Backgrounds: The purpose of this study is to identify characteristic transcriptomic profile of AMI and recapitulate genetic elements whose expression is markedly elevated in AMI event, as well as to suggest large-scale molecular markers which allow diagnosing AMI in early times. Methods: To define testing group for early AMI detection, peripheral bloods from patients presented with 2 hours of pain onset were included as AMI. To assess and identify characteristic molecular profiling of AMI, total RNA of peripheral blood was subjected to human whole genome expression array (Human-6 V2, Illumina, USA) in 10 patients at 2.0짹0.5h after onset of AMI and compared with healthy subjects (N) or 2 weeks follow-up samples (FU) from the same patients. Results: Unsupervised hierarchical clustering analysis of gene expression profiling resulted in distinct molecular signature between AMI and healthy, follow-up groups. Large-scale genetic elements included S 100 calcium binding protein P, MMP 9, TNF-慣 induced protein 6,IL-2 receptor 棺 and BCL6, and many of them were previously reported as genetic marker for ischemic stroke. Conclusion: In this study, we present characteristic molecular signature of AMI by using whole genomic expression analysis and suggest large-scale genetic elements as early diagnostic marker or surrogate makers for guiding AMI from the peripheral blood of patients. These data also provide insight into inflammatory responses after AMI, and should be helpful in understanding pathogenesis and development of new treatment for AMI.