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Introduction: Chronic obstructive pulmonary disease is one of the main causes of morbidity, mortality, and health-care costs entire the world. During acute exacerbations, whether or not with a history of Cor pulmonale have an increased cardiac burden. Patients with COPD are at increased risk of cardiovascular disease, exacerbations increase strain on the heart. The prognostic and predictive value of highly sensitive troponin T seen during COPD exacerbations has been investigated. Aim: Assessment the clinical significance of highly sensitive troponin T (Hs cTnT) as a predictive and prognostic factor in patients with acute exacerbations of COPD. Patients and methods: This observational cross sectional study was carried on 79 patients from 2 May 2013 to 1 May 2015 with acute COPD exacerbation. Inclusion criteria: Patients with acute exacerbation of COPD. Exclusion criteria: Patients with severe renal impairment, persistent hemodynamic instability, myocardial infarction and cardiac arrest before admission demographics. full medical history, vital signs, ABGs and ECG were recorded. Serum cardiac enzymes CK, CK-MB and highly sensitive cardiac troponin T (hs cTnT) were measured. Results: 79 patients with acute exacerbation of COPD were enrolled. Mortality rate was (2.53%) Hs cTnT level showed a statistically significant difference comparing four reported categories of COPD exacerbation severity. Only life threatening form showed significantly higher hscTnT level compared to moderate and severe forms. Conclusion: The study showed that highly sensitive cardiac Troponin T was significantly elevated in COPD patients with exacerbation. Troponin T may help the assessment and the prognosis in patients with COPD exacerbations.