases); ABCA1 R219K gene mutation frequency was similar in the two groups, K carriers ratio in CHD and control group were 67.8% and 66.7%. Compared with CHD-conventional treatment group, after 16 weeks treatment, CHD-ravastatin group had lower level of TC, TG, LDL-C, apoB and higher level of HDL-C and apoA-I. The change regulation of after 8 weeks treatment was the same, the difference was statistically significant (P<0.05). K carriers of CHD group had higher HDL-C, apoA-I level and lower TG level, and LDL-C, apoB, TC level in RR, RK, KK genotypes had no differences before and after pravastatin therapy. The HDL-C, apoA-I level of K carriers were significantly higher than RR type(P<0.05); ABCA1 gene mutation promoted the curative effect of pravastatin therapy. CONCLUSION ABCA1 gene mutation has effects on CHD patients’ blood plasma lipid level, especially HDL-C and apoA-I level.