Design and Rationale for the Endothelin-1 Receptor Antagonism in the Prevention of Microvascular Injury in Patients with non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention (ENDORA-PCI) Trial

Liou, Kevin; Jepson, Nigel; Buckley, Nicholas A.; Chen, Vivien; Thomas, Shane; Russell, Elizabeth; Yu, Jennifer

doi:10.1007/s10557-016-6641-x

Cited by 6 publications

(5 citation statements)

References 47 publications

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“…Guddeti et al 255 found that in patients with non-STEMI, adjunct treatment with an ET A -selective ERA during PCI improves microvascular blood flow and myocardial perfusion, an observation also made by Papadogeorgos et al 256 257 investigated the effects of acute pretreatment with ambrisentan (Volibris ® ) in patients with non-STEMI / non-ST elevation ACS undergoing PCI. Ambrisentan reduced levels of highsensitivity troponin T by >75% and also reduced preprocedural coronary myeloperoxidase activity as an index of neutrophil activation.…”

Section: Coronary Artery Disease/ischemic Heart Diseasementioning

confidence: 89%

“…Ambrisentan reduced levels of highsensitivity troponin T by >75% and also reduced preprocedural coronary myeloperoxidase activity as an index of neutrophil activation. 258,259 Adlbrecht et al studied the effect of ET A -receptor blockade using the peptide antagonist BQ-123 during PCI in clinically stable patients with posterior-wall ST elevation ACS. Treatment resulted in improved microvascular function and smaller infarct size at 6 months follow-up, suggesting possible long-term benefits.…”

Section: Coronary Artery Disease/ischemic Heart Diseasementioning

confidence: 99%

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Endothelin: 30 Years From Discovery to Therapy

2019

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Discovered in 1987 as a potent endothelial cell–derived vasoconstrictor peptide, endothelin-1 (ET-1), the predominant member of the endothelin peptide family, is now recognized as a multifunctional peptide with cytokine-like activity contributing to almost all aspects of physiology and cell function. More than 30 000 scientific articles on endothelin were published over the past 3 decades, leading to the development and subsequent regulatory approval of a new class of therapeutics—the endothelin receptor antagonists (ERAs). This article reviews the history of the discovery of endothelin and its role in genetics, physiology, and disease. Here, we summarize the main clinical trials using ERAs and discuss the role of endothelin in cardiovascular diseases such as arterial hypertension, preecclampsia, coronary atherosclerosis, myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) caused by spontaneous coronary artery dissection (SCAD), Takotsubo syndrome, and heart failure. We also discuss how endothelins contributes to diabetic kidney disease and focal segmental glomerulosclerosis, pulmonary arterial hypertension, as well as cancer, immune disorders, and allograft rejection (which all involve ET A autoantibodies), and neurological diseases. The application of ERAs, dual endothelin receptor/angiotensin receptor antagonists (DARAs), selective ET B agonists, novel biologics such as receptor-targeting antibodies, or immunization against ET A receptors holds the potential to slow the progression or even reverse chronic noncommunicable diseases. Future clinical studies will show whether targeting endothelin receptors can prevent or reduce disability from disease and improve clinical outcome, quality of life, and survival in patients.

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Section: Coronary Artery Disease/ischemic Heart Diseasementioning

confidence: 89%

Section: Coronary Artery Disease/ischemic Heart Diseasementioning

confidence: 99%

Endothelin: 30 Years From Discovery to Therapy

2019

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“…53 In the setting of acute STEMI, a randomized trial of initial antiplatelet therapy in 76 patients undergoing primary PCI disclosed that, compared with an oral loading dose of 600 mg clopidogrel, an oral loading dose of 180 mg ticagrelor was associated with a lower IMR at the end of the procedure (22.2±18.0 versus 34.4±18.8 U; P =0.005). 54 In other randomized, controlled trials in acute MI, IMR is being used to assess the comparative efficacy of antiplatelet therapies 55 (NCT0273334), vasodilator therapy, 56 and low-dose intracoronary thrombolysis (T-TIME [A Trial of Low-Dose Adjunctive alteplase During Primary PCI]; NCT02257294).…”

Section: Discussionmentioning

confidence: 99%

Comparative Prognostic Utility of Indexes of Microvascular Function Alone or in Combination in Patients With an Acute ST-Segment–Elevation Myocardial Infarction

et al. 2016

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“…Catheter room physicians have been actively searching for effective treatments to avoid CMVD or adverse clinical outcomes after PCI, such as vasodilatory agents or low-dose intracoronary thrombolytic. [25][26][27] Using AMR to accurately and rapidly estimate the status of coronary microcirculation and stratify the risk of patients, which makes it possible for intra-operative intervention.…”

Section: Discussionmentioning

confidence: 99%

Microcirculatory Resistance Based on a Single Angiographic View in ST- segment Elevation Myocardial Infarction Patients

Zhang,

Dai,

Zhang

et al. 2023

Preprint

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Background Angio-based microvascular resistance (AMR) was proposed as a tool to quantitatively assess coronary microvascular based on single angiographic projection. The aims of this study are to assess the diagnostic accuracy and prognostic significance of AMR in ST-segment elevation myocardial infarction (STEMI) patients. Methods AMR was measured (Of these, 22 patients measured index of microvascular resistance (IMR)) in 70 STEMI patients after primary percutaneous coronary intervention (pPCI). ST-segment resolution (STR) was assessed 2 hours after pPCI simultaneously. Transthoracic echocardiography was performed within 1 day and approximately 1 year after pPCI. STEMI patients underwent pPCI were followed up for 7.3 years and the primary endpoint was the major adverse cardiac and cerebral events (MACCEs). Results AMR showed significant correlations with IMR (R = 0.334, P = 0.005). AMR has good predictive power for STR after pPCI (area under the curve: 0.889, sensitivity: 94.59%, specificity: 75.76%) in receiver operating characteristic (ROC) curve. Low-AMR patients showed markedly improved left ventricular ejection fraction (LVEF) 1 year after pPCI (42(40–49) vs 41(39–44), P = 0.041). High-AMR patients showed higher risk for MACCEs than those with Low-AMR (HR = 3.90, P = 0.02). In multivariate cox regression analysis, AMR was considered an independent predictor of MACCEs (HR: 1.153, P = 0.020). Conclusions AMR was a reliable tool for the estimation of microvascular resistance and prognosis in the absence of intracoronary pressure-temperature sensor wire and adenosine based on single angiographic projection.

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Design and Rationale for the Endothelin-1 Receptor Antagonism in the Prevention of Microvascular Injury in Patients with non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention (ENDORA-PCI) Trial

Abstract: The ENDORA-PCI study will investigate whether endothelin antagonism with Ambrisentan attenuates the peri-procedural rise in IMR in patients with NSTEACS undergoing PCI, and thus potentially the risk of PMI.

Cited by 6 publications

References 47 publications

Endothelin: 30 Years From Discovery to Therapy

Endothelin: 30 Years From Discovery to Therapy

Comparative Prognostic Utility of Indexes of Microvascular Function Alone or in Combination in Patients With an Acute ST-Segment–Elevation Myocardial Infarction

Microcirculatory Resistance Based on a Single Angiographic View in ST- segment Elevation Myocardial Infarction Patients

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