Acute myocardial infarction
Conditions
Interventions
Experimental group:Esmolol is administered intravenously
Control group:Intravenous injection of physiological saline
Sponsors
Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Inclusion criteria
Inclusion criteria: Inclusion criteria. 1) ECG meeting the definition of acute anterior wall myocardial infarction (ST-segment elevation = 2 mm in at least 2 adjacent leads of V1-V5 or new complete left bundle branch block). 2) Emergency coronary angiography and PCI within 24 hours of symptom onset and TIMI flow recovery grade 3. 3) Ventricular rate = 60 bpm recorded by ECG after PCI. 4) post-PCI systolic blood pressure (SBP) = 90 mmHg and mean arterial pressure (MBP) = 65 mmHg. 5) peripheral oxygen saturation > 90%. 6) Age = 18 years. 7) Study subjects agreed to be enrolled and signed an informed consent form.
Exclusion criteria
Exclusion criteria: Exclusion criteria. 1) Second and third degree atrioventricular block. 2) Presence of beta-blockers or esmolol use contraindicated. 3) Cardiogenic shock or SBP <90 mmHg. 4) significant congestive heart failure (Killip classification = grade 3). 5) history of prior myocardial infarction or ECG showing signs of old myocardial infarction. 6) coronary angiography confirmed combined vascular disease other than the offender vessel and the need for elective further surgical intervention. 7) previous EF = 30%. 8) combined valvular disease, hypertrophic cardiomyopathy, restrictive cardiomyopathy, obstructive cardiomyopathy, constrictive pericarditis, primary pulmonary hypertension, or other severe congenital heart disease. 9) Other acute or chronic illnesses, abnormal laboratory tests that may increase the risk of study enrollment or interfere with the interpretation of the data. 10) Patients who are unable to successfully complete the study follow-up schedule. 11) Patients who are unable to complete a cardiac magnetic resonance examination.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sudden cardiac death;Malignant ventricular arrhythmias;Readmission for heart failure; | — |
Secondary
| Measure | Time frame |
|---|---|
| Myocardial infarct size, left ventricular volume and left ventricular systolic function were performed by cardiac magnetic resonance at 5-7d and 6 months after PCI;Left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction were assessed by cardiac ultrasound within 48 h and at 6 months after PCI;NT-proBNP?TNT; | — |
Countries
China
Contacts
Public ContactGuannan Li
Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School
Outcome results
None listed