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All Journal Indonesian Journal of Cardiology Heart Science Journal Narra J Jurnal Klinik dan Riset Kesehatan Deka in Medicine
Anjarwani, Setyasih
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From joint to heart: Cardiovascular implications of rheumatoid arthritis Raharjo, Fajar; Anjarwani, Setyasih
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e361

Abstract

Rheumatoid arthritis is a commonly encountered autoimmune disease and a progressive chronic inflammatory condition that often leads to permanent joint damage. Systemic inflammation in rheumatoid arthritis is linked to various comorbid conditions such as interstitial lung disease, osteoporosis, metabolic syndrome, cardiovascular disease, infections, malignancies, cognitive dysfunction, depression, and fatigue, which can increase morbidity and mortality in rheumatoid arthritis patients. Approximately 36% of patients report worse health and limitations in daily activities, while nearly 30% require more assistance with personal care compared to individuals without rheumatoid arthritis. Epidemiological data from 1990 to 2017 show an incidence of rheumatoid arthritis of 246.6 per 100,000 people aged 33-54 years, with prevalence in women 2-3 times higher. In Southeast Asia, the incidence is 89 per 100,000 in individuals aged 13-22 years, while in Indonesia, it is estimated at around 5-7.5 per 100,000 population. Cardiovascular disease is the primary cause of mortality in rheumatoid arthritis patients, with myocardial infarction being the major contributor. The pathogenesis of rheumatoid arthritis is still complex and involves immunological processes that occur long before joint inflammation symptoms appear, including genetic modifications and environmental factors that lead to deimination and joint disturbances. Cardiovascular manifestations, particularly myocardial infarction, occur due to an atherosclerotic process triggered by rheumatoid antibody complexes. Given the higher cardiovascular risk in rheumatoid arthritis patients, early detection and awareness of these manifestations are crucial for better management.
Tinjauan Mendalam Pengaruh Insufisiensi Renal terhadap Major Adverse Car- diovascular Event (MACE) dan Mortalitas pada Pasien Infark Miokard Akut Ele- vasi Segmen St (IMA-EST) Nurudinulloh, Akhmad Isna; Anjarwani, Setyasih
Jurnal Klinik dan Riset Kesehatan Vol 4 No 1 (2024): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.1.6

Abstract

The widespread implementation of invasive procedures such as coronary angiography and primary percutaneous coronary intervention (PCI) into the routine management of patients with acute ST-segment elevation myocardial infarction (STEMI) in the last 10 years has led to a significant improvement in patient prognosis. At the same time, this also raises new problems and questions, mostly related to the fact that there are many elderly patients and/or patients with comorbidities who need to undergo this invasive procedure. One of the most important comorbidities is renal insufficiency. STEMI patients with renal insufficiency typically present with more extensive atherosclerotic lesions, including diffuse coronary calcification, which poses a challenge to the interventional cardiologist due to a higher risk of periprocedural complications, higher risk of restenosis, major adverse cardiovascular event (MACE) , and patient mortality. This review discusses in depth the influence of renal insufficiency on MACE and mortality in STEMI patients. Keywords: renal insufficiency, STEMI, MACE, mortality.
Correlation Between Smoking and Il-1 Level and Arterial Stiffness as Measured By Cavi in the Young Adult Population Without other Cardiovascular Risk Factors. Galih Prakosa, Ardani; Tjahjono, Cholid Tri; Kurnianingsih, Novi; Sargowo, Djanggan; Anjarwani, Setyasih
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.5

Abstract

Background: Recent studies have shown that arterial stiffness is a strong predictor of cardiovascular events and all-cause mortality, with CAVI (Cardio-Ankle Vascular Index) as a non-invasive arterial stiffness testing method indaily practice.Objective: This study was conducted to examine the relationship between smoking -as a risk factor for arterial stiffness- and CAVI values, as well as levels of IL-1β (Interleukin 1β) as a cytokine that plays a role in the pathophysiology of arterial stiffness.Methods: Eighty-four participants, including smokers and non-smokers without other cardiovascular risk factors, were included in the study. Demographic data, medical history, and smoking behavior were taken using a questionnaire, then IL-1β and CAVI levels were examinedResults: The mean level of IL-1β in smoking subjects was significantly higher (15.09 ± 0.48) than in non-smoking subjects (5.53 ± 0.79; p=0.001). CAVI values in smoking subjects were also significantly higher (8.0 ± 0.06) than in non-smoking subjects (6.9 ± 0.02; p=0.001). Further analysis showed a strong positive correlation between smoking and IL-1β levels (r=+0.776; p=0.001) and CAVI values (r=+0.759; p=0.001).Conclusion: This study shows that smoking significantly correlates with IL-1β levels and CAVI values. The greater number of cigarettes used per day and the longer duration of smoking, there was a positive correlation between IL-1β levels and arterial stiffness as measured by CAVI.
The Effect of Exercise Training as Adjuvant Treatment on Functional Capacity in Congenital Heart Disease with Negative Vaso Reactivity Test Pulmonary Hypertension Patient at Saiful Anwar Hospital Malang Pratiwi, Irma Kamelia; Martini, Heny; Tjahjono, Cholid Tri; Anjarwani, Setyasih; Handari, Saskia Dyah
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.3

Abstract

BackgroundPulmonary hypertension associated with congenital heart disease (CHD) is an important subgroup that accounts for approximately 11% of all patients with PAH. Physical limitations are one of the main symptoms of hemodynamic changes in patients with PH. Objective This study aimed to evaluate the effect of physical exercise therapy for 12 weeks as an additional therapy with PDE-5 inhibitors on the functional capacity of patients with Congenital Heart Disease accompanied by Pulmonary Artery Hypertension (CHD – PH). MethodThis research was an analytic experimental study with a prospective cohort research method. This study used data sources obtained from medical records to adjust subjects based on inclusion and exclusion criteria, initial cardiac training test examination data was carried out at IPJT in patients selected as subjects. The patient's clinical outcomes were followed in the next 12 weeks. ResultThis research was conducted on 16 samples divided into two groups, namely the control and study groups. The evaluation after 12 weeks found that there was an increase in mileage as measured through the 6MWT submaximal test and a better duration of physical activity in the study group tested through the Endurance Shuttle Walk Test (ESWT). This is consistent with the effect of physical exercise, which suppresses systemic inflammation and causes vasodilation, thereby increasing oxygen delivery to the tissues. This causes more optimal aerobic metabolism and reduces lactate production. So that the patient did not quickly feel tired during activities. However, there was no significant increase in the Incremental Shuttle Walk Test. This could be due to the relatively short training duration of 12 weeks. Conclusion A positive correlation exists between physical exercise and increased functional capacity of patients with CHD who were evaluated using 6MWT and ESWT.
Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Abstract

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.
Early Management of Shock Condition in STEMI Patient Nugraha, Yudha Tria; Anjarwani, Setyasih; Satrijo, Budi; Rohman, Mohammad Saifur
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.9

Abstract

Background: Acute myocardial infarction is one of the emerging cardiovascular events worldwide. Infarcts of the inferior wall were present between one-third and half of the patients with RV involvement. The worse outcome was strongly associated with cardiogenic shock, and 7% of cases were caused by RV failure.Objective: This study aimed to describe the diagnosis and management of cardiogenic shock in STEMICase presentation: A male in his 40s was brought to our hospital 12 hours after the onset of persistent epigastric pain. He had a history of hypertension and a family history of diabetes Mellitus. Diagnostic procedures included blood tests, ECG, X-rays, coronary angiogram, and echocardiography. He underwent PCI to implant DES in his proximal RCA, which had 100% occlusion. The patient was admitted to the intensive cardiovascular care unit for 30 hours and died due to various complications.Conclusion: Current case was very complicated and seriously life-threatening. After acute myocardial infarction, Important problems kept coming up one after the other, and they all affected each other. Patients with cardiogenic shock must be found quickly and treated quickly and aggressively.
Benefits of Low Dosage of Colchicine Administration on Decreasing Rehospitalization and Mortality within 30 Days in Post-Acute Coronary Syndrome Patients with ST-Segment Elevation Undergoing Percutaneous Coronary Intervention Satrijo, Budi; Ashari, Yordan Wicaksono; Rohman, Mohammad Saifur; Anjarwani, Setyasih; Tjahjono, Cholid Tri
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.6

Abstract

Background: The role of inflammation in myocardial infarction and post-infarction MI remodeling has become a concern for the development of treatment in the last decade. Colchicine can prevent increased inflammation during acute injury.Objective: This study focused on the role of colchicine as an on-top medical treatment, hoping it can reduce mortality and short-term rehospitalization in patients with STEMI.Methods: 347 AMI patients (18-80 year old adults) who visited RSUD dr. Saiful Anwar Malang, between February 2022 and January 2023, participated in this prospective, randomized, double-blinded, placebo-controlledexperiment. Patients were split into two groups and given either a placebo or  colchicine 0.5 mg daily for a month. Standard medical therapy was administered concurrently to both groups as an approachable guideline. The study endpoints were mortality and rehospitalization rates.Result: After one month of follow-up, there was a reduction in rehospitalization due to cardiovascular causes (2 [1.3%] vs. 4 [2.7%], HR 3.42 [1.36-8.56], p<0.05), which was significant in the treatment group compared to the control group. Also, there was a reduction in all-cause mortality, but not statistically significant (2 [1,3% v 3 [2,0%], HR 3,38 [0,53-7,48], p>0,05). In the treated group, there was also a lower non-cardiovascular rehospitalization rate compared to placebo, but not significant (4 [2.6%] vs. 7 [4.7], HR 0.42 [0.15-1.02], p<0.05).Conclusion: The administration of low-dose colchicine for one month has shown benefits in reducing rehospitalization in patients with STEMI who receive PCI therapy.
Hypothermia theraphy in patients post cardiac arrest Yudha, Tria; Prasetya, Indra; Tjahjono, Cholid Tri; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.5

Abstract

Cardiovascular disease is the leading cause of death in several developing countries, and many of these deaths occur before reaching the hospital due to cardiac arrest. Most patients who return to spontaneous circulation (ROSC) and are brought to the hospital experience severe neurological damage during cardiac arrest, and this damage is the cause of in-hospital mortality. Improvements in survival and neurologic improvement of patients with CA have focused on two main therapy areas. The first area is improved education and skills of medical and paramedical personnel to improve perfusion post CA. The second area is a greater emphasis on post-resuscitation care which includes optimizing oxygenation and ventilation, avoiding hypotension, treating causes of CA such as acute coronary ischemia, and initiating hypothermia therapy if necessary, as in the 2020 guidelines and recommendations from the American Heart Association (AHA), International Liaison Committee of Resuscitation, and European Resuscitation Council covering the entire spectrum of post-resuscitation care.  The AHA guidelines 2020 recommend optimizing hypothermia therapy for 24 hours with a target temperature between 320C - 360C in ROSC patients to improve clinical outcomes of neurological status after cardiac arrest. This is contrast to the study of Martinell et al in their research which concluded that there was no significant difference in survival rates within 30 days after cardiac arrest in patients who received either hypothermia therapy or those who did not. Hypothermia therapy, which is currently part of the post-resuscitation care recommendations, has varied variables and remains controversial in its implementation. Based on this, this referent will discuss the effects of hypothermia therapy on post-cardiac arrest patients, the stages, and the practical aspects of implementing hypothermia therapy.
The complex relationship between arterial carbon dioxide levels and acute heart failure: implications for prognosis and management Afifah, Yuri; Prasetya, Indra; Anjarwani, Setyasih; Pashira, Andranissa Amalia
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.2

Abstract

Acute Heart Failure (AHF) can affect carbon dioxide levels in the body by altering the balance between ventilation and carbon dioxide production, leading to either hypocapnia or hypercapnia. Arterial carbon dioxide (CO2) levels are essential for maintaining respiratory function and acid-base balance. However, the relationship between arterial CO2 levels and AHF remains complex and not fully understood. Diverse factors affect arterial CO2 levels in patients with AHF, including neurohormonal activation, respiratory compensation for hypoxemia, and changes in pulmonary perfusion. Hypocapnia, characterized by low arterial CO2 levels (PaCO2 < 35 mmHg), is commonly observed in AHF due to hyperventilation-driven respiratory alkalosis secondary to pulmonary congestion. It showed a strong connection with the survival rates of patients following a cardiac arrest. Nevertheless, elevated levels of carbon dioxide in the blood, known as hypercapnia, with a partial pressure of arterial carbon dioxide (PaCO2) exceeding 45 mmHg, can also arise in the later phases of acute heart failure (AHF), indicating fatigue in respiratory muscles or deterioration in pulmonary edema. Abnormal arterial CO2 levels have been associated with increased morbidity and mortality in AHF patients, serving as a valuable prognostic marker.  
Predictive value of PaCO2 on mortality in patients with acute heart failure Afifah, Yuri; Prasetya, Indra; Baskoro, Shalahuddin Suryo; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.9

Abstract

Background: Patients with AHF may experience fluctuations in carbon dioxide levels, resulting in either hypercapnia or hypocapnia. Recent research has highlighted the significance of the relationship between CO2 fluctuation and patient outcomes. Objective: The aim of this study was to explore the relationship between arterial carbon dioxide pressure (PaCO2) upon admission to the ICCU in patients with AHF. Methods: A single centre retrospective observational study was performed, the patient were enrolled from patient medical record between 2021 and 2023. Participants were divided into three groups based on PaCO2 levels. The study end point was length of hospitalization, mortality at ICCU and mortality in hospital. Statistical analysis used various tests to compare outcomes, with significance set at p<0.05, and ROC analysis evaluated mortality prediction. Result: The study included 150 patients: 97 with hypocapnia, 33 with normal PaCO2, and 19 with hypercapnia. In-hospital mortality was 37.5%, and 1-month mortality was 33.3% in the hypercapnia group. PaCO2 >45 mmHg was linked to higher in-hospital mortality (OR 6.900, p <0.001) and 30-day mortality (OR 5.600, p <0.001), PaCO2 <35 mmHg showing a protective association in ICCU and in-hospital mortality (OR 0.202, p<0.001) and 30-day mortality (OR 0.237, p<0.001). Length of stay was not significantly affected by either hypocapnia or hypercapnia. The ROC for predicting in-hospital mortality was 0.648 and for 30-day mortality was 0.626 in the PaCO2 >45 mmHg group. Conclusion: PaCO2 levels at ICCU admission predict mortality in AHF patients. Hypercapnia is associated with higher in-hospital and 30-day mortality, while hypocapnia appears protective.
Co-Authors Adi, Andi Wahjono Afifah, Yuri AJI, BAYU Andria Priyana Aryanugraha, Teguh Ashari, Yordan Wicaksono Astiawati, Tri Atma Gunawan Bagaswoto, Hendry P. Bambang Widyantoro Baskoro, Shalahuddin Suryo Caesario, Fahreza Cholid Tri Tjahjono Danny, Siska S. Dewi U. Djafar, Dewi U. Djanggan Sargowo Emil Fathoni, Emil Endang, Jusup Galih Prakosa, Ardani Habib, Faisal Hakim, Afdhalun Hakim, Dennis I. Hakim, Dennis Ievan Haryati, Lina Hendry Purnasidha Bagaswoto Ilhami, Yose R. Ilhami, Yose Ramda Indra Prasetya Iskandar Iskandar Ispar, Akhtar Fajar Muzakkir Ali Juzar, Dafsah A. Juzar, Dafsah Arifa Karolina, Wella Kurnianingsih, Novi Kurniawan, Dea Arie Lestari, Puspa Martini, Heny Mayangsari, Veny Mazwar, Irmaliyas Mohammad S. Rohman Mohammad Saifur Rohman Muzakkir, Akhtar F. Muzakkir, Akhtar Fajar Nahar Taufiq, Nahar Nugraha, Krishna Ari Nugraha, Tria Yudha Nugraha, Yudha Tria Nurudinulloh, Akhmad Isna Pashira, Andranissa Amalia Pramudyo, Miftah Pratama, Vireza Pratiwi, Irma Kamelia Putra, Iwan Cahyo Santosa Putri, Valerinna Yogibuana Swastika R A, I Made Junior Raharjo, Fajar Rahimah, Anna Fuji Rizal, Ardian Rosyidi, Muhammad Azhar Ruspiono, Evit Sakti, Pradhika Perdana Saskia Dyah Handari Satrijo, Budi Setiawan, Dion Siska Suridanda Danny Sungkar, Safir Suprayoga, Imam Mi'raj Swastika Putri, Valerinna Yogibuana Vori, Ira Widito, Sasmojo Wirawan, Hendy Yogibuana, Valerinna Yudha, Tria Zulkarnain, Edrian zunardi, Lutfi hafiz