Circumstances and mode of in-hospital death following 9,914 consecutive patients undergoing percutaneous coronary interventions in the northwest of England.

AIM: To better describe the epidemiological causes of in-hospital death after percutaneous coronary intervention (PCI) in the present stent era. METHODS: Systematic review of all in-hospital deaths following PCI in North West England from 2001 to 2003. Sixty-two in-hospital deaths (0.6%) were identified from 9,914 consecutive PCIs performed during the study period. The medical records of 4 patients were missing, leaving 58 patients to be reviewed with a standard data extraction tool to determine a circumstance and a mode of death. Medical records were reviewed at each center and cases were discussed at regional consensus meetings. All the collected data were validated by random cross-checking of data by exchange site visits. Multivariate logistic regression was used to identify risk factors for deaths related to procedural complications. RESULTS: Low output failure was the most common mode of death, occurring in 42 patients (72.4%). The circumstance of death was a procedural complication in 35 patients (60.3%), and preexisting acute cardiac disease in 23 patients (39.7%). Significant predictors of death from procedural complications were treatment of left main stem (odds ratio [OR] 13.8; p < 0.001) or graft lesions (OR 5.6; p < 0.001), and female sex (OR 3.0; p = 0.002). CONCLUSIONS: Procedural complications account for over half of all post-PCI deaths. We have identified several risk factors that may help reduce the number of deaths related to procedural complications.

Plastic and moldable metals by self-assembly of sticky nanoparticle aggregates.

Deformable, spherical aggregates of metal nanoparticles connected by long-chain dithiol ligands self-assemble into nanostructured materials of macroscopic dimensions. These materials are plastic and moldable against arbitrarily shaped masters and can be thermally hardened into polycrystalline metal structures of controllable porosity. In addition, in both plastic and hardened states, the assemblies are electrically conductive and exhibit Ohmic characteristics down to approximately 20 volts per meter. The self-assembly method leading to such materials is applicable both to pure metals and to bimetallic structures of various elemental compositions.