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.