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Background: Acute coronary syndrome ACS patients presented to Emergency Department ED require rapid differential diagnosis. Although troponin is the gold marker for ACS, there still undiagnosed patients. MicroRNAs circulate in human plasma and affected by varying cardiac pathologies. miRNA-208 was found to be elevated with ACS specially AMI. Aim of Study: The aim of this study was to investigate cTnI levels, correlated to miRNA-208 levels in ACS patients to evaluate rapid, accurate and final diagnosis in ED. Subjects and Methods: One hundred consecutive patients with ACS presenting to the Emergency Department of the National Heart Institute, Giza (Egypt) between March and June 2018, were recruited for the study, stratified into four groups according to the final diagnosis as AMI (including twenty five patients) and unstable angina UA (including twenty three patients), other cardiac patients (eighteen patients) and non cardiac (fourteen patients) twenty control subjects. Were included their cardiac markers and miRNA-208 levels were assayed and compared to the control healthy group on admission. Results: Results revealed significant difference between cardiac levels on admission compared to that obtained for miRNA-208. Only miRNA-208 levels were diagnosed on admission compared to that of cTnI. MiRNA-208 was found to be increased up to 38.6 folds without differential cut off. Conclusion: Early measurement of both troponin I and miRNA-208 may revolutionize the diagnostic accuracy and therapeutic decision-making in patients with symptoms suggestive of ACS; differentiate between UA or AMI patients on admission. Cardiac troponin 1 cTnI alone require more time to be controlled as diagnostic while high sensitive cTn may lead to false positive results. MiRNA-208 can be used as a novel marker for early diagnosis of ACS although RT-PCR still time consuming, requires time improved techniques. Correspondence to: Dr. Mohamed Y. Nasr, The Department of Biochemistry of Molecular Biology, Genetic Engineering Biotechnology Researches Institute, Sadat City University

Studies MicroRNA 208 as a Novel Cardiac Marker in Acute Coronary Syndrome in Egyptian Patients