title: Short, midterm and late results of percutaneous coronary interventions for left main coronary artery disease.
abstract: BACKGROUND
  Left main coronary artery disease is found in 4-6% of patients undergoing diagnostic coronary angiography. Coronary artery bypass graft is the gold standard. However, percutaneous coronary intervention is a continuously evolving substitution for surgery in such patients.
  
  
  METHODS
  We report a retrospective study of 32 patients with relevant left main coronary artery disease treated by angioplasty in our faculty, between January 2005 and March 2011.
  
  
  RESULTS
  The mean age of the population on the study was 59.7±10.9 years. The sex-ratio was 3.57. The rate of angiographic success was 97%. The in-hospital stay was uneventful in 94%¨of our patients. Only one patient died of cardiogenic shock complicating an acute anterior myocardial infarction. After a mean follow up of 18.5 ± 15.4 months, the in-stent restenosis rate was 16.12%. The rate of major adverse cardiac events (MACE) was 29%. Independent predictive factors of MACE were: cardiogenic shock on admission (p=0.022), emergency procedures (p=0.033), Euroscore > 6 (p=0.001), Parsonnet score > 20 (p=0.036), High C réactive protein levels on admission (p=0.007),le taux de créatinine (p=0.008), un diamètre de référence du TCCG < 3.5 mm (p =0.036) et l'utilisation de stents  (p=0.036) and the use of bare metal stents (p=0.036). Independent predictive factors of in-stent restenosis were: use of bare metal stents (p=0.004) and Paclitaxel drug eluting stents (p=0.037).
  
  
  CONCLUSIONS
  Percutaneous coronary intervention is safe and a validated alternative to coronary artery bypass graft for left main coronary artery disease. However, it should be reserved to selected patients and limited to experienced centers.
authors.forename: Rym
authors.initials: R
authors.lastname: Gribaa
authors.forename: Mehdi
authors.initials: M
authors.lastname: Slim
authors.forename: Kacem
authors.initials: K
authors.lastname: Slim
authors.forename: Helmi
authors.initials: H
authors.lastname: Ben Salem
authors.forename: Elyes
authors.initials: E
authors.lastname: Neffati
authors.forename: Sana
authors.initials: S
authors.lastname: Ouali
authors.forename: Fehmi
authors.initials: F
authors.lastname: Remadi
authors.forename: Essia
authors.initials: E
authors.lastname: Boughzela