Outcomes of patients undergoing PCI for ostial coronary lesions- a single center study

Introduction

Ostial lesions are a subset of proximal coronary lesions which are technically difficult to treat and are associated with worse clinical outcomes. However, outcomes of patients undergoing percutaneous coronary intervention (PCI) of ostial lesions with the use of contemporary drug eluting stents (DES) have not been well described.

Methods

We conducted a single center, all-comer prospective registry study, enrolling patients undergoing PCI with the use of contemporary DES between July 2016 and February 2018. Clinical outcomes were compared between patients undergoing PCI of ostial versus proximal non-ostial lesions. The primary endpoint was target vessel revascularization (TVR). Secondary endpoints included Target lesion failure (TLR) and major cardiovascular adverse events (MACE) at 12 months.

Results

A total of 1856 patients were enrolled in the study (83.2% male, 66.2±11.1 years) of which, 91 patients were treated for ostial lesions and 243 were treated for proximal non ostial lesions. Baseline and procedural characteristics were similar between the two groups except for older age in the ostial lesions group (69.6±10.2 versus 66.4±9 years, p=0.014). Procedural complications did not differ between groups. At 12 months TVR and TLR were numerically higher among patients undergoing PCI of ostial versus non-ostial lesions without reaching statistical significance (5.5% vs. 3.3%; p=0.35 and 4.4% vs. 2.5%; p=0.47 respectively). The rate of MACE was also similar between the two groups.

Conclusion

In patients undergoing PCI with the use of contemporary DES, clinical outcomes were similar among patients treated for ostial compared to proximal non-ostial lesions. Larger studies are required to further evaluate the performance of contemporary DES in this subset of lesions.