ShenFu Injection for Myocardial Protection in Patients With Acute ST Segment Elevation Myocardial Infarction

Study Overview
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Brief Summary
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The purpose of this study is to evaluate whether perioperative use of Shenfu Injection could reduce myocardial injury (enzymatic infarct size and infarct volume according to cardiac magnetic resonance imaging) in patients with STEMI after primary PCI

Official Title
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A Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Effect of Shenfu Injection on Reperfusion Injury in Patients With Acute ST Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention: A Pilot Trial

Conditions
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Myocardial Infarction

Intervention / Treatment
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* Drug: Shenfu Injection
* Drug: 5% Glucose Injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 and <75 years; First-time acute anterior STEMI; The time from onset of ischemic symptom to the time of initial PCI balloon inflation ≤6 hours; >0.1 mV ST segment elevation in at least two contiguous precordial leads according to electrocardiogram; Scheduled for primary PCI; The presence of left anterior descending branch (LAD) occlusion in proximal or middle segment with pre-PCI TIMI flow 0 or 1 according to baseline coronary angiogram; Written informed consent. Exclusion Criteria: Hypertrophic cardiomyopathy, aortic valve stenosis and/or regurgitation, pericarditis, or myocarditis; Cardiogenic shock, severe ventricular arrhythmia, serious heart failure (Killip class III and above) or mechanical complications; Patients after cardiopulmonary resuscitation (CPR) (including cardioversion); Patients who have already received thrombolytic therapy; Prior myocardial infarction or coronary artery bypass surgery; Known serious hepatic, renal, blood, respiratory, or neuropsychiatric diseases; Malignant tumor, lymphoma, HIV-positive, or hepatitis; Uncontrolled hypertension (systolic BP >160 mm Hg or a diastolic BP >100 mmHg on at least two consecutive readings); Patients with active bleeding, major surgery or trauma within 3 months and cerebrovascular accident within 6 months; History of anemia (hemoglobin<90g/L) or thrombocytopenia (thrombocyte<90×109/L); Multi-vessel disease with non-culprit vessel intervention; Breastfeeding, pregnant, or potentially fertile women; Patients who have known to be allergic to Shenfu Injection or its components or patients with serious adverse effect; Patients with potential contraindication to CMR; Participation in other clinical trial in recent 3 months; Patients who cannot complete this trial or comply with the protocol.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Shenfu Injection<br>80ml Shenfu Injection + 70ml 5% glucose injection), ivdrip, 30 minutes before PCI and 1-5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes. | Drug: Shenfu Injection<br> <br> * Other names: Shenfu Zhusheye;|
| Placebo Comparator: 5% Glucose Injection<br>150 ml 5% glucose injection, ivdrip, 30 minutes before PCI and 1-5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes. | Drug: 5% Glucose Injection<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Infarct size | Infarct size was assessed by measuring the area under the curve (AUC) of creatine kinase isoenzyme (CK-MB) within 72 hours after PCI and by performing cardiac magnetic resonance (CMR) imaging at 4±1days after PCI. | immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI, as well as 4±1days after PCI | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| AUC of cardiac troponin I (cTnI) |  | immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI | 
| Peak value of CK-MB and cTnI |  | 72 hours after PCI | 
| ST segment resolution (%) according to ECG |  | up to 24 hours after PCI | 
| Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and Left ventricular ejection fraction (LVEF) |  | up to 28 days after PCI | 
| Main adverse cardiovascular and cerebrovascular events (MACCE, including death, non-fatal myocardial infarction, target vessel revascularization, stroke, new-onset severe heart failure, re-hospitalization for heart failure) |  | up to 28 days after PCI | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shenfu Injection, Reperfusion Injury, Myocardial Protection, Percutaneous Coronary Intervention