The goal of this clinical trial is to investigate whether morphine modulates the functions of the stellate ganglion to reduce myocardial ischemia/reperfusion injury in AMI patients. It will also assess the safety of injecting morphine around the stellate ganglion via ultrasound guidance. The main questions it aims to answer are:
1. Does morphine regulate stellate ganglion function to reduce myocardial ischemia/reperfusion injury in AMI patients? 2. What medical problems do participants experience when receiving injected morphine around the stellate ganglion? Researchers will compare morphine to a placebo saline (as a control group) to determine whether stellate ganglion infiltration with morphine effectively treats patients with AMI following primary PCI.
Participants will:
* Receive a single injection of morphine or saline around the stellate ganglion. * Evaluate the percentage of infarct size 7 days after surgery, or at discharge if the duration is shorter than 7 days. * Record their symptoms and any major adverse cardiovascular and cerebrovascular events within 30 days post-surgery.
Aged ≥18 years, Male or Female.
Acute ST-segment elevation myocardial infarction (STEMI) patients planned for percutaneous coronary intervention (PCI). Acute STEMI is defined as: electrocardiogram shows ST-segment elevation ≥0.2 mV in two or more adjacent leads, or new left bundle branch block (LBBW).
Within 24 hours of the onset of infarct-related chest pain.
Obtaining informed consent from the patient and their family.
Patients with severe complications of myocardial infarction, such as uncontrollable acute left heart failure and pulmonary edema, severe cardiogenic shock after cardiopulmonary resuscitation, severe mechanical complications including ventricular septal defect, papillary muscle rupture, and rupture of the left ventricular free wall;
Patients with old myocardial infarction, or cardiomyopathy, or malignant arrhythmias controlled by antiarrhythmic drugs;
Patients with coagulation disorders due to systemic diseases and those who are currently using anticoagulants and are not suitable for injection;
Patients allergic to opioids or with a history of opioid addiction and those participating in other clinical studies;
Parallel
Morphine
DrugMorphine (10 mg, 10 ml) is injected around the stellate ganglion using ultrasound guidance prior to coronary artery recanalization
saline placebo
DrugSaline (10 ml) is injected around the stellate ganglion using ultrasound guidance prior to coronary artery recanalization
The percentage of myocardial infarct size
The percentage of myocardial infarct size is measured by MRI either 7 days after primary PCI or at discharge if the duration is shorter than 7 days.
The incidence of major adverse cardiovascular and cerebrovascular events (MACCE)
The incidence of MACCE, including cardiac death, rehospitalization for heart failure, recurrent myocardial infarction, coronary revascularization, and stroke, will be recorded within 30 days post-surgery.
Postoperative plasma hs-cTnI levels
The levels of plasma hs-cTnI will be recorded at 24 hours post-surgery.
Evaluation of no-reflow phenomenon
The ST segment resolution will be evaluated by electrocardiograph (ECG) at 2 hours, 24 hours or 7-day reperfusion.
The incidence of microvascular obstruction
The incidence of microvascular obstruction is evaluated by MRI either 7 days after primary PCI or at discharge if the duration is shorter than 7 days.
Click on the lead sponsor to view all of their trials.
