Primary percutaneous transluminal coronary angioplasty (PTCA) has been shown to be superior to thrombolytic therapy for the treatment of patients with acute myocardial infarction (AMI), in terms of enzymatic infarct size, left ventricular function, and clinical outcome. 1 Zijlstra F. de Boer M.J. Hoorntje J.C. Reiffers S. Reiber J.H. Suryapranata H. A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med. 1993; 328: 680-684 Crossref PubMed Scopus (1175) Google Scholar , 2 Grines C.L. Browne K.F. Marco J. Rothbaum D. Stone G.W. O’Keefe J. Overlie P. Donohue B. Chelliah N. Timmis G.C. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med. 1993; 328: 673-679 Crossref PubMed Scopus (1878) Google Scholar , 3 Zijlstra F. Hoorntje J.C.A. de Boer M.J. Reiffers S. Miedema K. Ottervanger J.P. van’t Hof A.W. Suryapranata H. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction. N Engl J Med. 1999; 341: 1413-1419 Crossref PubMed Scopus (601) Google Scholar The use of stents and glycoprotein IIb/IIIa inhibitors has resulted in a further improvement in clinical outcome. 4 Suryapranata H. van’t Hof A.W.J. Hoorntje J.C. de Boer M.J. Zijlstra F. Randomized comparison of coronary stenting with balloon angioplasty in patients with acute myocardial infarction. Circulation. 1998; 97: 2502-2507 Crossref PubMed Scopus (325) Google Scholar , 5 Stone G.W. Grines C.L. Cox D.A. Garcia E. Tcheng J.E. Griffin J.J. Guagliumi G. Stuckey T. Turco M. Carroll J.D. Rutherford B.D. Lansky A.J. Controlled Abciximab, and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) InvestigatorsComparison of angioplasty with stenting with or without abciximab, in acute myocardial infarction. N Engl J Med. 2002; 346: 957-966 Crossref PubMed Scopus (1193) Google Scholar However, only few and inconsistent data have been reported with regard to primary PTCA for AMI due to left main coronary occlusion (LMCO). 6 Erbel R. Meinertz T. Wessler I. Meyer J. Seybold-Epting W. Recanalization of occluded left main coronary artery in unstable angina pectoris. Am J Cardiol. 1984; 53: 1725-1727 Abstract Full Text PDF PubMed Scopus (37) Google Scholar , 7 Spiecker M. Erbel L. Rupprecht H.J. Meyer J. Emergency angioplasty of totally occluded left main coronary artery in acute myocardial infarction and unstable angina pectoris—institutional experience and literature review. Eur Heart J. 1994; 15: 602-607 Crossref PubMed Google Scholar , 8 Quigley R.L. Milano C.A. Smith L.R. White W.D. Rankin J.S. Glower D.D. Prognosis and management of anterolateral myocardial infarction in patients with severe left main stenosis disease and cardiogenic shock the left main shock syndrome. Circulation. 1993; 88: 65-70 Google Scholar , 9 Chauhan A. Zubaid M. Ricci D.R. Buller C.E. Moschovich M.D. Mercier B. Fox R. Penn I.M. Left main intervention revisited early and late outcome of PTCA and stenting. Cath Cardiovasc Diagn. 1997; 41: 21-29 Crossref PubMed Scopus (66) Google Scholar , 10 Marso S.P. Steg G. Plokker T. Holmes D. Park S.J. Kosuga K. Macaya C. Moses J. White H. Verstraete S.F. Ellis S.G. Catheter-based reperfusion of unprotected left main stenosis during an acute myocardial infarction (the ULTIMA experience). Am J Cardiol. 1999; 83: 1513-1517 Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar The aim of this study was to evaluate the efficacy of primary PTCA for LMCO, and to describe the clinical features, outcome, and prognostic determinants.