Outcomes of isolated ostial LAD PCI versus multivessel PCI including ostial LAD lesions

Ostial lesions of the left anterior descending (LAD) coronary artery are critical targets for revascularization due to their role in supplying a large portion of the myocardium, and are often accompanied by multivessel disease, complicating treatment planning and prognosis.

This was a retrospective, single-center study. Patients with ostial LAD PCI isolated or in conjunction with PCI in another vessel were included and were grouped into isolated ostial LAD PCI (n = 276) or multivessel PCI including ostial LAD PCI (n = 218). The primary endpoint was major adverse cardiovascular events (MACE) defined by a composite of all-cause mortality, myocardial infarction, stroke, or unplanned repeat revascularization.

Participants undergoing multivessel PCI were significantly older, with a median age of 70 years (IQR: 62-77), compared to 68 years (IQR: 59-75) in the isolated ostial LAD PCI group (p = 0.036). The sex distribution was similar between groups, with females comprising 26.6% of the multivessel PCI group and 28.6% of the isolated ostial LAD group (p = 0.619). At a median follow-up of 756 days (IQR: 433-1165), the incidence of MACE was comparable between groups, occurring in 28.4% of the multivessel PCI group versus 25.4% in the isolated ostial LAD PCI group (adjusted HR 1.04; 95% CI 0.73-1.48; p = 0.81).

In patients undergoing ostial LAD PCI, treatment of an additional vessel did not increase the risk of MACE in long-term follow-up.