Aim To investigate the early diagnosis value of combining measurement of cardiac troponin-I (cTn-I), creatine kinase-MB (CK-MB), myoglobin (Myo) and thrombus precursor protein (TpP) in patients with acute myocardial infarction (AMI)accompanying ST-elevation. Methods Blood samples were drown from 52 patients within 2 h, 3～4 h and 5～6 h after chest pain attack. Fluorescent immunoassay was used for quantitative determination of cTn-I, CK-MB and Myo; while enzyme-linked immunosorbent assay was used to determine TpP level. Results 38 patients were diagnosed as AMI, while 14 as non-AMI. The positive rate of both TpP and Myo within 2 h, 3～4 h, 5～6 h in patients with AMI were significantly higher than those of patients without AMI (P=0.025～0.000); while the positive rate of both CK-MB and cTn-I only within 5～6 h after attack were significantly elevated in patients with AMI compared with non-AMI (P=0.000). The sensitivity, accuracy, and negative predictive value of the diagnosis of AMI by TpP were better than those by Myo, CK-MB and cTn-I within 2 h after attack (p<0.05～0.01), but there were no significantly different between TpP and Myo 3～4 h after attack, and there were no significantly different among the 4 marker 5～6 h after attack. The specificity of the diagnosis of AMI by cTn-I was best among the 4 marker. Conclusions TpP is a sensitive diagnostic indicator of AMI, while cTn-I is a specific diagnostic indicator of AMI, and the combining measurement of cTn-I, CK-MB, Myo and TpP have early diagnostic value for AMI.