The purpose of the study is to examine prospects for the use of copeptin and matrix metalloproteinases in acute coronary syndrome. The study included 152 men with ACS. After evaluation of traditional markers of myocardial damage, patients were divided into 2 groups: the first group included patients with myocardial infarction — 84 people, the average age was 56.6±1.0 years, the second — with unstable angina — 68 people aged 61.4±1.2 years. All patients on admission, after 6 hours and 6 days of hospitalization were evaluated levels of CFM, troponin I, copeptin, MMP 1, MMP 2, MMP 7, MMP 9 and TIMP 1. The concentration of copeptin in patients with IT is 4 times higher than in the group with NS. By the 6th day of hospitalization, the concentration of copeptin decreases, maintaining much higher than in the control and in the group with NS. The levels of MMP1, 2, 7 and 9 were significantly higher in different time periods in the presence of myocardial damage. According to the obtained data, copeptin can be used as a marker of myocardial damage both in the early and in the delayed period. Patients with MI showed an increase in the level of MMP 1, 2, 7 and 9, but the possibility of their use as a marker of myocardial damage requires further study.