Musallam A, Chezar-Azerrad C, Torguson R, et al. - Because of elastic fiber content, calcium burden, and angulation, challenges may be encountered in managing ostial coronary artery lesions during percutaneous coronary intervention (PCI). Researchers here reported procedural and clinical major adverse cardiac events (MACE) linked with PCI for ostial lesions, focusing on ostial left circumflex (LC) lesions vs ostial left anterior descending artery (LAD) and right coronary artery lesions. From 2003 to 2018, they identified a total of 4,759 patients with ostial or very proximal coronary artery lesions, who were treated with PCI at MedStar Washington Hospital Center (Washington, DC), for inclusion in this study; 2,236 ostial/very proximal LAD, 980 ostial/very proximal LC, and 1,543 ostial/very proximal right. For the LC group, the presenting clinical syndrome was mainly stable or unstable angina, whereas in the LAD, MI was more frequent. At 1 year, the LC group had the target lesion revascularization (TLR)-MACE rate of 16.7% vs 12.5% in the LAD and 11.8% in the right group. The LC group had mortality rates of 11.2% vs 8.4% in the LAD and 6% in the right group. Findings thereby suggest that compared with PCI of ostial or very proximal LAD or right lesions, PCI of ostial or very proximal LC lesions was linked with greater rates of TLR-MACE.