Background: Percutaneous coronary intervention (PCI) of stenoses involving ostial coronary lesions is technically demanding and has been associated with lower procedural success and poorer clinical and angiographic outcomes when compared with non-ostial lesions. The aim of this study is to evaluate clinical and angiographic outcomes between Sirolimus-eluting stent (SES) and Paclitaxel-eluting stent (PES) for the treatment of ostial coronary lesions.
Methods: From Jan. 2005 to May 2009, 157 consecutive patients (159 lesions) with de-novo single isolated ostial lesions underwent PCI with drug-eluting stent (DES) at 3 centers were enrolled. Ostial lesion was defined as ≥ 50% diameter stenosis rising within 5 mm of either left anterior descending coronary artery (n=103) or left circumflex artery (n=14) or right coronary artery (n=42) measured by quantitative coronary analysis. Angiographic follow-up was performed at 9~12 months. Study end-points were stent thrombosis (ST) and MACE (major adverse cardiac events) including myocardial infarction (MI), cardiac death, revascularization for 1 year.
Results: Baseline characteristics between the patients with two DES were similar. For 1 year follow-up, total MACE was 8.5% in patients with SES and 7.8% with PES (p=0.890). ST was observed in 2.8% in patients with SES and 2.0% in patients with PES (p=1.746). Follow-up angiography was done in 63.7% and binary angiographic restenosis was 12.8% in patients with SES and 8.7% with PES (p=0.591).
Conclusions: DES is safe and effective in patients with de-novo ostial coronary lesions. Although clinical and angiographic outcomes between SES and PES appear no differences, further large and randomized trials will be warranted.
Key Words: Drug-eluting stent, Ostial coronary lesion, Percutaneous coronary intervention
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