Multiple cardiovascular comorbidities and acute myocardial infarction: temporal trends (1990–2007) and impact on death rates at 30 days and 1 year

BACKGROUND: The objectives of this community-based study were to examine the overall and changing (1990-2007) frequency and impact on 30-day and 1-year death rates from multiple cardiovascular comorbidities in adults from a large central New England metropolitan area hospitalized with acute myocardial infarction (AMI). METHODS: The study population consisted of 9581 patients hospitalized with AMI at all 11 medical centers in the metropolitan area of Worcester, MA, during 10 annual periods between 1990 and 2007. The comorbidities examined included atrial fibrillation, diabetes, heart failure, hypertension, and stroke. RESULTS: Thirty-five percent of participants had a single diagnosed cardiovascular comorbidity, 25% had two, 12% had three, and 5% had four or more comorbidities. Between 1990 and 2007, the proportion of patients without any of these comorbidities decreased significantly, while the proportion of patients with multiple comorbidities increased significantly during the years under study. An increasing number of comorbidities was associated with higher 30-day and 1-year postadmission death rates in patients hospitalized with AMI. CONCLUSION: Patients hospitalized with AMI carry a significant burden of comorbid cardiovascular disease that adversely impacts their 30-day and longer-term survival. Increased attention to the management of AMI patients with multiple cardiovascular comorbidities is warranted

Rapid formation of regulated methacrylate networks yielding tough materials for lithography-based 3D printing

Multifunctional methacrylates are highly reactive monomers for radical photopolymerization, but yield brittle materials due to their inhomogeneous and highly crosslinked network architecture. Addition fragmentation chain transfer (AFCT) reagents serve as additives for the regulation of radical network formation and pave the way to photopolymer networks with high toughness. However, AFCT reagents (e.g. β-allyl sulfones) tend to have a negative influence on the reaction speed which limits them for lithography-based 3D fabrication. Vinyl sulfone esters are described as a new class of AFCT reagents for methacrylate-based photopolymerization without the drawback of retardation but good regulation of network architecture. The resulting materials show high network homogeneity, low shrinkage stress, and a significant increase in C[double bond, length as m-dash]C double bond conversion and toughness. This promises great potential for vinyl sulfone esters as AFCT reagents in photopolymer applications. First 3D parts have been successfully fabricated via digital light processing.