Inclusion Criteria:  All patient of sample size admitted to cardiology departmentof Assiut university hospital with :  Acute typical chest pain Positive cardiac enzymes ECG show recent ischemic changes ECHO show SWMA  Exclusion Criteria:  Patients not fulfill inclusion criteria. Patients with other diseases which may cause increase of neopterin level as viral infections, intracellular bacteria or parasites infections, certain malignancies, allograft rejection