Beyond ß-Blockade: ACE Inhibitors Reduce Non-Cardiac Mortality in High Killip Grade AMI Patients.

OBJECTIVE: This study evaluates the 3-year clinical outcomes of high Killip grade (III/IV) acute myocardial infarction (AMI) patients treated with either ß-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI) or BB and angiotensin receptor blockers (ARB). METHODS: A total of 13,105 patients were registered at the Korea Acute Myocardial Infarction Registry at the National Institute of Health (KAMIR-NIH). Among them, 871 patients with high Killip classification AMI were divided into the BB + ACEI group (n = 489) and the BB + ARB group (n = 381). Following propensity score matching, 343 patients were selected in each group. All patients completed a 3-year follow-up period. RESULTS: The results indicate no significant differences between the BB + ACEI group and BB + ARB group in terms of cardiac death, recurrent myocardial infarction, and the rate of repeat percutaneous coronary intervention. However, the BB + ACEI group exhibited significantly lower risks in major adverse cardiac events (HR = 0.574, 95% CI: 0.421-0.783, p < .001), all-cause mortality (HR = 0.561, 95% CI: 0.404-0.778, p = .001), and non-cardiac death (HR = 0.365, 95% CI: 0.208-0.639, p < .001) compared to the BB + ARB group. CONCLUSION: Our results suggest that BB + ACEI treatment is more beneficial than BB + ARB for high Killip grade AMI patients. Additionally, the BB + ACEI group has a superior preventative effect on mortality compared to the BB + ARB group.

Hollow microsphere probes formed by hollow core optical fiber discharging for monitoring gas pressure and temperature.

A hollow core fiber (HCF) is spliced with a single-mode fiber, and then, the end face of the HCF is etched to form a microsphere interferometer for measuring gas pressure and environmental temperature. The total length of each microsphere is less than 200 µm. We fabricated two such structures and used femtosecond laser pulses to drill micro-holes on the HCF walls of both structures. One of the structures is directly used to measure air pressure, achieving a sensitivity of up to 2.857 nm/MPa while being almost insensitive to temperature. This structure is capable of assessing pressure down to 3.4 kPa within the range of 0-0.5 MPa. Another structure is filled with thermally sensitive material dimethyl silicone oil through a micro-hole, and then, it is sealed with AB adhesive to form a harmonic Vernier effect temperature sensor, with a sensitivity of up to -5.16 nm/°C. This structure is capable of assessing temperature down to 0.38 °C within the range of 30-60 °C. Additionally, the sensors have good repeatability and stability and compact structure and simple manufacturing and can be used as a sensing probe for monitoring gas pressure and temperature under extreme environments.