Clinical Outcomes of Isolated Non-Left Main Side Branch Ostial Stenosis: Medical Therapy versus Percutaneous Coronary Intervention (the ALP-SBO registry)

Aim: Side branch (SB) ostial stenosis is a frequent bifurcation lesion and its optimal treatment strategy is still debated. Although the efficacy of the optimal medical therapy is well known, the comparison of the medical treatment and percutaneous coronary intervention (PCI) is controversial. Methods: A total of 357 consecutive patients with isolated SB ostial stenosis (Medina 0.0.1 classification) was evaluated retrospectively. Patients were divided into two groups; patients with only medical therapy (n = 305) and patients undergoing PCI (n = 52). Target vessel revascularization (TVR), myocardial infarction (MI), and mortality were evaluated as major adverse cardiovascular outcomes (MACE). Results: The mean age of the patients was 58.2 +/- 10.3 years. 102 patients (28.6%) were female. 279 patients(78.2%) had diagonal lesion while 78 (21.8%) had obtuse marginal lesion. The SB stenosis ratio (70 +/- 16;88 +/- 13, p < 0.001) and SB lesion length (7.5 +/- 6.6; 14.7 +/- 6.0, p < 0.001) were higher in the PCI group. SB ostialstenting (38 patients [73.1%]) was the common PCI technique. There were no signifi cant differences in terms of TVR (1.3%; 1.9%, p = 0.277, medical vs PCI groups, respectively), MI (8.2%; 7.7%, p = 0.302, medical vsPCI groups, respectively), mortality (10.2%; 9.6%, p = 0.095, medical vs PCI groups, respectively) and MACE(18.0%; 15.4%, p = 0.113, medical vs PCI groups, respectively) between groups. Additionally, in Kaplan-Me-ier long-term survival analysis, there were no differences in TVR (log-rank p = 0.247), MI (log-rank p = 0.295), mortality (log-rank p = 0.086), and MACE (log-rank p = 0.107) between groups. Conclusions: Medical therapy instead of PCI seems to be an appropriate and optimal treatment strategy inpatients with non-left main SB ostial stenosis.