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To determine the frequency and association of single nucleotide polymorphism of transcription cell factor7-like2 rs7903146 (CT) in metabolic syndrome patients with and without acute coronary syndrome. The cross-sectional comparative study was conducted at the University of Health Sciences, Lahore, Pakistan, from July to December 2017. Patients of metabolic syndrome with and without acute coronary syndrome were selected from Sheikh Zayed Hospital, Lahore, and the Punjab Institute of Cardiology, Lahore. Healthy subjects were enrolled