Chatterjee A, White JS, Hashim T, Leesar MA. Jailing polymer jacketed guide-wires during bifurcation coronary interventions is associated with procedural myocardial infarction. World J Cardiol 2017; 9(5): 442-447 [PMID: 28603592 DOI: 10.4330/wjc.v9.i5.442]
Corresponding Author of This Article
Massoud A Leesar, MD, Division of Cardiovascular Disease, University of Alabama at Birmingham, 1520 3rd Ave S FOT 907, Birmingham, AL 35294, United States. mleesar@uabmc.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. May 26, 2017; 9(5): 442-447 Published online May 26, 2017. doi: 10.4330/wjc.v9.i5.442
Jailing polymer jacketed guide-wires during bifurcation coronary interventions is associated with procedural myocardial infarction
Arka Chatterjee, Jeremy S White, Taimoor Hashim, Massoud A Leesar
Arka Chatterjee, Taimoor Hashim, Massoud A Leesar, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 35294, United States
Jeremy S White, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, United States
Author contributions: Chatterjee A formulated the research question, designed the study, performed statistical analyses and wrote the manuscript; White JS and Hashim T were involved in individual chart reviews to extract data and verify accuracy; Leesar MA supervised the study as senior investigator.
Institutional review board statement: The Institutional Review Board of the University of Alabama at Birmingham approved the study.
Informed consent statement: The institutional Review Board of the University of Alabama at Birmingham waived the need for informed consent since this was a retrospective study using de-identified data only.
Conflict-of-interest statement: None of the authors have any disclosures/conflicts of interest pertaining to this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Massoud A Leesar, MD, Division of Cardiovascular Disease, University of Alabama at Birmingham, 1520 3rd Ave S FOT 907, Birmingham, AL 35294, United States. mleesar@uabmc.edu
Telephone: +1-205-9347898 Fax: +1-205-9340973
Received: October 28, 2016 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 Processing time: 203 Days and 22.8 Hours
Abstract
AIM
To study the relationship of jailed polymer jacketed guide wires (PGW) with procedural myocardial infarction (PMI) after bifurcation coronary interventions.
METHODS
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.
RESULTS
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).
CONCLUSION
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.
