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Background: Nicorandil has been demonstrated to have a cardioprotective effect, when used in conjunction with primary percutaneous coronary intervention (PCI). Even over the long term, PPCI using intravenous and intracoronary forms have evidence that it improves cardiac function and lessen the effects of reperfusion injury. There is however little data on role of oral form in ST segment elevation myocardial infarction (STEMI) patients. Objective: The purpose of this trial was to determine whether giving a single oral dosage of nicorandil before primary PCI had any cardioprotective effects on patients who had their first anterior STEMI following the onset of symptoms by six hours. Patients and Methods: 80 patients who had undergone primary PCI as a mean of reperfusion for first attack of anterior STEMI were enrolled in the study. The patients were split into two equal groups: Nicorandil 20 mg single oral dose was given to group A, the study group, and group B, the control group, didn't receive nicorandil. Results: Group A had higher left ventricle ejection fraction, (43.550 % ± 5.114) compared to control (40.325 % ±5.753), (P=0.010), lower peak values of cardiac enzymes, CK total levels peaked at 1899.

Background: In patients with coronary artery disease (CAD), regardless of their diabetes status, both hypoglycemia and hyperglycemia are unfavourably associated to cardiovascular events. According to the results of numerous research, both diabetic and non-diabetic patients with ST-elevation myocardial infarction (STEMI) frequently experience hyperglycemia, which is linked to a higher risk of in-hospital morbidity and mortality. Objective: In patients undergoing elective percutaneous coronary intervention (PCI), the goal of this study is to evaluate the association between elevated pre-procedural random blood glucose levels and peri-procedural myocardial injury. Patients and Methods: 110 patients with chronic coronary syndrome who underwent elective PCI at Ain Shams University Hospitals' Cardiology Department. made up this cohort study. They were split into two equal groups, 55 were hyperglycemic and the rest 55 were euglycemic. Prior to the procedure, cardiac troponin (I) and blood glucose levels were assessed. Blood samples for cardiac troponin were then collected 12 hours later Results: Regarding the incidence of myocardial injury and infarction, there were statistically significant difference between the 2 groups, with the incidence of both conditions being greater in the hyperglycemic group (P-value = 0.001, 0.022 respectively). All five individuals with myocardial infarction had higher blood sugar levels. 23 patients belonging to the hyperglycemic group had myocardial injury. On the contrary only 7 patients with myocardial injury belonged to the euglycemic group. The cut-off point of blood glucose level at which myocardial infarction occurred was 166 mg/dl with 100% sensitivity and 72.4% specificity, and that at which myocardial injury occurred was 130 mg/dl with 76.7% sensitivity and 62.5% specificity. Conclusion:We draw the conclusion that patients undergoing elective PCI are more likely to experience peri-procedural myocardial damage and infarction when their pre-procedural plasma glucose levels are excessively high, regardless of their diabetes status.

Background Regardless of the diabetic status of patients with coronary artery disease, both hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. Numerous studies have concluded that hyperglycemia is common in diabetic and non-diabetic patients with STelevation myocardial infarction (STEMI) and is associated with a higher risk of death and in-hospital complications. Aim and Objectives The aim of this study is to assess the relationship between elevated preprocedural random blood glucose level and peri-procedural myocardial injury in patients undergoing elective percutaneous coronary intervention. Patients and Methods This Cohort study included 110 patients who presented with chronic coronary syndrome to the cardiology department of Ain Shams university hospitals and underwent elective PCI. They were divided into 2 equal groups, 55 as hyperglycemic group and 55 as euglycemic group. Blood glucose level was measured immediately before the procedure. Blood samples for cardiac troponin (I) were obtained before the procedure and 12 hours after the procedure. Results There was statistically significant difference between the two groups regarding incidence of both myocardial infarction and myocardial injury, both being higher among the hyperglycemic group (P-value: 0.022) &(P-value: 0.001) respectively. All five patients who had myocardial infarction belonged to the hyperglycemic group. 23 patients with myocardial injury belonged to the hyperglycemic group while only 7 patients with myocardial injury belonged to the euglycemic group. Conclusion We conclude that abnormally high pre-procedural plasma glucose levels in patients undergoing coronary angioplasty are associated with an increased incidence of peri-procedural myocardial injury and infarction in patients undergoing elective PCI.