title: Acute and long-term outcomes of drug-eluting stent implantations in aorto-ostial, left anterior descending artery-ostial, and nonostial lesions.
abstract: BACKGROUND
  This study was designed to evaluate the acute and long-term clinical and angiographic outcomes of drug-eluting stent (DES) implantations in aorto-ostial, left anterior descending artery (LAD)-ostial and nonostial lesions.
  
  
  METHODS
  From the CAPTAIN (cardiovascular atherosclerosis and percutaneous transluminal interventions) registry, a total of 61 patients with 61 aorto-ostial, 173 patients with 173 LAD-ostial, and 1,954 patients with 2,391 nonostial lesions were treated with DES implantations.
  
  
  RESULTS
  Compared to patients with LAD-ostial and nonostial lesions, those with aorto-ostial lesions had a larger late loss (0.43 ± 0.66, 0.42 ± 0.63, and 0.95 ± 0.93 mm, respectively, P = 0.001), higher loss index (0.18 ± 0.28, 0.18 ± 0.26, and 0.39 ± 0.38, respectively, P = 0.001), and restenosis rate (7%, 6%, and 25%, respectively, P < 0.001) at a 6-9 months angiographic follow-up. During the long-term follow-up period of 34 ± 26 months, the aorto-ostial group had a higher rate of target vessel failure (21.7% vs. 12.3% vs. 10.9%, respectively, P = 0.030) and a lower cardiovascular event-free survival rate, as determined by the Kaplan-Meier analysis, than the other two groups (P = 0.002).
  
  
  CONCLUSIONS
  In spite of treatment with DES implantation, aorto-ostial stenosis is still associated with higher restenosis and lower cardiovascular event-free survival rates than LAD-ostial and nonostial lesions during a long-term follow-up; however, LAD-ostial stenoses are not associated with a higher risk than nonostial lesions.
authors.affiliation: Second Section of Cardiology, Department of Medicine and PCI Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chen
authors.forename: Shang-Hung
authors.initials: SH
authors.lastname: Chang
authors.forename: Ming-Jer
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Chao-Yung
authors.initials: CY
authors.lastname: Wang
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Fen-Chiung
authors.initials: FC
authors.lastname: Lin
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: aorto-ostial lesion; drug-eluting stent; left anterior descending artery-ostial lesion; ostial lesion