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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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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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Journal : The Journal of Society Medicine (JSOCMED)

 1 
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.
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
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.139

Abstract

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.
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
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (321.673 KB) | DOI: 10.47353/jsocmed.v1i3.12

Abstract

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

Abstract

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.
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.
Triglyceride/High-Density Lipoprotein Ratio as a Predictor of Major Cardiovascular Events Within 6 Months Post-Treatment in Patients with Acute Myocardial Infarction and Type 2 Diabetes Mellitus at Haji Adam Malik General Hospital, Medan Taufik, Yasdika Imam; Hasan, Refli; Akbar, Nizam Zikri
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.227

Abstract

Introduction: Cardiovascular disease (CVD) remains the leading global cause of death, with coronary artery disease (CAD) and stroke contributing to 15 million deaths in 2016. Type 2 diabetes mellitus (DM) increases the risk of complex CAD, characterized by diffuse, calcified, and multivessel lesions. While the triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio is a potential independent predictor of CVD, its prognostic value for mortality in diabetic CAD patients undergoing statin therapy remains unclear. This study aimed to analyze the association between the TG/HDL-C ratio and cardiovascular and all-cause mortality in this population. Methods: This cross-sectional analytical study examined the relationship between the TG/HDL-C ratio and major cardiovascular events in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients with type 2 DM receiving statin therapy. Data were collected through clinical observation and medical records. Statistical analysis utilized the Chi-square or Fisher’s Exact test to assess associations, with statistical significance defined as p <0.05. Results: The study included 72 patients (72.2% male; mean age 58.6±8.5 years) with type 2 DM (mean duration 10.5±3.9 years) and acute coronary syndrome (61.1% NSTEMI). Among participants, 61.1% were smokers, 48.6% had hypertension, and lipid profiles revealed 100% hypertriglyceridemia, 87.5% elevated LDL, and 33.3% low HDL. A high TG/HDL ratio was observed in 72.2% of subjects and was significantly associated with major adverse cardiovascular events (OR=3.32; p=0.025), indicating a 3.32-fold higher risk in the high TG/HDL ratio group. Conclusion: The TG/HDL-C ratio can serve as an effective parameter for estimating the risk of MACE in ACS patients with T2DM.
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