Primary percutaneous coronary intervention in CAD patients: A comparison of major adverse cardiovascular events of second- and third-generation drug-eluting stents.

Background: Biodegradable polymer (BP) drug-eluting stents (DES) have been introduced as a novel solution to the problems of durable polymer (DP) stents. In Pakistan, very few studies are available for the treatment intervention in post-primary percutaneous coronary intervention (PPCI) patients. Our study will compare the major adverse cardiovascular events (MACEs) and their predictors in patients with coronary artery disease (CAD) undergoing PPCI with second- or third-generation DES. Methodology: An observational, retrospective, cohort study was carried out on CAD patients undergoing PPCI with either second- (DP-XIENCE Prime/XIENCE Xpedition) or third-generation (BP-BioMatrix NeoFlex/BioMatrix Alpha) DES. MACEs were assessed after 1 year of PPCI procedure in 341 patients and screened as per inclusion/exclusion criteria (167 in the second-generation group and 174 in the third-generation group). Results: The number of male patients (86.2%) was more than female patients in our study population. MACEs were reported in 4.19% patients after 1 year duration, and the percentage of MACEs was more in the second-generation DES group (4.77%) than in the third-generation group (3.44%); however, statistical analysis has not found any significant difference (p = 0.534). The rate of myocardial infarction (1.19% vs. 0.57%) and stent thrombosis (1.8% vs. 1.15%) was more in the second-generation DES group. However, restenosis (1.19% vs. 1.15%) and cardiac death (0.59% vs. 0.57%) were almost same in both groups. A significant association was found between MACEs and diabetes mellitus (p = 0.025), hypertension (p = 0.035), smoking (p = 0.008), and a family history of CAD (p = 0.018). Conclusion: BP-BioMatrix and DP-XIENCE DES have comparable clinical outcomes. Findings of the current study will assist the policy makers and healthcare providers in the rationalization of scarce resources and evidence-based patient care. However, longer follow-up studies are required for convincing results.

Synergetic adhesion in highly adaptable bio-inspired adhesive.

Biologically inspired adhesives microstructure requires enough flexibility to make a conformal attachment to the surface as well as high rigidity to maintain the mechanical stability of structure against buckling. To tackle these conflicting factors for the synthetic adhesives is a challenge towards large-scale production and utilizing in practical applications. Addressing this problem, we have fabricated a honeycomb structure with a soft elastic film, partially covering the cavity of the honeycomb pattern. Honeycomb structure provides enough support to maintain the structural stability of the microstructure and soft PDMS film over the pattern provides sufficient flexibility to form a strong attachment with the target surface. Meanwhile, the resemblance of the designed structure to the octopi's sucker generates a negative pressure resulting in suction forces. To justify this suction effect, we compared our results with other controlled honeycomb microstructures (1) without any elastic film (2) with elastic film covering the whole cavity of the honeycomb pattern. Experimental results and theoretical prediction demonstrate the synergistic role of van der Waals and suction forces in the proposed partial-film honeycomb microstructure. The synergistic role of adhesive forces makes this structure a stronger, durable, and surface adaptable adhesive. We also investigated the critical role of the viscous forces for our proposed microstructure in water and silicon oil wetting conditions which signify the contribution of capillary forces.

Biomimetic Patch with Wicking-Breathable and Multi-mechanism Adhesion for Bioelectrical Signal Monitoring.

Wearable bioelectrical monitoring devices can provide long-term human health information such as electrocardiogram and other physiological signals. It is a crucial part of the remote medical system. These can provide prediction for the diagnosis and treatment of cardiovascular disease and access to timely treatment. However, the patch comfort of the wearable monitoring devices in long-term contact with the skin have been a technical bottleneck of the hardware. In this study, the biomimetic patch with wicking-breathable and multi-mechanism adhesion performance to achieve adaptability and comfortability to human skin has been reported. The patch was designed based on a conical through-hole and hexagonal microgroove to directionally transport sweat from skin to air which gives the patch the breathable performance. The breathable and drainage capability of the biomimetic patch was experimentally verified by analyzing the conical through-hole and hexagonal microgroove with the structural mechanism of wicking. Multi-mechanism adhesion of the Ag/Ni microneedle array and PDMS-t adhesion material ensures the stability of patch signal acquisition. This study provides a new way for enhancing the breathability and adaptability of the patch to realize accurate bioelectrical signal monitoring under sweat conditions on human skin.