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All Journal Majalah Kedokteran Nusantara The Journal Of Medical School Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Sumatera Medical Journal Contagion: Scientific Periodical Journal of Public Health and Coastal Health Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Heart Science 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
Division Of Cardiology Of Department Of Internal Medicine, Faculty Of Medicine, Universitas Sumatera Utara
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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Association of Risk Factors for Coronary Artery Disease with The Incidence of Abdominal Aortic Calcification On Abdominal CT-Scan Imaging in H. Adam Malik General Hospital Assania, Rizka Farahin; Daulay, Elvita Rahmi; Refli Hasan
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.v2i3.38

Abstract

Introduction: Coronary Artery Disease (CAD) is the one of manifestation for cardiovascular disease and a cause of death and disability. Abdominal aortic calcification (AAC) has been shown to be strongly associated with atherosclerosis and CAD events. This study to investigated the association of risk factors for CAD with the incidence of AAC on abdominal CT Scan. Method: This study was an observational analytic study with a cross-sectional design on 105 patients who underwent abdominal CT scans with/without intravenous contrast at Radiology Department of  H. Adam Malik General Hospital. AAC score was identified calcification on the abdominal aorta (from 1 cm above the origin of the celiac trunk to 1 cm below the iliac bifurcation) use the Agatston method. Analyzing the association CAD risk factors such as gender, age, diabetes mellitus, hypertension, smoking, and alcohol and AAC score. Results: The results of the analysis using the Chi Square comparative test showed that there was a significant relationship between age (p=0.000), hypertension (p=0.017), diabetes (p=0.006), in othe words there is no significant relationship between gender (p = 0.613), smoking (p=0.22) and alcohol (p=0.28) with AAC score. Conclusion: There is a significant relationship between age, hypertension and diabetes with the AAC score.
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

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.
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

Abstract

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.
Correlation of Platelet Distribution Width (PDW) and Troponin I in Acute Myocardial Infarction -, Maulinda Putri; Refli Hasan; Rahmad Isnanta
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 3 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (746.674 KB) | DOI: 10.32734/jetromi.v2i3.4287

Abstract

Background. Coronary artery disease (CAD) is caused by narrowing of the coronary arteries. In the event of acute myocardial infarction (AMI), there will be an increase in heart markers. Several studies have examined the relationship between Platelet Distribution Width (PDW) and AMI, but there is no specific correlation with troponin as the most sensitive and specific cardiac biomarker for AMI. This study aims to see the correlation PDW values with troponin I in patients with AMI. Method. This study was a cross-sectional method to determine the correlation of PDW variable values ​​with troponin I in patients with AMI. In this study, the sample consisted of 64 people. Results. There is a moderate correlation between PDW and troponin I (r2= 0.72, p <0.001). There is a strong correlation with positive direction between PDW and Troponin I in patients with AMI based on the onset of chest pain (<6 hours and > 6 hours : r2 = 0.647 p <0.001and r2 = 0.756, p <0.001). Conclusion. Platelet Distribution Width (PDW) is strongly correlated with Troponin I in patients with AMI, and based on chest pain onset also has a significantly positive correlation.
Effect of Salam leaf extract (Syzygium Polyanthum) to serum IL-10 levels on Acute Coronary Syndrome in Wistar Strain Mice Model Tanjung, Yulisa Astari; Refli Hasan; Rahmad Isnanta
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 3 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (558.692 KB) | DOI: 10.32734/jetromi.v2i3.4296

Abstract

Background Coronary Heart Disease (CHD) is one of the leading causes of death in developed and developing countries.  Syzygium polyanthum leaf (daun salam) are reported to have anti-inflammatory, antioxidant, antidiabetic, antimicrobial, antihypertensive, antitumor, antidiarrheal, acetylcholinesterase inhibition, and lipase inhibitory activity. The purpose of this study was to prove the effect of bay leaf extract (Syzygium polyanthum) on serum interleukin (IL)-10 levels in the heart of Wistar Strain Mice Model of Acute Coronary Syndrome (ACS). Methods This is an experimental study to compare the IL-10 level in 32 ACS mice which were divided into 8 groups. Serum IL-10 values were collected and analyzed according to the corresponding group with and without bay leaf extract administration, on day 1,4,7, and 14. Result: There is an IL-10 value increasing with the duration of examination following the onset of ACS induction. The highest average IL-10 value was found on the 14th day, in the two groups. On the same day, it was seen that the treatment group had a higher IL-10 value compared to the control group (p<0.001). The result showed that the concentration of IL-10 was significantly greater among the treatment group, which  reveal the potential benefit of bay leaf extract in patients with ACS. Conclusion: There was found a significant difference of serum IL-10 between Wistar Strain Mice Model of ACS that was given S. polyanthum leaf extracts. S. polyanthum leaf extract has quite extensive benefits in the cardiovascular system.
Association of Neutrophil Lymphocyte Ratio (NLR) with Global Registry of Acute Coronary Events (GRACE) Scores in Acute Coronary Syndrome Baginda Yusuf Siregar; Refli Hasan; Rahmad Isnanta
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 3 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (595.978 KB) | DOI: 10.32734/jetromi.v2i3.4312

Abstract

Background. Inflammation plays an important role in the initiation of atherosclerosis from the beginning of plaque to rupture cause Acute Coronary Syndrome (ACS). Neutrophil Lymphocyte Ratio (NLR) indicator of systemic inflammation in ACS. Risk stratification was needed for assessment and selection of initial invasive strategies and find the best strategy in ACS. The Global Registry of Acute Coronary Events (GRACE) scores recommended risk stratification of ACS. Aims of the study to determine the association and cut-off value NLR with risk stratification GRACE score. Method. This study is analytical with a cross-sectional retrospective design. Data were analyzed after distribution test, then mean difference and correlation test was using the SPPS program where p <0.05 was considered statistically significant. Results. This study showed significantly higher NLR value in the high risk stratification and intermediate-risk compared to low risk stratification (7.9 ± 2.7 vs 3.6 ± 1.7; p=0.001) (5.2 ± 2.3 vs 3.6 ± 1.7; p=0.018). Significant correlation between NLR ​​with GRACE scores (r=0.570; p<0.001). Significant AUC values ​​were obtained (0.782, p <0.001, IK95% 0.674-0.89), and cut-off values NLR 4 ​​with sensitivity (78.8%) and specificity (70.3%) on the GRACE score. Conclusion. The significant association between NLR ​​with GRACE risk score in ACS.
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

Abstract

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

Abstract

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.
Correlation of MPV and IPF with Troponin-I Levels in Acute Coronary Syndrome Patients Angelina, Marcellia; Permatasari, Ranti; Ganie, Ratna Akbari; Hasan , Refli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2292

Abstract

Acute Coronary Syndrome (ACS) is a leading cause of death worldwide, with platelet activation playing a crucial role in the formation and evolution of atherothrombosis. Platelet indices, such as Mean Platelet Volume (MPV) and Immature Platelet Fraction (IPF), play a significant role as indicators of platelet activation. Troponin-I is a specific protein for the myocardium and serves as an ideal biomarker, providing crucial insights into the extent of myocardial damage. This study aims to identify the relationship between MPV and IPF with Troponin-I levels in patients with ACS. This research was a cross-sectional study involving 52 ACS patients undergoing treatment at H. Adam Malik Hospital, Medan, from February 2023 to May 2023. Blood samples were taken upon admission and examinations for MPV, IPF, and Troponin-I were conducted. The data were analyzed using SPSS software, and the Spearman test was employed. A p-value less than 0.05 was considered statistically significant. No correlation was found between MPV and Troponin-I, with a p-value of 0.251. Similarly, there was no correlation between IPF and Troponin-I, with a p-value of 0.090. However, a strong correlation was observed between MPV and IPF, with a p-value < 0.001 and an r-value of 0.840. The findings indicate insignificant results between MPV and IPF values in relation to Troponin-I levels in ACS 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

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.
Co-Authors -, Maulinda Putri A. Afif Siregar A. Afif Siregar Abdul Halim Raynaldo Ahmad, Herwindo Akbar, Nizam Zikri Aldino Satria Adhitya Ali Nafiah Nasution Ali Nafiah Nasution Amin, Mustafa M. Andra, Cut A. Andra, Cut Aryfa Andra, Cut Aryfa Angelina, Marcellia Anggia C Lubis Ardini, Tengku Winda Ashrinda, Dika Assania, Rizka Farahin Baginda Yusuf Siregar Bertha Gabriella Napitupulu Cut Aryla Andra Dalimunthe, Naomi Niari Daulay, Elvita Rahmi Doni Firman Dudut Tanjung Effendy, Elmeid Eyanoer, Putri C. Harris Hasan Harris Hasan Harris Hasan Hasan, Harris Hasan, Harris Hasan, Harris Herman William Parlindungan Ilyas, Kamal Kharrazi Karo, Kartika br Kesumawardani, Enggar Sari Ketaren, Andre Pasha Ketaren, Andre Pasha Khairul, Andi Khairunnisah, Dina Lubis, Anggia Chairuddin Mardianto Masrul Lubis Muhtar, Zulfikri Mukhtar, Zulfikri Muttaqien, Chairiza Nizam Akbar Nizam Akbar Nizam Zikri Akbar Nurwijayanti Opim Salim Sitompul Permatasari, Ranti Pratiwi, Harvinda Arya Purba, Antonius Leonardo Putra, Muhammad Hafiz Mahruzza Rahmad Isnanta Rahmad Isnanta, Rahmad Rambe, Aldy S. Ramzi, Defriyan Ratna Akbari Ganie, Ratna Akbari Raynaldo, Abdul Halim Realsyah, T Reynaldo, Abdul Halim Rusda, Muhammad Safri, Zainal Sembiring, Rosita Sheila Dhiene Putri Siahaan, Basten Jeremiah Siallagan, Delpiana Sinaga, Akbar Siregar, Jelita Siregar, Muhammad Harmen Reza Sitepu, Andika Tamba, Ratna Mariana Tanjung, Yulisa Astari Taufik Sungkar, Taufik Taufik, Yasdika Imam Teti Hariani Pane Yusrina Saragih Zainal Safri Zainal Safri Zulfikri Mukhtar Zulfikri Mukhtar