Background: Drug-eluting stent is increasingly used in a variety of real world percutaneous coronary interventions (PCI). PCI of ostial lesion is known to be associated with reduced procedural success, increased complications and restenosis. This study aimed to evaluate the efficacy and safety of Sirolimus-eluting stent (Cypher^TM , SES) compared to bare metal stent (BMS) for the treatment of ostial lesions.
Methods: The study group comprised a total 65 patients (pts) with 66 ostial lesions underwent standard PCI with SES (SES group) and 302 pts with 325 ostial lesions with BMS (BMS group). We retrospectively analyzed the efficacy and safety of SES compared to BMS for the treatment of ostial lesions. The in-hospital, 30-day and 6-month clinical outcomes in both groups were compared.
Results: Baseline clinical, angiographic and procedural characteristics were similar between the two groups except history of hyperlipidemia, hypertension was higher in the SES group and previous myocardial infarction, PTCA, CABG and unstable angina were higher in the BMS group. Despite these relatively uneven baseline characteristics, procedural and in-hospital complications were similar between the two groups. Although the rate of death, revascularization and major adverse cardiac events (MACE) were not different between the two groups, non-Q wave myocardial infarction (MI) was lower in the SES group at 30-days (6.5% vs. 19.5%, P=0.04) and 6 months (7.5% vs. 20.8%, P=0.05).
Conclusion: Treatment of ostial lesion in patients undergoing PCI with SES is safe and feasible with lower rate of non-Q-wave MI at 30 days compared to BMS and this benefit continued up to 6 months without increasing death, revascularization and MACE.