Intranasal Dexmedetomidine and Perioperative Myocardial Injury in Patients Having Percutaneous Coronary Interventions

Prior treatment

• Use of drugs that may interfere with the study medication within 1 week before surgery, including α2-adrenergic receptor agonists (e.g., clonidine) or antagonists, and tricyclic antidepressants;

Other illness

• Allergy or contraindication to dexmedetomidine, including severe sinus bradycardia (resting heart rate \< 50 beats/min), sick sinus syndrome, second-degree or higher atrioventricular block without pacemaker implantation;
• Uncontrolled hypertension (systolic blood pressure \> 180 mmHg or diastolic blood pressure \> 110 mmHg) or hypotension (systolic blood pressure \< 90 mmHg);
• Language, visual, or hearing impairment that may affect questionnaire assessment;

Lab values

• Patients with severe cardiac insufficiency (left ventricular ejection fraction \< 40% or New York Heart Association functional class Ⅲ-IV), cardiogenic shock, or hemodynamic instability;
• Hepatic or renal insufficiency (Alanine Aminotransferase/Aspartate Aminotransferase/Creatinine \> 3 times the upper limit of normal);

Other

• BMI \> 30 kg/m²;
• Known or suspected sleep apnea;
• Nasal anatomical abnormalities interfering with nasal spray administration;
• Pregnant or lactating women;
• Participation in another clinical trial that may conflict with this trial.

• Aged 45-85 years(inclusive);
• Able to confirm understanding of risks, benefits, and treatment alternatives of receiving intranasal dexmedetomidine, and he/she or his/her legally authorized representative provides written informed consent prior to any study-related procedure.
• Diagnosed with coronary artery disease with objective evidence of ischemia or silent ischemia, meeting the indications for elective PCI.
• Designated American Society of Anesthesiologists (ASA) physical status II-Ⅲ (ranging from mild systemic disease to severe underlying conditions; patients with marked limitation in ordinary physical activity, yet still capable of light daily activities).