Outcome of Stable Patients With Acute Myocardial Infarction and Coronary Artery Bypass Surgery Within 48 Hours: A Single-Center, Retrospective Experience.

BACKGROUND: The optimal timing of coronary artery bypass grafting (CABG) in clinically stable patients with acute myocardial infarction who are unsuitable for percutaneous coronary intervention is unclear. We report our experience with early CABG in these patients. METHODS AND RESULTS: Between January 2001 and May 2015, 766 patients with ST-segment-elevation myocardial infarction (STEMI, n=305) or non-STEMI (NSTEMI, n=461) not including cardiogenic shock underwent CABG within 48 hours at our department. STEMI patients were younger than non-STEMI patients (age 65 years [range: 58-72] versus 70 years [range: 62-75], P<0.001) with a lower EuroSCORE II (4.12 [range: 2.75-5.81] versus 4.58 [range: 2.80-7.74], P=0.009). STEMI patients had undergone preoperative percutaneous coronary intervention more often (20.3% versus 7.8%, P<0.001). Time to surgery was shorter in STEMI compared with non-STEMI patients (5.0 hours [range: 3.2-8.8] versus 11.7 hours [range: 6.4-22.0], P<0.001). No significant differences concerning arterial graft use (93.8% versus 94.8%, P=0.540) or complete revascularization (87.5% versus 83.4%, P=0.121) were observed. The rate of strokes did not differ between the groups (2.0% versus 3.9%, P=0.134). Thirty-day mortality was lower in STEMI patients (2.7% versus 6.6% P=0.018), especially when CABG was performed within 6 hours (1.8% versus 7.1%, P=0.041). Survival of STEMI and non-STEMI patients was 94% versus 88% after 1 year (P<0.001), 87% versus 73% after 5 years (P<0.001), and 74% versus 57% after 10 years (P<0.001). Independent predictors of 30-day and long-term mortality included preoperatively increased lactate values, age, atrial fibrillation, and reduced left ventricular function. CONCLUSIONS: Stable STEMI patients showed a lower rate of perioperative complications and better survival compared with non-STEMI patients when CABG was performed within 48 hours.

Lattice symmetries and the topologically protected transport of colloidal particles.

The topologically protected transport of colloidal particles on top of periodic magnetic patterns is studied experimentally, theoretically, and with computer simulations. To uncover the interplay between topology and symmetry we use patterns of all possible two dimensional magnetic point group symmetries with equal lengths lattice vectors. Transport of colloids is achieved by modulating the potential with external, homogeneous but time dependent magnetic fields. The modulation loops can be classified into topologically distinct classes. All loops falling into the same class cause motion in the same direction, making the transport robust against internal and external perturbations. We show that the lattice symmetry has a profound influence on the transport modes, the accessibility of transport networks, and the individual transport directions of paramagnetic and diamagnetic colloidal particles. We show how the transport of colloidal particles above a two fold symmetric stripe pattern changes from universal adiabatic transport at large elevations via a topologically protected ratchet motion at intermediate elevations toward a non-transport regime at low elevations. Transport above four-fold symmetric patterns is closely related to the two-fold symmetric case. The three-fold symmetric case however consists of a whole family of patterns that continuously vary with a phase variable. We show how this family can be divided into two topologically distinct classes supporting different transport modes and being protected by proper and improper six fold symmetries. We discuss and experimentally demonstrate the topological transition between both classes. All three-fold symmetric patterns support independent transport directions of paramagnetic and diamagnetic particles. The similarities and the differences in the lattice symmetry protected transport of classical over-damped colloidal particles versus the topologically protected transport in quantum mechanical systems are emphasized.

Defect Dynamics in Artificial Colloidal Ice: Real-Time Observation, Manipulation, and Logic Gate.

We study the defect dynamics in a colloidal spin ice system realized by filling a square lattice of topographic double well islands with repulsively interacting magnetic colloids. We focus on the contraction of defects in the ground state, and contraction or expansion in a metastable biased state. Combining real-time experiments with simulations, we prove that these defects behave like emergent topological monopoles obeying a Coulomb law with an additional line tension. We further show how to realize a completely resettable "nor" gate, which provides guidelines for fabrication of nanoscale logic devices based on the motion of topological magnetic monopoles.

Topological protection of multiparticle dissipative transport.

Topological protection allows robust transport of localized phenomena such as quantum information, solitons and dislocations. The transport can be either dissipative or non-dissipative. Here, we experimentally demonstrate and theoretically explain the topologically protected dissipative motion of colloidal particles above a periodic hexagonal magnetic pattern. By driving the system with periodic modulation loops of an external and spatially homogeneous magnetic field, we achieve total control over the motion of diamagnetic and paramagnetic colloids. We can transport simultaneously and independently each type of colloid along any of the six crystallographic directions of the pattern via adiabatic or deterministic ratchet motion. Both types of motion are topologically protected. As an application, we implement an automatic topologically protected quality control of a chemical reaction between functionalized colloids. Our results are relevant to other systems with the same symmetry.

Magnetic guidance of the magnetotactic bacterium Magnetospirillum gryphiswaldense.

Magnetospirillum gryphiswaldense is a magnetotactic bacterium with a permanent magnetic moment capable of swimming using two bipolarly located flagella. In their natural environment these bacteria swim along the field lines of the homogeneous geomagnetic field in a typical run and reversal pattern and thereby create non-differentiable trajectories with sharp edges. In the current work we nevertheless achieve stable guidance along curved lines of mechanical instability by using a heterogeneous magnetic field of a garnet film. The successful guidance of the bacteria depends on the right balance between motility and the magnetic moment of the magnetosome chain.