Background: Acute coronary syndrome (ACS) is accounting for any condition causing sudden reduced blood flow to the
heart. Some trace elements play role in the development of ACS. Aim: This study aimed to evaluate the linkage between
serum zinc, copper, iron level and cardiac markers in acute coronary syndromes. Methods: Eighty patients were divided
into four groups. Group I (patients with unstable angina), Group II (acute myocardial infarction early 6 h), group III (acute
myocardial infarction late 6 h) and group IV (patients with reperfusion therapy). Fifteen apparently healthy individuals
served as a control group. Different risk factors as age, sex, diabetes and dyslipideamia were addressed in different
groups. The correlation between Fe, Zn and Cu versus cardiac enzymes were demonstrated. The receiver operating
characteristic (ROC) analysis was conducted. Results: Male and diabetic patients were significantly higher. The CK and
Tn were significantly increased in groups I, II and III. The CK-MB levels were significantly increased in group II and group
III. The AST levels were significantly increased in group III. The serum iron level was significantly lower in group I, II and
III. Serum zinc show slight decrease in groups II and III. No significant correlation was obtained concerning serum Cu.
In group II, there were significant positive correlation between Fe versus Tn, CK-MB and CK. The (ROC) analysis was
identified the optimal Fe, Zn and Cu plasma level for potential prediction of development of ACS. Conclusion: Fe and Zn
values were lower in ACS patients. Cu values did not show difference.
Acute coronary symdrome, Cardiac biomarkers, Risk factors, Zinc, Iron, Copper.