All rights reserved. Abstract:Background: Poisoning by cardiovascular drugs has harmful effects and may lead to morbidity and mortality. In cases of myocardial injury, circulating miRNA-208 levels elevate after their leakage into the bloodstream at an early stage of myocardial insult. This study aims to assess the possible role of miRNA-208b in the early detection of myocardial injury in acute intoxicated patients with cardiovascular drugs such as digoxin, beta blockers and calcium channel blockers.Methods: This study enrolled 40 patients with cardiovascular drug toxicity admitted to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) from January 2016 to December 2016 in addition to 40 healthy subjects as the normal control group. Blood samples for miRNA-208b determination and troponin were collected on admission for the patients group and in the early morning for the control group. The demographic and clinical data were collected for every patient. Results: Age and sex distribution revealed that most of studied patients were in the age group of 18-24 years accounting for 50% with female predominance 85%. Beta blockers acute toxicity was the commonest cardiovascular drug toxicity (50%) followed by digitalis (35%) then calcium channel blockers (15%). The box plot outlook suggested that patients with a fold change in miRNA-208b higher than 1, was at risk of having a cardiac injury (ie. Troponin positive). Conclusion:This study concluded that miRNA-208b is a sensitive and specific biomarker in early detection of cardiac injury in patients with cardiovascular drugs poisonings for the early treatment of cardiotoxicity.