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All Journal Medical Journal of Indonesia Indonesian Journal of Cardiology Cardiovascular and Cardiometabolic Journal (CCJ) Narra J Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED)
Hasan, Harris
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Association of Triglyceride/High Density Lipoprotein Cholesterol Ratio and Coronary Lesion Severity in Acute Myocardial Infarction Patients at Adam Malik Hospital, Medan Sinaga, Akbar; Hasan, Refli; Reynaldo, Abdul Halim; Hasan, Harris; Akbar, Nizam Zikri; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 3 (2023): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i3.30

Abstract

Introduction: Coronary heart disease is the leading cause of worldwide death. A number of markers have been identified in terms of the atherogenic potential of the lipid profile.The TG/HDL-C ratio is an easy and economical non-invasive examination method as a predictor of coronary heart disease severity. The aim of this study is to assess the relationship of the TG/HDL ratio with the severity of coronary lesions. Method: This cross-sectional study included 53 acute myocardial infarction patients undergoing coronary angiography. Exclusion criteria include (1)AMI patients receiving fibrinolytic therapy, (2) Patients who have routinely consumed lipid lowering drug for 6 weeks,(3) Incomplete coronary angiography and medical records. The TG/HDL ratio is the result of dividing the triglyceride value by HDL. The TG/HDL ratio was divided into 2 groups, namely the TG/HDL ratio <4 group and the TG/HDL ratio >4 group. The severity of coronary lesions was described by the SYNTAX score, which was divided into two: the low SYNTAX score group (≤22) and patients with a low SYNTAX score (≤22) and medium-high SYNTAX score (≥23). Bivariate analysis was performed to find the relationship between the TG/HDL ratio and the SYNTAX score. The value of p<0.05 was considered statistically significant. Results: From 53 patients, 26 patients (49.1%) had a SYNTAX score ≥ 23 and 27 patients (50.9%) had a SYNTAX score < 23. Patients with NSTEMI, DM risk factors, and obesity were higher in the SYNTAX score group ≥23. From the results of statistical analysis, there was a significant relationship between the TG/HDL ratio with coronary lesion severity (p = 0,004). Conclusion: Enhancement of TG/HDL ratio is correlated with coronary lesion severity in acute myocardial infarction patients using the SYNTAX score.
The Relationship Between Serum Apolipoprotein B Levels and Severity of Coronary Lesions Using The Syntax Score in Non-St Segment Elevation Acute Myocardial Infarction Patients at Haji Adam Malik General Hospital Medan Kesumawardani, Enggar Sari; Safri, Zainal; Hasan, Harris; Hasan, Refli; Andra, Cut Aryfa; Ardini, Tengku Winda
Journal of Society Medicine Vol. 2 No. 4 (2023): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i4.32

Abstract

Introduction: Acute coronary syndrome mainly occurs as a result of plaque rupture of atherosclerosis. Apolipoprotein B (apoB) is a large glycoprotein, playing a role in lipoprotein metabolism and human lipid transport reflecting the number of circulating atherogenic particles. The purpose of this study was to assess the relationship of serum apoB levels with coronary lesion severity. Method: This is a cross-sectional study involving patients who was diagnosed with Non-ST Elevation Myocardial Infarction (NSTEMI) who underwent coronary angiography in November 2021 to July 2022. The NSTEMI criteria follow the Universal Definition of Myocardial Infarction and coronary severity is assessed using a SYNTAX score. Bivariate analysis was conducted looking for the relationship between apoB with SYNTAX scores with p<0.05 considered statistically significant. Results: The subjects of the study is 70 people, dominated by male 50 patients (71.4%). The median age of the subjects was 56 (38-77) years. Median levels of apoB was 107 (32-150) mg/dL. The average SYNTAX score was 25.66 ± 10.83. Using the Pearson correlation test, it was shown that there is a significant correlation between apoB and coronary lesion severity obtained r=0.442 (p<0.001). Conclusion: There is a significant correlation between apoB and coronary lesion severity using SYNTAX scores in NSTEMI patients.
The Relationship Between Aerobic Physical Exercise to Functional Capacity in Heart Failure Patients at Haji Adam Malik General Hospital Medan Khairunnisah, Dina; Hasan, Harris; Reynaldo, Abdul Halim; Haykal, Teuku Bob; 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.v2i9.87

Abstract

Introduction: The prevalence of heart failure is known to increase day by day, as well as the incidence of rehospitalization and death. One way that can be done is to optimize health status and perform cardiac rehabilitation. Aerobic exercise is recommended for patients with heart failure. Aerobic exercise has been shown to increase functional capacity in patient with heart failure. The aim of this study is to assess the relationship between aerobic exercise with functional capacity improvement in patient with heart failure in Haji Adam Malik General Hospital, Medan. Method: This study was conducted using prospective cohort method on 35 patients with heart failure in a cardiac rehabilitation program at Haji Adam Malik General Hospital, Medan. Functional capacity and 6-Minute Walk Test (6MWT) data were collected before and after aerobic exercise. Univariate and bivariate data analysis were performed using SPSS. Results: 35 samples were included in this study, with an average age of 54,57±1,28 years and dominated by male. The result showed an increase in distance after aerobic exercise program compared to the initial examination (373,6±133,64 vs 192,57±64,68) with p-value <0,001. There was an increase in functional capacity from 3,55±1,12 MET to 6,6±2,44 MET after aerobic exercise (P<0,001). Conclusion: There is a significant relationship between aerobic exercise and functional capacity improvement in patients with heart failure at Haji Adam Malik General Hospital, Medan.
The Relationship between LDL/ HDL Ratio and Coronary Lesion Severity Measured by Syntax Score in Patients with Non-Elevation Acute Myocardial Infarction at Hajj Adam Malik General Hospital, Medan Hashmi, T. Rifqi; Hasan, Harris; Lubis, Hilfan Ade Putra
Journal of Society Medicine Vol. 3 No. 5 (2024): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.146

Abstract

Introduction: Coronary artery disease (CAD), results from reduced myocardial perfusion leading to angina, myocardial infarction (MI), and/or heart failure. It accounts for one third to one half of cardiovascular cases. A higher SYNTAX score indicates a more complex condition and poorer prognosis in patients undergoing coronary revascularization especially with PCI. This study aims to determine how the LDL/HDL ratio relates to the complexity of coronary lesions (Syntax Score) in coronary heart disease based on characteristics. Methods: The type of this study was observational analytic retrospective with a cross sectional design. The study was conducted using secondary data through medical record data of patients diagnosed with NSTEMI. Results: The subjects were 60 people with an average age of  58,1±8,629. It was found that the mean value of the LDL/HDL ratio was 3,95±3,837, in patients with an LDL/HDL ratio ≥ 2.517 it was found that there were 40 sample(66.7%) of whom had a lesion severity level of Syntax score ≥23 ,27 samples (45%), and in patients with an LDL/HDL ratio < 2.517, 20 samples (33.3%) were found to have a lesion severity level of Syntax score ≥ 23 with 4 samples (6.7%). Conclusion: There is a relationship between the LDL/HDL ratio and the severity of CAD based on the Syntax score with LDL/HDL ratio values being higher in patients with moderate-severe CAD than in patients with mild CAD.
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.
Relationship of left ventricular diastolic dysfunction with quality of life in heart failure patients with reduced ejection fraction (HFrEF) Khaidirman, Sophia K.; Hasan, Harris; Andra, Cut A.; Lubis, Hilfan AP.; Dangana, Amos; Haykal, T. Bob
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.707

Abstract

Heart failure is a complex clinical manifestation due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). Diastolic dysfunction of the LV plays an important role in worsening the quality of life (QoL) in heart failure patients. The aim of this study was to assess the relationship between the severity or grade of LV diastolic dysfunction and QoL in heart failure with reduced ejection fraction (HFrEF) patients. A retrospective cohort study was conducted at the Cardiac Center of H. Adam Malik Hospital, Medan, Indonesia, from January 2022 to December 2022. This study included inpatients and outpatients aged above 18 years who were diagnosed with HFrEF, identified by echocardiography with an ejection fraction of ≤40%. Echocardiography was performed to evaluate left ventricular diastolic dysfunction, and QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6–12 months after the severity of LV diastolic dysfunction was confirmed. The MLHFQ was classified into good and poor QoL. The severity of LV diastolic function was measured using the E/A ratio, mean E/e' ratio, tricuspid regurgitation velocity (TR Vmax), and left atrial volume index (LAVI), and was classified into grades I, II, and III. The relationships between the severity of diastolic dysfunction and other factors with QoL were measured using Chi-squared, Fisher's exact test, or Mann-Whitney test, as appropriate. A total of 96 patients were included in the study, of which 56 (58.3%) patients had grade I, 12 (12.5%) had grade II, and 28 (29.2%) patients had grade III of LV diastolic dysfunction. There were 77 (80.2%) and 19 (19.8%) patients with good and poor QoL, respectively. This study revealed a significant relationship between the severity of LV diastolic dysfunction and QoL in HFrEF patients with p=0.040. In conclusion, the degree of LV diastolic dysfunction is related to the QoL of HFrEF patients and therefore better comprehensive management strategies should be considered in HFrEF cases to address the impact of LV diastolic dysfunction on QoL.
Acute Kidney Injury as Predictor of Major Adverse Cardiac Event (MACE) in 3 Months after Admission of Acute Heart Failure Patients in Haji Adam Malik General Hospital Medan Chan, Muhammad Ikhsan; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Hasan, Harris; Sarastri, Yuke; Sitepu, Andika
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 5 No. 2 (2024): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v5i02.2024.82-94

Abstract

Highlights: 1. This study provides novel evidence that acute kidney injury (AKI) is a strong predictor of major adverse cardiovascular events (MACE) in patients with acute heart failure, highlighting the critical need for early detection and intervention to improve outcomes. 2. This research underscores the importance of incorporating kidney function assessment into the comprehensive management of acute heart failure patients. - Background: Acute heart failure is a condition with high morbidity and mortality. Decreased renal function after hospitalization is a predictor of longer hospitalization and increased mortality. Patients with acute renal failure, especially injury or failure grade, have a worse long-term prognosis compared to patients without acute renal failure, which will lead to MACE. Major adverse cardiovascular events are a combination of non-fatal stroke, non-fatal myocardial infarction, or cardiovascular death. Material and Methods: This study was a retrospective cohort study of 159 patients with acute heart failure at HAM General Hospital from April 1, 2023 to December 31, 2023. Electrocardiographic, laboratory, and echocardiographic data were collected. Patients were categorized according to RIFLE classification and monitored to see MACE in the samples. Bivariate tests were performed to see the correlation between samples. Furthermore, Kaplan-Meier curves were analyzed to see the survival rate. Results: Total subjects were 159 patients consisting of 98 acute heart failure patients with AKI and 61 heart failure patients without AKI. There was a correlation between heart failure patients who developed acute renal failure and the number of days of hospitalization (p = 0.000), in hospital mortality (p = 0.002), rehospitalization in less than 3 months (p = 0.000), and mortality in less than 3 months (p = 0.001). Conclusion: Acute kidney injury has a correlation with MACE so that it can be a predictor of major cardiovascular events in patients with acute heart failure.
The Relationship Between Platelet and Lymphocyte Ratios and Left Atrial Thrombus Formation in Patients with Severe Mitral Stenosis due to Rheumatic Heart Disease at Haji Adam Malik Hospital Medan Ramzi, Defriyan; Hasan, Harris; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.205

Abstract

Introduction: Rheumatic heart disease is an immune disease condition that often causes damage to the structure of the heart valves, such as mitral stenosis. One of the complications of severe mitral stenosis is thrombus in the left atrium. This condition is closely related to inflammation, so inflammatory cells such as lymphocytes and platelets are closely related to their severity and complications. Therefore, this study aims to see the ability of mitral platelet and lymphocyte ratios to the incidence of left atrial thrombus. Methods: This study is an analytical descriptive study with a cross-sectional research design, conducted at the Integrated Heart Center of Haji Adam Malik Hospital, from November 2024. The parameters of echocardiography, blood laboratory, as well as thrombus in the left atrium data were acquired. A statistical analysis test will be was done to assess the difference in the average ratio of platelets and lymphocytes based on the presence of thrombus in the left atrium, as well as the ability of the predictor of the ratio. Statistical analysis was carried out using SPSS software, a P value of < 0.05 was considered significant. Results: There are a total of 175 samples in this study. A total of 45 (25.7%) of the sample had thrombus in the left atrium. The median value and interquartile range of the Platelet/Lymphocyte Ratio (PLR) were higher in the thrombus group in the left atrium compared to the group without thrombus in the left atrium (P = 0.0001). The ROC curve analysis showed PLR parameters, with P = 0.0001, AUC 0.713, and 95% CI 0.620 – 0.806. The threshold value of PLR 132.5 has a sensitivity of 71.1% and a specificity of 61.0% has the ability to predict the presence of thrombus in the left atrium. Conclusion: The PLR ratio has a significant association with the occurrence of thrombus in the left atrium, in the condition of severe mitral stenosis due to rheumatic heart disease
Relationship between Coronary Artery Calcium Score (CACS) and Diastolic Dysfunction in Patients with Stable Coronary Heart Disease at Adam Malik General Hospital Medan Putra, Muhammad Hafiz Mahruzza; Hasan, Refli; Sitepu, Andika; Hasan, Harris; Ketaren, Andre Pasha; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.221

Abstract

Introduction: Coronary artery calcium score (CACS) is a specific indicator of coronary atherosclerosis that plays a role in assessing the degree of calcification in atherosclerosis. Diastolic function is the first aspect of cardiac function to be impaired in ischemic heart disease. This study aims to determine the relationship between calcium scoring and diastolic dysfunction. Methods: This analytical observational study with cross-sectional design evaluated the relationship between coronary artery calcium score (CACS) and left ventricular diastolic function in patients with stable CAD. Data were collected retrospectively from medical records at RSUP H. Adam Malik Medan during Nov 2023-Nov 2024. CACS was assessed using coronary CT scan, while left ventricular diastolic function was measured by echocardiography. Data analysis used chi-square test, Mann-Whitney U test, and ROC curve analysis to evaluate CACS threshold in predicting diastolic dysfunction. Results: Among 158 analyzed samples, 113 patients had diastolic dysfunction. A calcium score ≥100 was found in 46.2% of patients, showing 1.318 times higher risk of diastolic dysfunction versus those with scores <100 (p = 0.006; 95% CI 1.083–1.605). ROC analysis showed CACS had moderate predictive ability for diastolic dysfunction with AUC of 0.647 (p = 0.004). A calcium score threshold of 45 had 65.5% sensitivity and 62.2% specificity in detecting diastolic dysfunction. Type 2 diabetes mellitus, urea, and creatinine levels were also significantly associated with diastolic dysfunction (p < 0.05). Conclusion: Calcium score shows a significant relationship with diastolic dysfunction in stable CAD patients and can predict diastolic dysfunction in patients undergoing coronary CT scan.
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Co-Authors Akbar, Nizam Zikri Ambari, Ade Meidian Anandini, Hesti Andra, Cut A. Andra, Cut Aryfa Anggoro Budi Hartopo Anggraeni, Vita Yanti Ardini, Tengku Winda Arityanti, Dean Badai Bhatara Tiksnadi Chan, Muhammad Ikhsan Cholid Tri Tjahjono Dangana, Amos Desandri, Dwita Rian Dwiputra, Bambang Erwan, Nabila Erina Faisal Adam, Faisal Febrianora, Mega Ferhat, Muhammad Fitra, Maha Hasan, Refli Hashmi, T. Rifqi Haykal, T. Bob Hergaf, Indah Widyasari Ilyas, Kamal Kharrazi Irsad Andi Arso, Irsad Andi Kesumawardani, Enggar Sari Ketaren, Andre Pasha Khaidirman, Sophia K. Khairunnisah, Dina Krevani, Citra Kiki Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Lubis, Hilfan AP. Makes, Indira Kalyana Muhammad Ridwan Mukhtar, Zulfikri Nasution, Ali Nafiah Putra, Muhammad Hafiz Mahruzza Qhabibi, Faqrizal Ria Ramzi, Defriyan Raynaldo, Abdul Halim Reynaldo, Abdul Halim Rita Hamdani Safri, Zainal Sarastri, Yuke Sinaga, Akbar Sitepu, Andika Susilowati, Eliana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Teuku Bob Haykal Yasmine Fitrina Siregar Zebua, Juang Idaman