Review of literature: Atherogenesis represents the main driver for CVDs and may be manifested with acute clinical events as acute coronary syndromes (ACS) and stroke. There is increasing evidence that inflammation plays a key role in the development of atherosclerotic vascular disease from atheroma formation to its rupture and development of clinical events. Aim of the study: the aim of this study is to detect the possible association between periodontal disease and ACS in a sample of Egyptian population attending the ICU in the National Heart Institute-Giza, Egypt and if serum levels of HS-CRP biomarker can participate in possible association between periodontal diseases and ACS.Material and methods: One hundred and twenty seven patients (n=127) participated in this study and were divided into three groups. The ACS group consists of 74 patients taken from the ICU of the National Heart Institute-Giza, Egypt after being diagnosed with acute coronary syndrome. The control group consists of 43 patients taken from the Department of Oral Medicine and Periodontology, Cairo- University perfectly matching the cardiac group in age, sex, and socioeconomic status but were free from any previous history of cardiovascular disease. A complete medical and periodontal assessment were done for both groups as well as serum sample taken forHS-CRP analysis. A third group of 10 patients were selected from the dental department of the National heart Institute with a previous history of coronary artery syndrome at least six month before the studyand were diagnosed as having moderate to severe periodontitis. The patients of this group had received a non surgical periodontal treatment in conjunction with combined antibiotic therapy for a week. A serum was collected for the analysis of HS-CRP level before and after treatment by six weeks. Results: Data were collected and samples analyzed for HS-CRP levels by using ELISA kit. Results does show that there was positive association between triglyceride serum levels and ACS (OR:1.93 with 95% CI: 1.10-3.39). Also, there was a strong association of ACS and low serum levels of HDL-c (OR: 7 with 95% CI: 3.7-13.04). In the ACS group, there was no difference in mean serum levels of HS-CRP between the subgroup that included gingivitis and initial periodontitis and the subgroup that included moderate and severe periodontitis. The HS-CRP serum levels were significantly higher in the ACS group (11.39 mg/L versus 7.37 mg/L) compared with the control group. The present study did not show association between periodontitis and serum level of HS-CRP > 3mg/L (OR: 0.51 with 95% CI: 0.16-1.67) or ≥10mg/dl (OR: 0.78 with 95% CI: 0.44-1.37). Conclusion: There was no association between periodontitis and ACS in the cohort studied. There was strong association between ACS and HS-CRP serum level. There was no association between HS-CRP and periodontitis. There was no association between lipid markers (TG, HDL-c, LDL-c, cholesterol) and periodontitis.