Published online May 26, 2017. doi: 10.4330/wjc.v9.i5.442
Peer-review started: November 2, 2016
First decision: January 14, 2017
Revised: February 1, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: May 26, 2017
To study the relationship of jailed polymer jacketed guide wires (PGW) with procedural myocardial infarction (PMI) after bifurcation coronary interventions.
Consecutive bifurcation interventions performed from January 2010 to October 2014 were included in the study. Chart review was performed to obtain demographic, clinical and procedural data. PMI was defined as Creatine Kinase MB > 3 × upper reference limit of normal. Multivariate logistic regression was used to ascertain relationship of PGW use with PMI.
Two hundred and ninety-three patients (age 63.5 ± 12.3 years; 33.8% diabetic) were included in the study. Eighty point two percent (n = 235) were true bifurcation lesions use of PGW was associated with PMI on univariate analysis (OR = 4.1; P = 0.002). This association remained significant after adjusting for other possible risk factors (OR = 3.5; P = 0.02).
Our results suggest that PGW use for side branch protection may be associated with PMI. Randomized studies are needed to validate these findings.
Core tip: This is a retrospective study aiming to investigate the relationship of jailed polymer jacketed guide wires (PGW) with procedural myocardial infarction (PMI) after a bifurcation coronary intervention. There is concern that this causes polymer shearing and distal micro-embolization. Our data suggests that jailed PGW are strongly associated with PMI, even after adjusting for pertinent risk factors. Thus caution should be exercised in routinely jailing PGW until further definitive data are available.