Effect of Preoperative Intranasal Dexmedetomidine on Postoperative Myocardial Injury in Patients Undergoing Coronary Artery Bypass Grafting
- 1Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
Abstract
Purpose: To evaluate the effects of preoperative intranasal dexmedetomidine on postoperative myocardial injury biomarkers in patients undergoing on-pump coronary artery bypass grafting (CABG).
Patients and Methods: In this randomized, double-blind, placebo-controlled trial, 70 patients undergoing on-pump CABG were assigned to receive intranasal dexmedetomidine (1 μg/kg) or saline 30 min before bedtime on the night before surgery and again 30 min before anesthesia induction. The primary outcome was serum high-sensitivity cardiac troponin T (hs-cTnT) at 24 h after surgery. Secondary outcomes included perioperative cardiac biomarkers, preoperative sleep quality, postoperative delirium, and adverse events.
Results: For the prespecified primary outcome, hs-cTnT concentrations at 24 h after surgery were significantly lower in the dexmedetomidine group than in the control group (estimated marginal means, 170.29 vs 357.29 ng/L; P < 0.001). Postoperative creatine kinase-MB (CK-MB) concentrations were also lower in the dexmedetomidine group (all P < 0.05). N-terminal pro-B-type natriuretic peptide showed a significant group-by-time interaction (P = 0.030), although between-group differences at individual postoperative time points were not significant. The dexmedetomidine group had higher Leeds Sleep Evaluation Questionnaire scores (62 [60–64] vs 44 [41–50]; P < 0.001) and a lower incidence of postoperative delirium (14.3% vs 37.1%; P = 0.029). Adverse events, mechanical ventilation duration, and intensive care unit (ICU) length of stay did not differ significantly between groups.
Conclusion: In this single-center trial, two-dose preoperative intranasal dexmedetomidine was associated with lower postoperative hs-cTnT and CK-MB concentrations, better subjective preoperative sleep quality, and a lower observed incidence of postoperative delirium. These findings are preliminary and require confirmation in larger, adequately powered multicenter randomized trials to determine whether the biomarker reductions translate into clinically meaningful cardiovascular benefits.
Trial Registration: Chinese Clinical Trial Registry, ChiCTR2500111431.
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BibTeX
@article{li2026effect,
title = {{Effect of Preoperative Intranasal Dexmedetomidine on Postoperative Myocardial Injury in Patients Undergoing Coronary Artery Bypass Grafting}},
author = {Qingping Li and Shuting Hu and Yuhan Fu and Lei Shen and Baihong Xiong and Dunyi Qi},
journal = {Drug Design, Development and Therapy},
year = {2026},
month = oct,
doi = {10.2147/dddt.s644667},
url = {https://doi.org/10.2147/dddt.s644667},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Effect of Preoperative Intranasal Dexmedetomidine on Postoperative Myocardial Injury in Patients Undergoing Coronary Artery Bypass Grafting
AU - Qingping Li
AU - Shuting Hu
AU - Yuhan Fu
AU - Lei Shen
AU - Baihong Xiong
AU - Dunyi Qi
PY - 2026
DA - 2026/10/27
JO - Drug Design, Development and Therapy
DO - 10.2147/dddt.s644667
UR - https://doi.org/10.2147/dddt.s644667
AB - Purpose: To evaluate the effects of preoperative intranasal dexmedetomidine on postoperative myocardial injury biomarkers in patients undergoing on-pump coronary artery bypass grafting (CABG). Patients and Methods: In this randomized, double-blind, placebo-controlled trial, 70 patients undergoing on-pump CABG were assigned to receive intranasal dexmedetomidine (1 μg/kg) or saline 30 min before bedtime on the night before surgery and again 30 min before anesthesia induction. The primary outcome was serum high-sensitivity cardiac troponin T (hs-cTnT) at 24 h after surgery. Secondary outcomes included perioperative cardiac biomarkers, preoperative sleep quality, postoperative delirium, and adverse events. Results: For the prespecified primary outcome, hs-cTnT concentrations at 24 h after surgery were significantly lower in the dexmedetomidine group than in the control group (estimated marginal means, 170.29 vs 357.29 ng/L; P < 0.001). Postoperative creatine kinase-MB (CK-MB) concentrations were also lower in the dexmedetomidine group (all P < 0.05). N-terminal pro-B-type natriuretic peptide showed a significant group-by-time interaction (P = 0.030), although between-group differences at individual postoperative time points were not significant. The dexmedetomidine group had higher Leeds Sleep Evaluation Questionnaire scores (62 [60–64] vs 44 [41–50]; P < 0.001) and a lower incidence of postoperative delirium (14.3% vs 37.1%; P = 0.029). Adverse events, mechanical ventilation duration, and intensive care unit (ICU) length of stay did not differ significantly between groups. Conclusion: In this single-center trial, two-dose preoperative intranasal dexmedetomidine was associated with lower postoperative hs-cTnT and CK-MB concentrations, better subjective preoperative sleep quality, and a lower observed incidence of postoperative delirium. These findings are preliminary and require confirmation in larger, adequately powered multicenter randomized trials to determine whether the biomarker reductions translate into clinically meaningful cardiovascular benefits. Trial Registration: Chinese Clinical Trial Registry, ChiCTR2500111431.
SN - 1177-8881
ER -