الفهرس 
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Abstract
cute coronary syndromes represent a group of clinical syndromes compatible with acute myocardial ischemia” refers to any group of symptoms attributed to obstruction of the coronary arteries, acute coronary syndromes (ACS) are due to the rupture or erosion of atheromatous plaques, and usually occurs as a result of one of three problems : 1. STEMI- ST-elevation myocardial infarction” (ST elevation, abnormal biomarkers) occurs when a coronary artery is completely blocked. 2. NSTEMI- non ST-elevation myocardial infarction (no ST elevation, abnormal biomarkers), occurs when the blockage in the coronary artery is not complete. 3. Unstable angina (no ST elevation, normal biomarkers), unstable angina includes: angina at rest, new angina, increasing angina occurs either because the degree of blockage it produces is not large enough, or because the clot doesn’t persist long enough, to produce cell death. The cardinal sign of ACS due to decreased coronary blood flow is chest pain experienced as tightness around the chest and radiating to the left arm and the left angle of the jaw. This may be associated with diaphoresis (sweating), nausea and vomiting, as well as shortness of breath, and the risk factors for CAD include DM , HTN , dyslipidemia, smoking.... etc In conjunction with clinical symptoms and electrocardiogram (ECG) changes, cardiac troponins (cTn) are currently the gold standard for the biochemical diagnosis of acute myocardial infarction (MI). Troponins are large proteins located predominately within the structure of myocardial fibers. Because of the large size and location of troponin, it can take several hours to detect serum levels of troponin in patients presenting with an acute MI. This can lead to a delay in diagnosis and treatment in patients with acute coronary syndrome (ACS). Summary 100 Heart-type fatty acid-binding protein (h-FABP) is a low molecular weight cytoplasmic protein. Because of its small size and location, it is released rapidly into the blood following myocardial damage. It is currently used to diagnose MI in patients presenting shortly after chest pain onset. However, the accuracy and utility of (h-FABP) for diagnosing MI and unstable angina is not well established. We therefore evaluated the diagnostic accuracy as well as sensitivity and specificity of (h-FABP) in patients presenting with acute myocardial infarction (AMI). -Objective: This study is designed to assess the role of “Heart Type free fatty acid binding protein”, as a diagnostic cardiac biomarker in patients with acute coronary syndrome -METHODS: The records of 50 patients diagnosed as an acute coronary syndrome classified according to ECG changes into ST segment myocardial infarction (STEMI) and Non ST segment elevation myocardial infarction/UA admitted to the intensive care unit, El Monofyia University Hospital from 30 minutes into 6 hours of chest pain onset between March 2012 to August 2014. Blood samples were obtained from all the study population for assessment of creatinine kinase-myocardial band (CK-MB), cardiac troponin I (cTn-I) first at the time of admission and the second one after 12 hours from onset of chest pain and the heart type free fatty acid binding protein (h-FABP) levels as well as lipid profile and other routine lab biochemistry. Then according to the result of the serum level of h-FABP , the patients were classified into two sub groups ,h-FABP positive and h-FABP negative. Summary 101 -Result: Our study results show: - The study showed no statistical difference between two main groups as regard Age and sex. - Among our patients there was no statistically significant difference between two groups, as regard the prevalence hypertension , smoking , dyslipidemia , previous history of ischemic heart disease or positive family history while there was statistically significant difference between two groups, as regards the prevalence of diabetes mellitus - As regard time of onset of chest pain between to main groups, there was no-significant statistically difference and there was significantstatistically difference sub groups There was non-significant statistical difference between the two main groups as regard the serum level of TG , the serum level of LDL, the serum level of HDL, the serum level of Cholesterol and the serum level of creatinine - There was significant statistical difference between two subgroups as regard the serum level of H-FABP and the serum level of first troponin while non- significant statistically significant as the serum level of CKMB as regard onset of chest pain - There was significant statistically difference between two main groups as regarding the serum level of second troponin. - There was significant statistically difference between two subgroups of FABP as regard the serum level of second troponin. -Conclusion: The (h-FABP) is an effective cardiac biomarker for the early diagnosis of acute coronary syndrome (STEMI) and (NSTEMI/UA) in patients presenting to (intensive care unit) within 6 hours of pain onset, compared to other cardiac markers as (CKMB) and (cTn-I)