Cardiac Troponin is a cardiospecific, highly sensitive marker of myocardial damage , but is also expressed by diseased skeletal muscle. Troponin T levels rise in serum about 3-4 hours after appearance of cardiac symptoms and remain elevated upto 14 days. It is an independent prognostic marker which can predict near, mid and long term outcome in patients with Acute Coronary Syndrome (ACS). It is also a useful tool in guiding anti-thrombotic therapy. Patients with ischemic symptoms who have elevated Troponin T levels receive greater benefit from Antiplatelet and Antithrombotic therapies.