الفهرس 
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Abstract
ummary Acute coronary syndrome (ACS) is a manifestation of coronary artery disease (CAD) and includes acute myocardial infarction (AMI) and unstable angina pectoris (UA). It is known that coronary artery disease results from a complex process known as atherosclerosis. Today, it is known that atherosclerotic plaque formation is built up not only from cholesterol but also inflammatory response may be present in plaques. STEMI is mostly caused by coronary artery occlusion which in most cases is caused by intracoronary thrombus. STEMI is treated either by fibrinolytic therapy or primary percutaneous coronary intervention (pPCI). Primary PCI is the preferred reperfusion strategy in patients with STEMI within 12h of symptom onset, provided it can perform expeditiously (120 min from STEMI diagnosis) by an experienced team. Pharmaco-invasive strategy is the use of Fibrinolysis combined with rescue PCI (in case of failed fibrinolysis) as well as routine early PCI strategy (in case of successful fibrinolysis). T-peak to T-end (TPE) interval, which is defined as the interval between the peak and end of the T-wave, represents the dispersion of repolarization. Abnormal repolarization and prolonged TPE interval are associated with increased malignant ventricular arrhythmia and sudden cardiac death (SCD) in many acquired and congenital cardiac diseases. Recently, the relationship between prolonged TPE interval and worse short- and long-term outcomes in patients with STEMI is established. even in patients with (STEMI) who are treated with successful primary percutaneous coronary intervention (pPCI).