Double blind, placebo controlled randomised trial assessing the efficacy of endothelin-1 receptor antagonism in the prevention of microvascular injury in patients with non-ST elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary intervention: the ENDORA-PCI trial

Coronary artery disease affects around 1.4 million Australians, and represents one of the most significant causes of death and disability in Australia and worldwide. Over the last two decades the focus in the treatment of coronary artery disease has primarily been on blood vessels of large calibre. However, it is becoming increasingly apparent that small vessels within the heart muscles, which are the main determinant of blood supply to the heart, may in fact have an equally important, if not more dominant role to play in patients with heart attacks or angina. It has also been suggested that small vessel problems may also be responsible for injury to the heart muscle during a stenting procedure, a potentially serious problem which remains a common issue despite recent technological advancement. Currently the understanding of these small vessels and treatment options are limited. This project aims to investigate the role of these small vessels in heart muscle injury during a stenting procedure and elucidate the possible mechanisms which predispose to or cause dysfunction within these small vessels. I also hope to find a treatment strategy which may benefit patients with small vessel problems and thus improve their overall outcome. If successful, I believe the results will have a wide reaching effect in patients with heart attacks, as well as in an emerging group of patients with angina secondary to small vessel dysfunction, which is resistant to conventional therapies.