Background: Coronary artery disease (CAD), its acute form, and acute coronary syndrome (ACS) are the leading cause of death all over the world. For initial assessment of a patient with ACS, ECG, imaging techniques and serum biomarkers all contribute in confirming the diagnosis. Cardiac Troponin (cTn) I and T are the current gold standard for the detection of myocardial necrosis. However, there is also emerging evidence suggesting that with the use of sensitive or high-sensitive cTn assays, a blood sample collected 2 or 3 h after presentation might be appropriate for an earlier rule in and rule out diagnosis of AMI compared with the recommended second blood draw 6–9 h after admission using conventional Troponin assay. Aim: The aim of this study was to examine the ability of High-Sensitivity Cardiac Troponin T for early detection of AMI in comparison with conventional Troponin assay. In addition, to study the clinical utility of kinetic changes of High-Sensitivity Cardiac Troponin T for diagnosis of ACS. Methods: This study was conducted on sixty subjects. Fifty patients who presented to emergency department in Ain-Shams University Hospital complaining of chest pain were highly suspicious to have acute cardiac ischemia, having no or non-specific ECG changes and their Cardiac Troponin I level on admission was below the test threshold value (100 ng/L). In addition, ten subjects serving as a healthy control group were also recruited. The fifty patients were subdivided into subgroup A which included 16 patients, with hs-TnT
