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Not yet recruitingNCT07549282Updated Jul 30, 2026

Intranasal Dexmedetomidine and Perioperative Myocardial Injury

A Phase 4 interventional study of Intranasal Dexmedetomidine and Normal saline in Coronary Heart Disease, Myocardial Injury and Myocardial Infarction, sponsored by Second Affiliated Hospital, School of Medicine, Zhejiang University. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-07-30.

Sponsored by Second Affiliated Hospital, School of Medicine, Zhejiang University · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

PCI is the standard treatment for CAD, yet perioperative myocardial injury occurs frequently in nearly 40% of patients. Perioperative stress and sympathetic overactivation break myocardial oxygen balance and lead to cardiac damage, which further raises short-term cardiovascular events and long-term mortality risks. Dexmedetomidine exerts cardioprotective effects by inhibiting sympathetic excitation, though intravenous use carries risks of hypotension and bradycardia. Intranasal dexmedetomidine shows equivalent efficacy with fewer side effects and better patient compliance. Since no standard perioperative anesthesia regimen exists for elective PCI patients and the clinical benefits of dexmedetomidine remain unconfirmed, this pilot study is designed to test the feasibility and safety of intranasal dexmedetomidine spray before launching large formal RCTs.

02

Conditions studied

  • Coronary Heart Disease
  • Myocardial Injury
  • Myocardial Infarction
  • Dexmedetomidine
03

In context

Coronary Disease

1,520 studies on the registry are indexed under Coronary Disease; 167 are open to participants now.

This study's planned enrollment of 140 is below the median of 160 across 778 interventional studies indexed under Coronary Disease.

Browse Coronary Disease studies →

Lead sponsor

Second Affiliated Hospital, School of Medicine, Zhejiang University is the lead sponsor of 1,047 studies on the registry; 502 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged between 18 and 85 years old;
  • Subjects are fully informed of the risks, benefits and alternative treatment regimens of intranasal dexmedetomidine administration. Written is signed by the subject themselves or their legal representative prior to any study-related procedures;
  • Confirmed diagnosis of coronary artery disease with objective evidence of myocardial ischemia or silent myocardial ischemia, and indications for elective percutaneous coronary intervention (PCI);
  • (ASA) physical status classification II to III (patients with mild to severe systemic underlying diseases; ordinary physical activities are markedly limited, yet mild daily activities can be performed).

Exclusion criteria

Exclusion Criteria:

  • Subjects with or to dexmedetomidine, including severe sinus bradycardia (resting heart rate \<50 beats per minute), sick sinus syndrome, and second-degree or higher atrioventricular block without pacemaker implantation;
  • Severe cardiac dysfunction ( \<40%), (NYHA) class III-IV heart failure, cardiogenic shock, or hemodynamic instability;
  • Poorly controlled hypertension (systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg), or hypotension (systolic blood pressure \<90 mmHg);
  • Coexisting obstructive sleep apnea hypopnea syndrome (OSAHS);
  • (BMI) >30 kg/m²;
  • Use of agents that may interfere with the study drug within 1 week before surgery, including α₂ adrenergic receptor agonists (e.g., clonidine), receptor antagonists, and tricyclic antidepressants;
  • Cognitive assessment cannot be completed due to language, visual or hearing impairment;
  • Hepatic or renal insufficiency (, aspartate aminotransferase, or serum creatinine exceeding 3 times the reference values);
  • Nasal anatomical abnormalities that preclude intranasal spray administration;
  • Pregnant or breastfeeding women;
  • Participation in other conflicting clinical trials.
Terms in these criteria, in plain language(9)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
140 participants (estimated)

Study arms

  • Experimental
    Dexmedetomidine Group

    The subjects received intranasal dexmedetomidine (100 μg, sprayed equally into both nostrils, two sprays per nostril) 15 minutes before surgery in the preoperative preparation area.

    Drug: Intranasal Dexmedetomidine

  • Placebo comparator
    Normal saline Group

    The subjects were given an equal volume of normal saline intranasally, which contained no active ingredient.

    Drug: Normal saline

Interventions

  • The subjects received intranasal dexmedetomidine (100 μg, sprayed equally into both nostrils, two sprays per nostril) 15 minutes before surgery in the preoperative preparation area.

  • DrugNormal saline

    The subjects were given an equal volume of normal saline intranasally, which contained no active ingredient.

06

What researchers measure

Primary outcomes

  1. Incidence of perioperative myocardial injury

    Definition of myocardial injury: In patients with a normal baseline cTn concentration (≤99th percentile upper reference limit \[URL\]), postoperative cTn elevation exceeding the 99th percentile URL; In patients with an elevated baseline cTn concentration (\>99th percentile URL) that was stable or decreasing, a postoperative cTn increase of \>20% from baseline, with an absolute value exceeding the 99th percentile URL.

    Time frame: From the end of surgery to 48 hours after surgery

Secondary outcomes

  1. Incidence of major perioperative myocardial injury

    For patients with normal baseline cTn levels, a cTn elevation exceeding 5 times the 99th percentile upper reference limit (URL) within 48 hours after PCI .For patients with elevated baseline cTn levels, the post-procedural cTn value must increase by \>20% from baseline, and the absolute post-procedural cTn value must exceed 5 times the 99th percentile upper reference limit (URL).

    Time frame: From the end of surgery to 48 hours after surgery

  2. Composite outcome at 30 days after PCI

    Consisting of: (1) myocardial infarction; (2) new-onset stroke or transient ischemic attack (TIA); (3) all-cause death; and (4) any unplanned revascularization.

    Time frame: 30 days after surgery

  3. Blood pressure stability

    Quantified by the absolute real variability of perioperative generalized mean arterial pressure (ARV-MAP). Calculation procedures are as follows: ① For continuous arterial blood pressure waveform data, calculate the mean MAP for each non-overlapping 15-minute time window. ② Compute the absolute value of the difference between the mean MAP of every pair of adjacent time windows. ③ Sum all these absolute values, then divide the total sum by the total observation duration (operative time). A lower ARV-MAP value indicates smaller temporal fluctuations in MAP, meaning more stable blood pressure.

    Time frame: From the start of the procedure to the end of the procedure

  4. Perioperative myocardial oxygen consumption

    Rate-pressure product (RPP) = heart rate (beats per minute) × systolic blood pressure (mmHg). Blood pressure and heart rate are recorded every 15 minutes after patients enter the operating room, and the mean value of RPP is calculated.

    Time frame: From the start of the procedure to the end of the procedure

Other outcomes

  1. Incidence of unplanned hospital readmission within 30 days after surgery

    Unplanned hospital readmission

    Time frame: 30 days after surgery

  2. Change in perioperative anxiety scores

    Anxiety was also assessed using the Perioperative Anxiety Scale-7 (PAS-7) , which ranges from 0 to 28, with higher scores indicating greater anxiety.

    Time frame: Before intervention; after intervention but before surgery; 1 day after surgery

  3. Sleep quality scores on postoperative day 1

    Sleep quality was assessed using the Richards Campbell Sleep Questionnaire (RCSQ), RCSQ uses a visual analog scale ranging from 0 to 100 for each item, where 0 represents the worst possible sleep condition (or the most negative description) and 100 represents the best possible sleep condition (or the most positive description). Patients are asked to place a slider at the position that best describes their sleep status the previous night. The total RCSQ sleep score is calculated as the mean of the first five items (Items 6-10). The sixth item (Item 11) assesses noise level and is scored separately.

    Time frame: Baseline, 1 day after surgery

  4. Hospitalization costs

    Hospitalization costs

    Time frame: Through patients discharge, an average of 2 days after surgery

  5. Postoperative pain scores

    Pain was assessed using the Numerical Rating Scale (NRS), ranging from 0 to 10, with higher scores indicating more severe pain.

    Time frame: Immediately after surgery

  6. Quality of life scores at 30 days after surgery

    Quality of life was assessed using the EuroQol Five-Dimensional Questionnaire (EQ-5D) EuroQol Five-Dimensional Questionnaire (EQ-5D): The EQ-5D includes a visual analog scale (EQ-VAS) ranging from 0 to 100, where higher scores indicate better health status.

    Time frame: 30 days after surgery

  7. Quality of life scores at 30 days after surgery

    Quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Kansas City Cardiomyopathy Questionnaire (KCCQ): The KCCQ consists of 23 items that quantify the following domains: physical limitations, symptoms (including symptom frequency, severity, and change over time), self-efficacy, social function, and quality of life. The total score ranges from 0 to 100, with higher scores representing better quality of life.

    Time frame: 30 days after surgery

  8. Length of hospital stay

    Length of hospital stay

    Time frame: Through patients discharge, an average of 2 days after surgery

  9. Acute adverse reactions

    drug reaction

    Time frame: From intervention to 6 hours after surgery

  10. Intraoperative hypotension

    Systolic blood pressure \<90 mmHg or \>30% decrease from baseline

    Time frame: From intervention to end of surgery

  11. Incidence of intraoperative hypoxemia

    Oxygen saturation \<90% lasting at least 30 seconds

    Time frame: From intervention to end of surgery

  12. Incidence of severe bradycardia

    Heart rate \<40 beats/min

    Time frame: From intervention to 6 hours after surgery

  13. Dosage of vasoactive agents

    Including atropine, norepinephrine and nitroglycerin

    Time frame: From intervention to 6 hours after surgery

07

Study locations

1 site
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 30, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07549282
Responsible party
Sponsor
First posted
Apr 24, 2026
Start date
Aug 2026 (estimated)
Primary completion
Jan 2027 (estimated)
Completion
Feb 2027 (estimated)
Last update
Jul 30, 2026

Study contacts

Min Yan, Doctor
Contact
zryanmin@zju.edu.cn
15888210247

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Dexmedetomidine

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