Objective: To investigate the impact of early initiation of intensive lipid-lowering therapy on the postoperative efficacy and inflammatory factors in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods: A total of 100 ACS patients undergoing PCI admitted to our hospital were selected as the study subjects. They were randomly divided into a control group (treated with statin combined with ezetimibe, n = 41), a study group 1 (initiated with statin combined with PCSK9 inhibitor immediately after surgery, n = 32), and a study group 2 (routinely administered oral statin and initiated with combined PCSK9 inhibitor before discharge, n = 27). The therapeutic efficacy, inflammatory factor levels, and incidence of adverse events were compared and analyzed among the three groups. Results: The therapeutic regimen in study group 1 demonstrated the optimal efficacy and impact on inflammatory factors, followed by study group 2, while the control group showed relatively weaker efficacy, with statistically significant differences (p < 0.05). The overall incidence of adverse reactions was 30.00% in the control group, 5.00% in study group 1, and 10.00% in study group 2, with statistically significant differences among the groups (p < 0.05), with the lowest incidence observed in study group 1. Conclusion: Early intensive lipid-lowering therapy can effectively improve lipid metabolism, suppress inflammatory responses, and reduce cardiovascular events in ACS patients after PCI, suggesting its pleiotropic cardiovascular protective effects.