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The aim of this study was to investigate Paraoxanase 1 (PON-1) activity in patients with ST-elevated and non–ST-elevated acute myocardial infarction (AMI) and to determine its correlation with Gensini scores (GSs).A total of 109 patients with AMI and 58 healthy subjects as control group were included in the study. Patients were divided into 2 subgroups as ST-elevated and non–ST-elevated AMI patients (Group I and II, respectively). Controls were named as Group III. PON-1 activity was determined on admission to emergency department for each group. In addition, GSs for patient groups were determined. Then, groups were compared according to their results.PON-1 levels in Group I and II were significantly lower when compared to Group III. Median GSs for Group I and II were 60 and 64, respectively. The cut-off value of PON-1 for diagnosis of AMI was ≤ 180 U/L, which was identified by receiver characteristics receiver curve analysis. However, we could not determine a significant relationship between serum PON-1 levels and GSs in patients with AMI.PON-1 levels measured on admission to emergency department may be used to rule out AMI. PON-1 levels in AMI patients are found to be inefficient in determining extension of ischemia measured by GS.