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All Journal Indonesian Journal of Cardiology SCRIPTA SCORE Scientific Medical Journal Heart Science Journal Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED)
Ketaren, Andre Pasha
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The Relationship between Pre Discharge Left Ventricle Diastolic Dysfunction and 30 days And 6 Months Rehospitalization in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) at Haji Adam Malik General Hospital Medan Khaidirman, Sophia Khairina; Mukhtar, Zulfikri; Sarastri, Yuke; Ketaren, Andre Pasha; Raynaldo, Abdul Halim; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 5 (2023): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i5.33

Abstract

Introduction: Heart failure (HF) is a complex clinal manifestation that cause abnormality of structural and/or functional of the heart. HF is due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). The aim of this study is to assess the relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge and 6 months post discharge. Method: This is a cohort retrospective study in HFrEF patients which are treated at Pusat Jantung Terpadu RSUP H. Adam Malik Medan on January 2021 until December 2021. Pre discharge echocardiography has been done to assess LV diastolic dysfunction and the we do the follow up of readmission at 30 days and 6 months by phone. Results: From 93 patients, there are 40 patients (43%) with grade I LV diastolic dysfunction, 22 patients (23,7%) with grade II LV diastolic dysfunction and 31 patients (33,3%) with grade III LV diastolic dysfunction. There are 34 patients (26,6%) with readmission at 30 days and 21 patients (26,6%) readmission at 6 months. There is a significant relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge (p value 0,000), but not at 6 months post discharge (p value 1,000). Conclusion: Grading of pre-discharge LV diastolic dysfunction on HFrEF patient is correlated with readmission at 30 days post discharge.
Correlation Between Pursuit Score And Severity Of Coronary Artery Lesion Assessed by Syntax Score Among Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) Patients in Adam Malik Hospital Medan Indra, Ridho Kurnia; Ketaren, Andre Pasha; Putra, Hilfan Ade
Journal of Society Medicine Vol. 2 No. 8 (2023): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i8.80

Abstract

Introduction: The PURSUIT score is a practical risk score for patients with acute coronary syndromes to assess prognosis and risk stratification. Prognosis and revascularization options in patients with multivessel disease can be determined based on the severity of coronary lesions based on angiography. However, only a few studies have investigated the association of this score with coronary lesion severity. This research is aim to evaluate correlation between PURSUIT score and severity of coronary artery lesions assessed by SYNTAX score in patients with NSTEMI at H.Adam Malik General Hospital Medan. Method: This research was a cross-sectional study in which the sample was taken by consecutive sampling at H. Adam Malik General Hospital in Medan on 70 patients diagnosed with NSTEMI. The hypothesis was evaluated using Pearson's correlation test for normally distributed numerical data or Spearman's correlation test for abnormally distributed data. The p value of 0.05 indicates statistical significance. Results: Mean PURSUIT score in this research was 11.0 + 3.31, while mean SYNTAX score was 25.6 + 10.8. A positive correlation was found between the PURSUIT score and the SYNTAX score with a low strength level (r = 0.258). Conclusion: The PURSUIT score has a weak correlation in predicting the complexity of coronary angiography among NSTEMI patients
The Relationship between D-Dimer Levels and Coronary Lesion Severity in Patients with Acute Myocardial Infarction with ST-Segment Elevation at Haji Adam Malik Hospital Medan Rialdy, M. Isfan; Akbar, Nizam Zikri; Haykal, T. Bob; Ketaren, Andre Pasha; Andra, Cut Aryfa; Sarastri, Yuke
Journal of Society Medicine Vol. 2 No. 9 (2023): September
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.89

Abstract

Introduction: Acute coronary syndrome results from rupture or erosion of an atherosclerotic plaque. D-dimer is a direct marker of fibronolysis events and an indirect marker of hypercoagulable state associated with atherosclerotic plaque formation and acute coronary syndrome. The purpose of this study was to determine the relationship between D-dimer levels and the severity of coronary lesions in ST Elevation Myocardial Infarction patients at H. Adam Malik Hospital Medan. Method: This study was conducted with a cross-sectional method on 72 ST Elevation Myocardial Infarction patients at H. Adam Malik Medan Hospital who underwent coronary angiography from December 2022 to May 2023. Definition of ST Elevation Myocardial Infarction followed the definition of Universal Definition of Myocardial Infarction and the severity of coronary lesions was calculated based on syntax score. Data were analyzed univariately and bivariately using SPSS to assess the association of D-dimer levels with syntax score with p<0.05 considered statistically significant. Results: The total study subjects were 72 people with an average age of 56,5410,84years. Most of the study samples were male 56 people (77.8%). The median D-dimer level was 605 and mean syntax score 22.027 + 14.61. There is a significant relationship between D-dimer levels and the severity of coronary lesions based on the syntax score (p: <0.001). Conclusion: There is a significant relationship between D-dimer and severity of coronary lesions in patients with acute myocardial infarction with ST segment elevation at H. Adam Malik General Hospital, Medan.
Relationship between QTc interval prolongation and mortality of acute ischaemic stroke patients during treatment and three months after treatment at Adam Malik Hospital Lubis, Al-Ma’ Arij Akbar; Andra, Cut Aryfa; Ketaren, Andre Pasha
Journal of Society Medicine Vol. 3 No. 3 (2024): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i3.135

Abstract

Introduction: QTc interval prolongation is associated with an increased risk of mortality and incident cardiocerebrovascular disease in high-risk individuals and the general population. In addition, QTc interval prolongation in patients with acute stroke is associated with a significantly greater risk of death within 3 months. Based on the description in the background above, this study aims to determine how the relationship of QTc interval prolongation to mortality in acute ischaemic stroke patients during treatment and three months post-treatment at H. Adam Malik Hospital Medan. Method: This study was an analytical study with a case control research design to determine the relationship of QTc interval prolongation to mortality in acute ischaemic stroke patients during treatment and three months post-treatment at Adam Malik Hospital Medan. The research time was carried out in March 2023 by taking a sample of cases from January 2021 to December 2022. The association of QTc interval prolongation with mortality of acute ischaemic stroke patients during treatment and three months post-treatment was analysed by Chi-square test. The statistical significance threshold used was p < 0.05. Results: In patients who died, the mean QTc interval was 490 ms (453.0 - 547.0 ms). Comorbidities in this study included 27 (32.9%) patients with Type 2 DM, 42 (51.2%) patients with hypertension, 7 (16.6%) patients with chronic kidney disease, 13 (15.8%) patients with atrial fibrillation, 1 (1.21%) with pneumonia, and 1 (1.21%) with upper feeding tract bleeding (PSMBA). Conclusion: QTc interval prolongation is associated with mortality in acute ischaemic stroke patients during treatment and three months post-treatment at H. Adam Malik Hospital Medan
Hubungan Peak Left Atrial Longitudinal Strain dengan Derajat Keparahan Penyakit Jantung Katup Mitral di RSUP Haji Adam Malik Medan Ryanti, Dina; Ketaren, Andre Pasha; Mukhtar, Zulfikri; Akbar, Nizam Zikri; Lubis, Anggia Chairuddin; Ardini, Tengku Winda
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1541

Abstract

Introduction: Mitral stenosis and regurgitation, are common throughout the world. Peak Left Atrial Strain (PALS) is a parameter for assessing left atrial deformation in the evaluation of atrial function and a predictor of long-term outcome of various heart diseases. In this study, we assessed the relationship between PALS and the severity of mitral stenosis and mitral regurgitation Methods: This is a cross-sectional study on 119 subjects with mitral stenosis and 103 mitral regurgitation who met the inclusion criteria at Haji Adam Malik General Hospital. PALS measurements were taken. Data were analyzed univariate, bivariate, correlate to assess the relationship between PALS and the severity of mitral valve disease Results: 119 patients with severe mitral stenosis. In mitral stenosis, the mean PALS is 8.2 (4.9-22.8). PALS was significantly higher in patients with sinus rhythm than in the group with AF (10.29 ± 3.89 vs 8.63 ± 7.8%; P = 0.002). PALS had a significant correlation with MVA, pressure gradient, and PHT (r = 0.676, P = <0.001; r=-0.594, P= 0.001 and r=-0.594, P= 0.001). Whereas in mitral regurgitation, it has an average PALS of 15.2 (7.8-19.2). PALS was also significantly higher in patients with sinus rhythm than in the group with AF (16.36 ± 2.43 vs 11.64 ± 2.89%, P = 0.001). PALS has a correlation with VC, PISA, EROA and RVol (r = -0.533, P=0.001; r=-0.618; r=-0.563, P=0.001; r= -0.528, P=0.001). Conclusion: PALS has a significant correlation with the assessment of the severity of mitral stenosis and regurgitation.
Validasi Skor PEACH sebagai Prediktor Mortalitas Selama Rawatan Paska Operasi Penyakit Jantung Bawaan Pada Dewasa di Rumah Sakit Umum Pusat Haji Adam Malik Medan Zebua, Juang Idaman; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Hasan, Harris; Akbar, Nizam Zikri
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1546

Abstract

Introduction: Congenital heart disease (CHD) is an abnormality in the structure and function of the heart that is acquired while still intrauterine where the incidence of CHD worldwide is estimated at around 8 cases per 1,000 live births. Even though the development of the medical science is currently advanced, there are still CHD patients who are lately diagnosed and found when the patient is an adult so it requires surgical interventions. The PEACH score is a score that can predict postoperative in-hospital mortality in adults CHD patients. This study aims to validate the PEACH score. Methods: This is a retrospective cohort study of 52 adult patients with CHD who underwent surgery at Haji Adam Malik General Hospital from January 2019 to April 2023. Validation was analyzed using a calibration and discrimination test to the PEACH score in predicting postoperative in-hospital mortality. Result: The incidence of in-hospital mortality was 8 (15.4%) patients. There is a relationship between the PEACH score group and the incidence of mortality (p=0.006). The results of the calibration test using the Hosmer and Lameshow analysis and the discrimination test using the Receiver Operating Characteristic analysis showed good validation (p=0.85; AUC=0.83). Conclusion: The PEACH score is valid for predicting postoperative in-hospital mortality in adult congenital heart disease at Haji Adam Malik General Hospital.
A Correlational Study Elevated Risk of Cardiometabolic Illness and the Prevalence of Obstructive Sleep Apnea Among the Population of Tebing Tinggi, North Sumatra, Indonesia Raynaldo, Abdul Halim; Pase, Muhammad Aron; Ketaren, Andre Pasha
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 3 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i3.14330

Abstract

Background: Obstructive Sleep Apnea (OSA) is a prevalent sleep-related breathing issue, marked by repeated full or partial blockages of the upper airways. It's a primary respiratory condition that heightens the chances of cardiometabolic diseases. In our research, we explored the link between the increased risk of cardiometabolic ailments and the potential for OSA. Method: We studied 75 participants during community service activities and investigated the association between the high risk of cardiometabolic disease and the risk of OSA in the Society of Tebing Tinggi. We measured variables such as gender, age, weight, height, Body Mass Index (BMI), blood pressure, heart rate, random blood glucose, waist and neck circumference, and total cholesterol. Subsequently, we categorized the data and performed chi-square tests to analyze the associations between various factors and the risk of OSA. Variables with p<0.05 are considered eligible for multivariate analysis using binary logistic regression. Results: We identified 42 patients had a high risk of OSA (59.2%), while 33 patients had a low risk (40.8%). The study identified significant links between OSA risk and gender, age, blood pressure, and neck circumference (p-values <0.001, <0.001, and 0.01 respectively). In contrast, BMI, heart rate, glucose levels, waist size, and cholesterol did not show a significant connection to OSA risk. This indicates that while certain factors like gender, certain age groups, hypertension, and neck size are important in assessing OSA risk. However, BMI, heart rate, random blood glucose, waist circumference, and total cholesterol are not significant factors in determining the risk of OSA (p=0.2, p=0.4, p=0.2, p=0.1, p=0.9). Conclusions: Higher risk of cardiometabolic diseases (older age, gender, hypertension, neck size) was positively associated with the risk of OSA.
Early detection of subclinical rheumatic heart disease through echocardiographic screening: a study in North Sumatra, Indonesia Ardini, Tengku Winda; Ilyas, Kamal Kharazzi; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Napitupulu, Bertha Gabriella; Batubara, Gio Justisia; Sarastri, Yuke; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Siregar, Yasmine Fitrina; Dewita, Auliya; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.10

Abstract

BACKGROUND: Given the urgent need to address the significant morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is a growing interest in exploring cost-effective screening approaches, such as handheld echocardiography.OBJECTIVES: The purpose of this study was to ascertain the prevalence of RHD in North Sumatra, Indonesia.METHODS: This descriptive observational study was conducted within the population of North Sumatra from 2022 to 2023. Junior high school students aged 12 to 15 years were included from randomly selected schools in Langkat, Tebing Tinggi, and Labuhan Batu. Data collection encompassed various parameters, including social demographic information, parental characteristics, environmental factors, household details, anthropometric measurements, physical assessments, auscultation findings, and echocardiographic data. The data were analyzed descriptively.RESULTS: In our study, a total of 692 children were examined, with an average age of 12.9 years and a standard deviation of 1.1 years, among whom 42.5% were male. Utilizing echocardiographic evaluations, we identified RHD in four children, yielding a prevalence rate of 0.6%. Further examination of these cases revealed that the majority, accounting for three individuals (75%), exhibited borderline RHD, while one child (25%) presented with definite RHD.CONCLUSION: In our study population, the prevalence of RHD was 0.6%. A broader echocardiographic screening program is necessary to determine the overall prevalence of RHD, assess the disease burden, and identify individuals earlier to prevent adverse outcomes.
Alteration of Right Ventricular-Pulmonary Arterial Coupling Before and After Decongestion in Non-Preserved Fraction Acute Heart Failure Patients at Adam Malik Hospital Medan Brahmana, Andrew Timanta; Ketaren, Andre Pasha; Andra, Cut Aryfa; Lubis, Anggia Chairuddin; Haykal, Teuku Bob; Siregar, Yasmine Fitrina; Lubis, Hilfan Ade Putra; Purba, Joy Wulansari; Akbar, Nizam Zikri
Journal of Society Medicine Vol. 4 No. 1 (2025): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i1.190

Abstract

Objective: To assess whether there is right ventricular-pulmonary artery (RV-PA coupling by tricuspid annular plane systolic excursion/pulmonary artery systolic pressure TAPSE/PASP) changes in determining the clinical results of decongestion in patients with acute heart failure (AHF) with non-preserved ejection fraction (non-HFpEF) before and after decongestive at Adam Malik Hospital Medan. Methods: This study is an observational study with a prospective approach and consecutively collected, in patients AHF with non-HFpEF at Adam Malik Hospital Medan in the period from September 2023 until November 2024d. The sample is an eligible population that meets the inclusion and exclusion criterias. Results: This study consisted total 44 subjects with majority of 37 men (75%), an average age of 61 years old. A total of 28 subjects (63.6%) had hypertension as comorbid. There were 33 people (75%) who had sinus rhythm. The most acute heart failure phenotype commonly found was acute decompensated heart failure (ADHF) with 21 subjects. The longest length of stay AHF was cardiogenic shock with a median of 9 days. A significant decrease in median heart (p 0.0001), tricpuspid valve gradient (TVG) examination showed a significant decrease in (p 0.0001), PASP examination had a significant decrease in the average (p 0.0001), RV-PA coupling showed a significant increment (p 0.0001). A significant relationship was found between RV-PA coupling changes and decongestion in all acute heart failure groups (p 0.005). No significant relationship between RV-PA coupling ratio with length of stay was found. Conclusion: There were differences found in RV-PA coupling as increment with significant value in complete and partial decongestion groups, with a RV-PA coupling cut-off value of 0.65 and sensitivity and specificity of 68.8% and 67.9%, respectively.
Relationship Between Left Atrium Reservoir Strain and One-Year Mortality After Surgery in Patients with Severe Primary Mitral Regurgitation Undergoing Mitral Valve Replacement at Haji Adam Malik General Hospital, Medan Abimanyu, Roni; Ketaren, Andre Pasha; Nasution, Ali Nafiah
Journal of Society Medicine Vol. 4 No. 2 (2025): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i2.200

Abstract

Introduction: Severe primary Mitral Regurgitation (MR) is a public health program that continues to grow. Echocardiography is still a tool to assess the severity and prognostic of mitral valve disease. LASr assessment has the benefit of assessing the prognostic in patients who have undergone mitral valve replacement surgery. This study aimed to determine the relationship between LASr and mortality one year after surgery for severe primary MR undergoing valve replacement surgery Methods: This study is an analytic study with a cross-sectional design on 55 subjects with severe primary MR who met the inclusion and exclusion criteria at Haji Adam Malik General Hospital. LASr was measured before surgery and followed by the incidence of mortality one year after mitral valve replacement surgery. Data were analyzed univarite and bivariate as well by correlation tests to assess the relationship between LASr and one-year mortality in severe primary MR undergoing valve replacement surgery Results: The study subject totaled 55 patients with an average age of 39,35 ± 12,59 years, 28 patients (50.9%) were male and 11 patients (20%) experienced mortality. The main cause of mitral valve abnormalities in this study was rheumatic, namely 39 cases (70.9%). The LASr threshold value was found to be 18.8 (sensitivity: 90.9%; specificity: 70.5%). (AUC: 0.851; P = 0.0001 and 95% CI (0.751 – 0.952). Conclusion: LASr has a significant correlation to predict one-year mortality in patients with severe primary mitral regurgitation undergoing mitral valve replacement surgery.
Co-Authors Abimanyu, Roni Akbar, Nizam Zikri Andra, Cut Aryfa Ardini, Tengku Winda Batubara, Gio Justisia Brahmana, Andrew Timanta Dewita, Auliya Hasan, Harris Hasan, Refli Haykal, T. Bob Ilyas, Kamal Kharazzi Ilyas, Kamal Kharrazi Indra, Ridho Kurnia Khaidirman, Sophia Khairina Lubis, Al-Ma’ Arij Akbar Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Marpaung, Ayesha Nazira Mukhtar, Zulfikri Napitupulu, Bertha Gabriella Nasution, Ali Nafiah Pase, Muhammad Aron Purba, Joy Wulansari Putra, Hilfan Ade Putra, Muhammad Hafiz Mahruzza Raynaldo, Abdul Halim Rialdy, M. Isfan RIZA RIVANY, RIZA Ryanti, Dina Sarastri, Yuke Siregar, Abdullah Afif Sitepu, Andika Teuku Bob Haykal Tina Christina L. Tobing, Tina Christina L. Yasmine Fitrina Siregar Zebua, Juang Idaman