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Relationship Between Neutrophil-to-Lymphocyte Ratio and High-Density Lipoprotein with Major Cardiovascular Events in Acute Myocardial Infarction with ST-Segment Elevation Undergoing Primary Percutaneous Coronary Intervention at Adam Malik Hospital, Medan Adam, Faisal; Hasan, Harris; Haykal, T. Bob
Journal of Society Medicine Vol. 4 No. 8 (2025): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.231

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.
Incidence of Bleeding Complications in Acute ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Ferhat, Muhammad; Lubis, Anggia Chairuddin; Safri, Zainal; Mukhtar, Zulfikri; Hasan, Harris; Haykal, Teuku Bob; Siregar, Yasmine Fitrina; Andra, Cut Aryfa
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 3 (2025): 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.v7i3.21143

Abstract

Background: This study aims to comprehensively describe the incidence, types, and associated risk factors of bleeding complications in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI), addressing a critical gap in the literature given the global burden of cardiovascular disease and the inherent bleeding risks of contemporary antithrombotic therapies. Methode: This retrospective cross-sectional study will investigate the incidence and types of bleeding complications, along with associated risk factors, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) at Adam Malik Hospital Medan, analyzing data from May 2022 to December 2024 through ethical review and statistical analysis using SPSS version 23. Result: Of 245 STEMI patients undergoing primary PCI, 42.9% experienced bleeding, predominantly minor (BARC 1 and 2, 94.2% combined), with significant associations observed between bleeding and lower hemoglobin, higher leukocyte and creatinine levels, higher TIMI score, Killip class 3 and 4, diabetes, use of maintenance heparin, and increased mortality (84.6% of all deaths occurred in bleeding patients), while hematuria and puncture site hematoma were the most common bleeding sources. Conclusion: This study found that 42.9% of 245 STEMI patients undergoing primary PCI experienced bleeding complications, predominantly minor (94.2%), with an average age of 55.22 years and a male majority. Keyword: Bleeding complications, Acute Coronary Syndrome (ACS), ST-Elevation Myocardial Infarction (STEMI), Primary Percutaneous Coronary Intervention (PPCI)
Heart or Grace Score for Diagnostic and Risk Stratification in Acute Coronary Syndrome Patients Napitupulu, Friendina; Hasan, Harris; Afif Siregar, Abdullah
Sumatera Medical Journal Vol. 8 No. 1 (2025): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v8i1.17168

Abstract

Background: Some studies found that HEART score is better than GRACE score either as a rule-in method for myocardial infarction or as a risk stratification. However, GRACE score was also found to have better discriminatory ability as a prognostic model for patients with myocardial infarction. Objective: This study aims to evaluate whether the HEART and GRACE scores have equal capabilities either as a diagnostic method for myocardial infarction or risk stratification to predict in-hospital Major Adverse Cardiovascular Events (MACE) in Acute Coronary Syndrome (ACS) patients at Adam Malik Hospital. Methods: This research is a retrospective and prospective observational study. Retrospective data was collected from all medical records of ACS patients from January to December 2022. Prospective data was collected by consecutive sampling until 46 samples were fulfilled from October 2023 at Adam Malik Hospital. Samples included in the research analysis were those who met the inclusion criteria. To compare each score, we use the area under the receiver-operating characteristics (AUC) method. Results: HEART score is superior to GRACE score as a diagnostic method with an AUC of 0.903, a cutoff of 6.5, sensitivity of 86%, and specificity of 80%. The GRACE score is superior to the HEART score as a risk stratification with an AUC of 0.719, a cutoff of 128.5, sensitivity of 66%, and specificity of 65%. Conclusion: HEART score is superior for diagnosis, and GRACE score is superior for risk stratification.