Stent implantation in aorto-ostial lesions: long-term follow-up and predictors of outcome

Aims: To compare the outcomes of drug-eluting (DES) vs. bare-metal (BMS) stents for stenting of native aorto-ostial lesions (AOL) and to identify predictors of major adverse cardio and cerebrovascular events (MACCE). Methods and results: A total of 181 patients (182 AOL) who underwent stenting of AOL were retrospectively identified: right-coronary artery in 130 (71.4%), left main in 52 (28.6%). In-hospital event rate was 1.1% (two non-Q-wave myocardial infarctions). Follow-up was possible in 98.3%, median time=23.9 months (IQR 12.1-37.7). Event rates and survival MACCE-free were not significantly different between DES and BMS. After multivariate analysis, only the logistic EuroSCORE >10% predicted MACCE (HR=4.66, 95% Cl: 2.38-9.12, p<0.001), whereas the predictors for TLR were age (HR=0.96, 95% Cl: 0.92-1.00, p=0.039) and the stented artery (RCA vs. LM, HR=10.2, 95% Cl: 1.37-75.45, p=0.024). Conclusions: AOL stenting can be performed with high success and low complication rates. At follow-up, no significant differences in event rates were found between DES and BMS; EuroSCORE>10% was the only predictor of MACCE.