الفهرس 
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Abstract
Patients presenting with acute coronary syndromes but without persistent ST segment elevation on ECG are diagnosed as either unstable angina or NSTEMI based on cardiac biomarkers (cardiac biomarkers are elevated in NSTEMI patients).
The practice of interventional cardiology has changed since the early 1990s with the advent of new and better devices & techniques with adjunctive medical therapy that notably reduced the rates of major complications of PCI.
The Coronary angiography has been used to improve epicardial arterial perfusion, also used recently for assessment the microvascular myocardial perfusion.
Unstable angina and NSTEMI patients should receive vasodilators in addition to the other anti-ischemic medications to relieve the coronary spasm that occurs on top of culprit lesions & to alleviate the anginal symptoms.
Nicorandil is a new anti-anginal medication that has dual vasodilator actions comparing with other antianginal medications so it improves the coronary blood flow, the microvascular perfusion and hence the myocardial blush during the invasive percutaneous management.
The aim of our study is to evaluate the impact of oral Nicorandil on the results of patients with Unstable Angina & NSTEMI underwent PCI regarding; the cardiac biomarkers, ECG changes, ECHO findings (LV EF & RWMAs) as well as TIMI flow & myocardial blush gradings.
The study included sixty patients admitted in Beni-Suef insurance & university hospitals by either NSTEMI or unstable Angina, all patients had underwent a diagnostic coronary angiography at Beni-Suef university hospital to determine the culprit lesions for which an elective PCI was done.
During the period in between the diagnostic coronary angiography & PCI (ranging from 15 to 20 days), all patients had received the following anti-ischemic medications;
-Aspirin: in a maintenance dose of 150 mg/day.
-Clopidogrel: in a maintenance dose of 75mg/d.
-Nitrate: Skin patches or oral nitrate preparations in the tolerant doses.
-Statin: in a dose of 40-80 mg/d.
-B-blocker:Most of patients received Bisoprolol in a dose of 5mg twice daily.
-Then Patients were assigned to one of two groups;
*group I: received oral Nicorandil in a dose of 10 mg twice daily. *group II: didn’t receive Nicorandil.
PCI was done for the culprit lesions in all patients, then the coronary TIMI flow and myocardial blush gradings had been evaluated post PCI.
The main finding of this study is the lack of any statistically significant difference between two treatment groups (oral Nicorandil & non-nicorandil groups) regarding the TIMI flow grade (P value 0.612) and the myocardial blush grade (P value 0.56) post PCI. However the study shows significant importance of oral Nicorandil in controlling the anginal symptoms (P value 0.046).
Also, it failed to show significant difference between Nicorandil & non Nicorandil groups regarding the left ventricular function (P value 0.087) & also the cardiac biomarkers (P value in unstable angina & NSTEMI patients were 0.66 & 0.73 respectively).