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Abstract About quarter of AMI patients do not present with the classic chest pain and the event would go unrecognized,unless ECG was recored in temporal proximity to farction.Therefore, the clinician must obtain serum cardiac markers exclude the diag-nosis of AMI. There are several biochemical cardiac markers on the display of AMI diagnosis. these include: old markers ( AST, LDH, CK and free fatty acids ). Recently devel-op)ed markers ( CK -MB, CK -MB isoforms, myoglobin / anhydrase III ratio, tropo-nins and glycogen phosphorylase BB isoenzyme) and the other promising markers endothelin, annexin V, hFABP, MLC, MHC, ICAM -1&2, VCAM 1, insulin re-ceptor gene LDL receptor gene and Lewis blood group antigens). These Promising markers are still in their infancy and represent hot areas of research and intensive work. Although CK is widely accepted as a sensitive early cardiac marker available in miost hospitals ,yet it has the drawbacks of false -positive results in patients with mus-ce diseases , alcohol intoxication, diabetes mellitus, vigorous exercise, convulsions, intramuscular injection, thoracic outlet syndrome and pulmonary embolism. Usually curred latter than at 0,12 and 24 hours, from admission. However, if AMI had oc-curred Vrred latter than 24 hours, the CK value is limited and other remote markers are need- ed, among these is LDH and its isoenzymes ( LD1 / LD2 ratio). But the wide sources oif origin for LDH& AST Limits their value in AMI.Troponins are of three types (T, I and C). CTn - T and I begin to increase 3 hours form )rm the onset of chest pain. CTn- I persists for 710 dayes, while CTn- T Persists for pr up to 10 14 days . CTn- I is more cardio-specific than CTn - T. CTn I is more. |