الفهرس 
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Abstract
This study was conducted on one hundred twenty patients with acute coronary syndrome, their age ranged from 48 - 58 years .Sixty patients had diabetes mellitus ,(32 were females , 28 were males) and sixty patients were not diabetic, (25 were females , 35 were males) and thirty apparently healthy individuals were included in this study as controls (10 were females ,20 were males) for comparison with age ranged from 49 -65 years
The patients were recruited from Coronary Intensive Care Unit, Assiut University Hospital. The patients were complained from tightness around the chest radiating to the left arm and the left angle of the jaw. Other symptoms could be associated as sweating, nausea and vomiting, as well as shortness of breath.
The patients diagnosed as acute coronary syndrome by Electrocardiogram as the following:-
• Unstable Angina patients: (55 patients), these patients had ST-segment depression or T-wave inversion.
• Myocardial Infarction: (65 patients), these patients had ST-segment elevation or new left bundle branch block.
The studied groups were classified as the following:
• group I: (30) apparently healthy individuals as control group.
• GroupII: (60) patients with acute coronary syndrome and diabetic.
• group III: (60) non diabetic patients with acute coronary syndrome.
All patients and controls were subjected to:-
1- Full medical history, clinical examination and ECG.
2- The Laboratory investigations were done as:
A- Peripheral heamogram.
B-Chemical investigations:
I- Serum glucose, urea and creatinine, lipid profile and glycated heamoglobin.
II- Serum CK, CK-MB and Troponin I.
III- Serum uric acid and high sensitivity-CRP (hs-CRP).
The result of the previous investigations revealed the following data: Serum uric acid and hs-CRP in the studied groups:
In all patients group when compared with control group, there were statistically very high significant elevation in the mean values of serum uric acid (P<0.001) and statistically high significant elevation in diabetic patients group when compared to non diabetic patients group (P<0.01).
The mean values of serum uric acid levels were elevated but not statistically significant in comparing myocardial infarction patients group with unstable angina patients group as well as hypertensive patients group when compared to non hypertensive patients group (P=0.13, P=0.2 respectively).
There were statistically very high significant elevation in the mean values of serum uric acid in diabetic myocardial infarction patients group when compared to diabetic unstable angina patients group as well as in comparing diabetic myocardial infarction patients group with non diabetic myocardial infarction patients group (P<0.001).
The mean values of serum uric acid show statistically high significant elevation in comparing diabetic unstable angina with non diabetic unstable angina (P<0.01),although there were statistically no significant difference in comparing non diabetic myocardial infarction patients group with non diabetic unstable angina patients group (P=0.22).
The mean values of serum uric acid show statistically significant elevation in non diabetic hypertensive and non hypertensive unstable angina patients group(P<0.04),while no statistically significant elevation in diabetic hypertensive and non hypertensive unstable angina patients group ,as well as diabetic hypertensive and non hypertensive myocardial infarction patients group (P=0.37, P=0.99 respectively).
As regared hs-CRP ,all patients group when compared to control group, there were statistically very high significant elevation in the mean values of hs-CRP, as well as when comparing myocardial infarction patients group with unstable angina patients group(P<0.001), and statistically high significant elevation of mean value of hs-CRP when comparing hypertensive patients group with non hypertensive patients group(P<0.01) ,while statistically significant elevation in comparing diabetic patients group with non diabetic patients group (P<0.04).
There were statistically very high significant elevation in the mean values of hs-CRP in diabetic myocardial infarction patients group compared to diabetic unstable angina group as well as when comparing non diabetic myocardial infarction patients group with non diabetic unstable angina patients group (P<0.001). Also statistically high significant elevation in the mean values of hs-CRP in comparing diabetic unstable angina with non diabetic unstable angina and diabetic myocardial infarction patients group compared to non diabetic myocardial infarction patients group (P<0.01,P<0.04 respectively).
The mean values of hs-CRP show statistically high significant elevation of hs-CRP when comparing diabetic hypertensive and non hypertensive unstable angina patients group (P<0.01) ,while no significant difference in diabetic hypertensive and non hypertensive myocardial infarction patients group as well as non diabetic hypertensive and non hypertensive unstable angina patients group(P=0.77, P=0.26 respectively).
There were statistically very high significant elevation of hs-CRP when comparing patients group with high serum uric acid values with those with normal serum uric acid values (P<0.001).
Serum glucose, glycated hemoglobin, urea, creatinine, cholesterol, triglyceride, LDL-c, HDL-c, CK, CK-MB and troponin I and their relation to the studied groups:
In comparing patients group with control group, there were statistically very high significant elevation of serum glucose, glycated hemoglobin ,serum cholesterol, CK, CK-MB and troponin I(P<0.001) ,as well as statistically high significant elevation in the mean values of serum creatinine and decrease of serum HDL-c level (P<0.01) ,and there were statistically significant elevation in the mean values of serum LDL-c (P<0.04), although no significant difference of mean value of serum urea and serum triglyceride level.
Statistically high significant elevation of serum glucose and glycated hemoglobin in diabetic patients group when compared with non diabetic patients group(P<0.01),on the other hand there were no significant difference in serum urea ,serum creatinine ,lipid profile ,CK ,CK-MB and troponin I levels.
Myocardial infarction patients group when compared with unstable angina patients group, there were statistically very high significant elevation of the mean values of CK ,CK-MB and troponin I (P<0.001) ,while there were no significant difference in serum glucose, glycated hemoglobin ,serum urea ,serum creatinine and lipid profile values.
In hypertensive patients group when compared with non hypertensive patients group ,there were statistically no significant difference in the mean values of serum glucose, glycated hemoglobin, serum urea, serum creatinine, lipid profile , CK, CK-MB and troponin I .
Statistically there were very high significant elevation in the mean values of serum creatinine,CK, CK-MB,glycated hemoglobin and troponin I in comparing all patients with high serum uric acid level with those with normal serum uric acid level (P<0.001),while serum glucose show significant elevation (P<0.04),but serum urea and lipid profile show no significant difference.
There were statistically no significant difference in glycated hemoglobin when comparing diabetic myocardial infarction patients group with diabetic unstable angina patients group as well as in non diabetic myocardial infarction patients group when compared with non diabetic unstable angina patients group (P=0.53, P= 0.23 respectively).
Statistically very high significant elevation in the mean value of glycated hemoglobin in comparing unstable angina diabetic patients group with unstable angina non diabetic patients group (P<0.001).
No significant difference in the mean values of glycated hemoglobin in comparing diabetic myocardial infarction patients group with and without hypertension ,as well as in diabetic unstable angina patients with and without hypertension and also in non diabetic unstable angina patients with and without hypertension (P=0.93, P= 0.21and P=0.17 respectively).
Correlation of uric acid between glucose, glycated hemoglobin,CK,CKMB,urea,creatinine,cholesterol,triglycerideLDL-c ,HDL-c,troponin I and hs-CRP in diabetic and non diabetic patients groups:
In diabetic patients group, there were statistically very high significant positive correlation between serum uric acid level and CK, CK-MB , troponin I and hs-CRP in diabetic patients group (P<0.001), and there were statistically significant positive correlation between serum uric acid level and serum creatinine (P<0.02).
In non diabetic patients group, there were statistically high significant positive correlation between serum uric acid level and CK (P<0.01), with significant positive correlation between serum uric acid and CK-MB (P<0.02), serum creatinine (P<0.03), troponin I (P<0.04) and hs-CRP (P<0.02).