الفهرس 
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Abstract
This study was designed to evaluate the significance of cardiac biomarkers CK-MB, Troponin I, hs CRP, and Myoglobin in patients admitted to CCU with acute chest pain in the period from ( March 2007 to December 2007 ), at EI Minia university hospital.
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This study include 35 patients divided into tow groups:
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Group I was subdivided according to ECG diagno is into:
subgroup (Ia) myocardial infarction (17 P~FS~).
subgroup (Ib) unstable angina (9 ,::>eFsons).
subgroup (Ie) chest pain (9 pefS011S ).
Group II control group ( 12 apparent healthy subjects ).
All included patients and control subjects were subjected to full history taking, complete clinical examination, ECG, Echocardiogram, and laboratory investigations including BUN, serum creatinine, uric acid, random blood glucose, total cholesterol, HDL, LDL, serum triglycerides, AST and AL T.
Cardiac markers ” CK-MB, cardiac Troponin I , hs CRP, and Myoglobin” were done at presentation to CCU and 6-8 hours after onset of chest pain.
In this study cardiac markers (CK-MB, Troponin I, and Myoglobin) were found to be highly significant increase in group I (patient group) when compared to group II (control group).
Summary& Conclusion
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In this study, CK-MB in group I (patient group) and subgroup la (myocardial infarction) shows a statistically significant increase in its level when comparing 1 st versus 2nd sample level , while in subgroup Ib (unstable angina) there was a non significant increase when comparing 1 st versus 2nd sample levels of CK-MB , so serial samples elevation in CK-MB is a vital component for diagnosis of acute myocardial infarction.
In the present study cardiac Troponin I show a significant increase
in group _I, subgroup I~ ,subgroup Ig when comparing 1 st to 2nd III”” sample levels, and so we could conclude that Troponin I is the Rerfect
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cardiac marker among patients with acute coronary syndrome
compared with CK-MB in a chest pain unit.
hs CRP which is an inflammatory marker playa key role in the initiation and progression of atherosclerosis which is the most common cause of acute coronary syndrome. It shows a significant increase in subgroup la when compared to subgroup Ib, and group II, so any increase in hs CRP level between baseline and 2nd sample is diagnostically useful in patients with acute chest pain of coronary origin and a negative result is associated with low risk of ischemic heart disease.
Myoglobin 1 st and 2nd sample levels show significant increase in
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subgroup la when compared to group II. So Myoglobin is highly
increase in patients with myocardial infarction especially zero to six hours after onset of chest pain symptoms.