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All Journal Sumatera Medical Journal Narra J Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Jurnal Al Ulum: LPPM Universitas Al Washliyah Medan The Journal of Society Medicine (JSOCMED) Jurnal Penyakit Dalam Indonesia

Hasan, Refli

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Author-ID : 1178543

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Economics, Econometrics & Finance Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Neuroscience Public Health

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Corelation Between Sum of Precordial ST Depression in Acute Inferior Myocardial Infarction with Stenosis Severity of Left Anterior Descending Artery Karo, Kartika br; Ketaren, Andre Pasha; Hasan, Refli; Hasan, Harris; Mukhtar, Zulfikri; Lubis, Anggia Chairuddin
Sumatera Medical Journal Vol. 2 No. 1 (2019): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Background : There were many studies proved that precordial ST depression in Inferior STEMI show LAD disease from angiografi, but there were also many who unproved . Altought LAD disease was not the main cause of precordial ST depression in Inferior STEMI, but there were many patients with Inferior STEMI who had high grade LAD disease. Sum of precordial ST depression is one of ECG criteria that can help us to prove it . The aim of this study in to know if there is corelation between sum of precordial ST depression with LAD disease and the severity of LAD disease in Inferior STEMI patients with precordial ST depression . Methods : We analized 60 patients inferior STEMI with precordial ST depression onset less than 24 hours that hospitalized in Haji Adam Malik General Hospital since December 2013-June 2017. Patients were divided in to 4 groups based on sum of precordial ST depression. Bivariate analysis were made to see the corelation between sum of precordial ST depression with LAD disease and severity of LAD, p value < 0.05 is statistically significant. Result : Bivariate analysis show that there is strong corelation between sum of precordial ST depression with LAD disease (p=0.01). Sum of precordial ST depression also corelate with severity of LAD (p=0.01). There are also corelation with location of the lesion in proximal LAD and the complexity of the lesion but not statistically significant (p=0.233 and p=0.102). Analysis ROC curve sum of precordial ST depression to LAD disease give the cut off ≥5.15 mm with sensitivity 70% and spesificity 76.2%(AUC 0,752 ,95% CI: 0,620 – 0,883 p<0,001) Conclusion : There is strong corelation between sum of precordial ST depression with high grade LAD disease. The more the sum of precordial ST depression the more posibility high degree LAD disease ( p=0.01).

Infark Ventrikel Kanan dengan Blok Atrioventrikular: Laporan Kasus dengan Tinjauan Pustaka Dalimunthe, Naomi Niari; Hasan, Refli; Ahmad, Herwindo; Isnanta, Rahmad; Realsyah, T; Safri, Zainal
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Inferior myocardial infarction is frequently accompanied by right ventricular infarction. This report presents two cases of right ventricular infarction accompanied by hemodynamic disorder and atrioventricular block complications. These patients were diagnosed with right ventricular infarction based on history, clinical presentations, and electrocardiography findings. The management approach for these patients involved optimizing volume and fluid status, using temporary pacemakers, and urgent percutaneous coronary intervention. This report highlights the need to promptly identify right ventricular involvement in inferior myocardial infarction, as the treatment strategies for right ventricular infarction are different from left ventricular infarction.

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
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i3.30

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
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i4.32

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.

Relationship between Atherogenic Index of Plasma (AIP) and Mayor Cardiovascular Event (MACE) in Patients with Acute Myocardial Infarction (IMA) with Percutaneous Coronary Intervention (PCI) in Haji Adam Malik Hospital Ramzi, Defriyan; Hasan, Refli; Safri, Zainal
Journal of Society Medicine Vol. 3 No. 5 (2024): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.139

Introduction: Atherogenic index of plasma (AIP) is a new biochemical parameter closely related to lipid metabolism in the body as a risk factor in atherosclerosis and coronary heart disease. This study aimed to determine whether AIP values could be used to predict major cardiovascular events (MACE) in the treatment period of ACS patients undergoing primary percutaneous coronary intervention processes. Methods: This study was an observational analytical study with retrospective data collection method. Patients who experienced ACS at RSUP Haji Adam Malik Medan and undergo IKP starting from April 2023 will be collected. Basic characteristic data including laboratory parameters and AIP values as well as MACE events were be collected. Data analysis were carried out whether there are differences in AIP values in MACE and Non-MACE patients, and predictive ability will be assessed through ROC/AUC curve analysis, and sensitivity and specificity values will also be obtained. Results: A total of 69 samples were obtained. A total of 25 patients (36.2%) experienced MACE. The most prevalent MACE in this study was death from all causes as many as 17 patients (24.6%). AIP value can be used as a predictor of MACE events: Death of All Causes (Cut Off value: 0.505; AUC: 0.673; P = 0.033; 95% CI 0.537 – 0.809; Sensitivity 64.7%; Specificity 59.6%), Acute Heart Failure (Cut Off value: 0.502; AUC: 0.695; P = 0.029; 95% CI 0.551 – 0.839; Sensitivity 69.2%; Specificity 60.7%), and Malignant Arrhythmia (Cut Off value: 0.582; AUC: 0.758; P = 0.026; 95% CI 0.578 – 0.938; Sensitivity 71.4%; Specificity 75.8%). Conclusion: The AIP index can be a good predictor of the incidence of MACE in ACS patients undergoing primary percutaneous coronary intervention.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) as a marker of coronary lesion severity in stable coronary artery disease (CAD) patients Andra, Cut A.; Rambe, Aldy S.; Hasan, Refli; Sembiring, Rosita; Firman, Doni; Eyanoer, Putri C.; Mukhtar, Zulfikri; Sungkar, Taufik; Rusda, Muhammad; Amin, Mustafa M.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.409

Coronary artery disease (CAD) remains a significant global health concern with considerable high morbidity and mortality and its development is influenced by various genetic and environmental factors. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a vital regulator of low-density lipoprotein receptor (LDLR) metabolism, directly impacting serum cholesterol levels. However, its role in development of CAD is not fully understood. The aim of this study was to assess the association between the level of PCSK9 and coronary lesion severity in patients with CAD. A case-control study using consecutive sampling was conducted among CAD patients at H. Adam Malik General Hospital and Murni Teguh Memorial Hospital, Medan, Indonesia. A total of 200 CAD patients were divided into two groups based on the SYNTAX score: control (score ≤22, n=100) and case (score >22, n=100). Plasma PCSK9 levels were measured from venous blood using quantitative sandwich enzyme immunoassay. The Chi-squared test was used to analyze the data. Our data suggested that PCSK9 level was associated with coronary lesion severity (p<0.001) of which high PCSK9 level was associated with severe coronary lesion. We also found that hypertension (p<0.001), smoking (p=0.072), diabetes (p<0.001), dyslipidemia (p<0.001), obesity (p=0.023), and family history (p=0.001) were associated with lesion severity. Using the receiver operating characteristic (ROC) curve analysis, the cut-off 70.35 ng/mL of PCSK9 had sensitivity 75% and specificity 78% to predict severe coronary lesion. This study highlights that PCSK9 level has moderate sensitivity and specificity to predict the coronary lesion severity among CAD patients.

Cardiometabolic Risk Assessment through Comprehensive Screening for Early Detection Andra, Cut Aryfa; Hasan, Refli; Khairul, Andi; Tamba, Ratna Mariana; Putra, Muhammad Hafiz Mahruzza
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.v5i3.12818

Background: The development of cardiovascular disease (CVD) is influenced by many risk factors, such as tobacco use, an unhealthy diet, and physical inactivity, that could result in obesity, hypertension, dyslipidemia, and diabetes mellitus. Continuing exposure to these risk factors can be prevented by routine screening for populations without any clinical symptoms. This study was conducted to obtain data on cardiometabolic profiles of people who participated in the Community Service Program of the Department of Cardiology and Vascular Disease, University of Sumatera Utara. Method: This research was a descriptive study with a cross-sectional research design. The study aims to screen for the cardiometabolic profile in the people of Tebing Tinggi City. Cardiovascular risk factors were obtained from interviewing the participants and on-the-spot examination with validated measurement tools. All data were processed and analyzed statistically using SPSS ver.26. Categorical variables are presented with frequency (n) and percentage (%). Numeric variables are presented with mean and standard deviation (SD) values for normally distributed data. As for the normal non-distributed data numerical variables are presented with the middle value (median) and the interquartile range. Results: All subjects in this study (n= 102) are 39 male and 63 female. Most participants were in the 4th to 5th decade, with normal heart rates and normal sinus rhythm. Most female participants had a low risk for obstructive sleep apnea (OSA) and the male had intermediate risk. Most participants had normal random blood sugar and total cholesterol but mostly had obesity. Near 20-30% of participants were grade I and II systolic hypertensives but normally had diastolic blood pressure. Conclusion: In this study, most of the cardiometabolic risks of patients in the Community Service program were obesity, followed by hypertension.

Correlation between Apolipoprotein B Levels with Coronary Lesion Area Based on the Gensini Scores in Coronary Heart Disease Patients Siallagan, Delpiana; Siregar, Jelita; Hasan, Refli
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.v5i3.14396

Background: Coronary heart disease (CHD) is caused by atherosclerosis. apolipoprotein B (Apo B) is a large glycoprotein, that plays a role in lipoprotein metabolism and human lipid transport, reflecting atherogenic cholesterol transport. The Gensini scoring system has the highest correlation with the severity of coronary artery stenosis as assessed by angiography. This study aims to determine the correlation between apolipoprotein B levels with the area of coronary lesions based on the Gensini score in patients with CHD Methods: This research is an observational study with cross cross-sectional data collection method of 76 coronary heart disease patients who were treated at H. Adam Malik General Hospital Medan (December 2021 – April 2022). Examination of the Apo B value was carried out by the immunoturbidimetry method (Architect). Coronary lesion area calculated from coronary angiography with Gensini score. The research was conducted after obtaining ethical approval and informed consent. Result: There were 57 male subjects (75 %). The mean age of the subjects was 56.17 years with the youngest age being 24 years and the oldest being 77 years. Most of the subjects who experienced STEMI amounted to 38 people (50 %). The mean Apo B level was 89.18 mg/dL. The mean Gensini score was 62.84. By using the Pearson correlation test, it was found that a significant correlation was found between Apo B and Gensini score, r = 0,288 (p = 0.012) Conclusions: There was a significant correlation between the levels of Apo B and coronary artery lesions based on the Gensini score. Apo B examination and Gensini score can be used as a risk assessment of severity in CHD patients. Further research is needed to involve a larger number of coronary heart disease patients.

Role of Chest Radiograph in Diagnosis of Acyanotic Congenital Heart Disease Siregar, Muhammad Harmen Reza; Daulay, Elvita Rahmi; Hasan, Refli
Journal of Society Medicine Vol. 1 No. 3 (2022): December
Publisher : CoinReads Media Prima

Background: Early diagnosis of acyanotic congenital heart disease could lead to early referral and treatment before the onset of irreversible sequelae. Despite the development of modern imaging methods, conventional chest radiographs remain an important component of diagnostic process in pediatric cardiology. The aim of this study is to determine the accuracy of the results of chest X-ray examination with echocardiography results in patients with suspected acyanotic congenital heart disease at H. Adam Malik General Hospital Medan in 2019-2020. Methods: This study was a retrospective cross-sectional analytical observational study with a diagnostic test design to compare the sensitivity and specificity of conventional chest radiography compared with echocardiography of patients with suspected acyanotic CHD with shunts. The sample population was all children <18 years with suspicion of cyanotic CHD who came for treatment at H. Adam Malik Hospital Medan in the period January 2019 - December 2020. The study used data from medical records at H. Adam Malik Hospital Medan. The collected data is then analysed for diagnostic tests. Results: This study had a sample of 64 people with the highest proportion of samples being women, the average age was 67.9±54.1 months, and the results of echocardiography of the ductus arteriosus were persistent. The results of the diagnostic test showed a sensitivity of 78% and specificity of 80%, 95% PPV value and 40% NPV value, LR+ 3.8 and LR- 0.2. Conclusions: chest X-ray is adequate as a diagnostic tool in acyanotic congenital heart disease with left-to-right shunt. Clinical suspicion accompanied by chest X-ray results suggesting acyanotic congenital heart disease should be further assessed.

The TIMI Risk Index as a Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Hospital Medan Purba, Antonius Leonardo; Hasan, Refli; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.204

Introduction: ST-segment elevation myocardial infarction (STEMI) is a severe cardiovascular condition requiring urgent treatment through Primary Percutaneous Coronary Intervention (PPCI). However, PPCI increases the risk of Contrast-Induced Nephropathy (CIN), a condition characterized by a significant rise in serum creatinine levels. To minimize the risk of CIN, identifying patients at high risk is essential. This study evaluates the TIMI Risk Index (TRI) as a predictor of CIN in STEMI patients undergoing PPCI at Haji Adam Malik Hospital, Medan. Methods: This observational analytical study employed a cross-sectional design, focusing on STEMI patients with symptoms lasting less than 12 hours who underwent PPCI between January 2023 and December 2024. Participants were selected according to inclusion and exclusion criteria. Bivariate analysis was used, with the chi-square test for normally distributed data and the Fisher exact test for non-normally distributed data, with a significance level of p < 0.05. Results: The results indicated that TRI effectively predicted CIN occurrence, with a p-value of 0.0001, an area under the curve (AUC) of 0.834, and a 95% confidence interval (CI) of 0.752–0.916. A TRI cut-off score of 23.47 demonstrated a sensitivity of 77.3%, specificity of 77%, a positive predictive value (PPV) of 47.05%, and a negative predictive value (NPV) of 91.8%. Conclusion: In conclusion, the TRI with a cut-off score of 23.47 is a reliable tool for predicting CIN in STEMI patients undergoing PPCI, offering high sensitivity, specificity, and NPV, which can help improve clinical outcomes by identifying at-risk patients.

Co-Authors Ahmad, Herwindo Akbar, Nizam Zikri Amin, Mustafa M. Andra, Cut A. Andra, Cut Aryfa Ardini, Tengku Winda Dalimunthe, Naomi Niari Daulay, Elvita Rahmi Doni Firman Effendy, Elmeid Eyanoer, Putri C. Hasan, Harris Hasan, Harris Ilyas, Kamal Kharrazi Karo, Kartika br Kesumawardani, Enggar Sari Ketaren, Andre Pasha Ketaren, Andre Pasha Khairul, Andi Lubis, Anggia Chairuddin Mukhtar, Zulfikri Muttaqien, Chairiza Opim Salim Sitompul Purba, Antonius Leonardo Putra, Muhammad Hafiz Mahruzza Rahmad Isnanta, Rahmad Rambe, Aldy S. Ramzi, Defriyan Raynaldo, Abdul Halim Realsyah, T Reynaldo, Abdul Halim Rusda, Muhammad Safri, Zainal Sembiring, Rosita Siallagan, Delpiana Sinaga, Akbar Siregar, Jelita Siregar, Muhammad Harmen Reza Sitepu, Andika Tamba, Ratna Mariana Taufik Sungkar, Taufik Taufik, Yasdika Imam

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