Effects of Early Vagus Nerve Stimulation on Infarct Damage and Functioning After Acute STEMI

The goal of this clinical trial is to investigate whether early non-invasive vagus nerve stimulation (nVNS) can reduce infarct damage and improve functioning after acute ST-elevation myocardial infarction (STEMI). It will assess the safety and effectiveness of nVNS in improving cardiac outcomes. The main questions it aims to answer are: * Does nVNS improve short-term prognosis post-STEMI by enhancing heart rate variability (HRV) and reducing inflammation? * Does nVNS reduce infarct size, improve left ventricular function, and lower inflammatory markers compared to sham stimulation? Participants will be randomly assigned to one of two groups: * Experimental group: Receive standard care plus nVNS for 60 minutes at the right ear using the Parasym device under ECG monitoring. * Control group: Receive standard care plus sham nVNS (placebo-like procedure without stimulation). Participants will undergo stimulation once for 60 minutes post-percutaneous coronary intervention (PCI), and be monitored for adverse reactions like bradycardia, with immediate cessation if needed. Key study details: * Inclusion criteria: Adults aged 25-75 years with confirmed STEMI (clinical signs and elevated troponin). * Exclusion criteria: Bradycardia (HR \< 50 bpm), extensive anterior MI, hypotension, or severe cardiac/medical conditions. * Intervention parameters: Stimulation targeting the auricular branch of the vagal nerve with 200µs pulse width, 20Hz frequency, and adjustable intensity (10-50mA), remaining below the pain threshold. Outcomes measured: * Primary outcomes: Wall motion score index (WMSI) and left ventricular ejection fraction (LVEF). * Secondary outcomes: HRV metrics, troponin levels, inflammatory markers (CRP, NLR), atrial fibrillation events, hospitalization duration, one-month survival, quality of life (HeartQOL scale), and one-year survival. Statistical analysis: Researchers will compare baseline characteristics using t-tests and chi-square tests. Main analyses will