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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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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

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.
Patient Experience after Mechanical Heart Valve Replacement Surgery at Central General Hospital Haji Adam Malik Medan Teti Hariani Pane; Dudut Tanjung; Refli Hasan
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 6, No 2 (2024): CONTAGION
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v6i2.21229

Abstract

Overall postoperative quality of life improves in patients undergoing mechanical mitral valve replacement. Heart valve replacement surgery is the definitive treatment for heart valve abnormalities. Patients undergoing heart surgery will experience mental and physical difficulties after leaving the hospital. Support is an important factor that a person needs when facing health problems. The aim of this study was to explore the experiences of patients undergoing mechanical heart valve replacement surgery to find better treatment plans. This type of research is qualitative research with a descriptive phenomenological approach. The participants in this study were 13 people who were patients who had undergone mechanical heart valve replacement surgery. This research was conducted in June-August 2023 at the Haji Adam Malik General Hospital. The data collection method uses in-depth interviews and research data is analyzed using the Colaizzi method. There are 5 themes identified, namely 1) Patients experience an improvement in their health condition after mechanical heart valve replacement surgery 2) Patients experience sleep disturbances 3) Patients experience anxiety regarding possible complications that occur after mechanical heart valve replacement surgery 4) Patients comply with the home care plan, and 5) Family support in efforts to maintain health after undergoing mechanical heart valve replacement surgery. The research results showed that the majority of participants reveal physical changes, namely complaints before surgery has reduced or disappeared completely but experiences sleep disturbances due to pain, anxiety. Participants also expressed their willingness to follow the treatment plan at home with support from the family. It is especially recommended that cardiovascular nurses involve the family to provide support in efforts to optimize the patient's health status after mechanical heart surgery.Keywords: Heart valve disease, Mechanical heart valve replacement surgery, Patient experience
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
Publisher : CoinReads Media Prima

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.
Quality of life assessment in patients after permanent pacemaker implantation at Haji Adam Malik Hospital Medan Khairunnisah, Dina; Ali Nafiah Nasution; Refli Hasan; Nizam Zikri Akbar; Anggia Chairuddin Lubis; Abdul Halim Raynaldo
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.15

Abstract

Background: PPM implantation is used to send electrical impulses to the heart muscle to correct heart rhythm disturbances also known as cardiac arrythmia. Assessing the patient's quality of life after a PPM implantation is crucial for predicting the therapy's effectiveness and success. Objectives: This study aims to assess the quality of life of patients following pacemaker implantation by using the SF-36 questionnaire. Methods: A cross-sectional study conducted from January 2021 to July 2023 on 60 outpatients with a minimum duration of PPM implantation of 6 months in the cardiology department of H. Adam Malik Hospital Medan. Patient’s quality of life was assessed based on the SF-36 questionnaire. Subjects then were grouped based on age, gender, PPM duration and location, as well as other echocardiographic parameters that may affect patient’s quality of life after PPM implantation. Results: There were 60 patients included in this study. Majority of patients were male (56.7%) with an average age of 67.98 ± 10.95 years old and most patients had comorbidities (81.7%). The majority of patients (93.3%) had a single-chamber permanent pacemaker implanted, with 68.3% of these devices’ ventricular leads positioned in the non-apical segment of the heart.  After assessing the quality of life, we found there’s a relationship between age, gender, and PPM lead locations with nearly all SF-36 domains (p<0.05). Additionally, there was a significant association between comorbidities and SF-36 scores, including physical function, physical limitations, and emotional limitations (p<0.05). There was a significant association between ejection fraction and SF-36 scores, including physical function, role limitations due to physical health problems, vitality, social function, bodily pain and general health. However, no relationship was found between IMT and PPM implantation duration with SF-36 scores (p>0.05). Conclusion: We identified a relationship between age, gender, comorbidities, PPM lead location, and ventricular ejection fraction with the quality of life of patients following PPM implantation
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
Publisher : CoinReads Media Prima

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.
RHEUMATIC HEART DISEASE SCREENING USING HANDHELD ECHOCARDIOGRAPHY: A STUDY AMON`G JUNIOR HIGH SCHOOL STUDENTS IN INDONESIA Ardini, Tengku Winda; Muttaqien, Chairiza; Sitompul, Opim Salim; Hasan, Refli; Effendy, Elmeid; Rusda, Muhammad
Jurnal Al Ulum LPPM Universitas Al Washliyah Medan Vol. 13 No. 2 (2025): Jurnal Al Ulum: LPPM Universitas Al Washliyah Medan
Publisher : UNIVERSITAS AL WASHLIYAH (UNIVA) MEDAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47662/alulum.v13i2.1007

Abstract

Considering the high burden of morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is increasing interest in assessing cost-effective screening modalities, particularly the application of handheld echocardiography. Our study aimed to determine the prevalence of Rheumatic Heart Disease (RHD) in Batu Bara, North Sumatra, Indonesia. Our descriptive observational study was carried out in the Batu Bara region of North Sumatra in May 2025. The study population comprised junior high school students aged 10 to 15 years from a selected school in Batu Bara. Data collection included sociodemographic variables, parental characteristics, environmental and household factors, anthropometric measurements, physical examination findings, auscultation results, and echocardiographic evaluations. All data were analyzed using descriptive statistical methods. A total of 190 children were assessed in this study, with a median age of 13 years, and females comprised 54.7% of the participants. Echocardiographic screening detected Rheumatic Heart Disease (RHD) in three participants, corresponding to a prevalence of 1.6%. Within our study population, the prevalence of RHD was 1.6%. Expansion of echocardiographic screening programs is warranted to comprehensively establish RHD prevalence, accurately evaluate disease burden, and facilitate earlier detection to mitigate adverse clinical outcomes.
RELATIONSHIP BETWEEN C-REACTIVE PROTEIN AND IL-6 LEVELS AND EJECTION FRACTION IN HEART FAILURE PATIENTS AT ADAM MALIK HOSPITAL Pratiwi, Harvinda Arya; Refli Hasan; Lubis, Masrul; Mardianto
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.v7i3.20467

Abstract

Background: Heart failure (HF) is a progressive condition markedby anatomical and functional cardiac defects. Inflammation is amajor factor in HF development. While some research implies a linkbetween elevated CRP and IL-6 levels and lower ejection fraction(EF), the results are inconsistent. This study aims to evaluate therelationship between C-reactive protein, IL-6 levels, and EF in heartfailure patients.Method: This cross-sectional analytic observational study wasconducted at Adam Malik Hospital to assess the relationshipbetween CRP and IL-6 levels and left ventricular EF (LVEF) in HFpatients. Result: The findings showed no significant connection betweenCRP and LVEF (p=0.391), implying that CRP does not directlyreflect systolic dysfunction. Conversely, IL-6 levels have asubstantial inverse connection with LVEF (p=0.001), indicating agreater link between systemic inflammation and cardiacperformance. Conclusion: These findings underline the importance of amultimodal approach to HF care, including the use of inflammatorymarkers for risk classification in this population. While CRP maynot be as accurate a predictor of systolic dysfunction, IL-6 appearsto be more closely related to heart failure severity. Keywords: CRP, Ejection fraction, Heart failure, IL-6.
Uji validasi Mayo Cardiac Intensive Care Unit Admission Risk Score (M-CARS) untuk menilai mortalitas selama rawatan pada pasien Cardiovascular Care Unit (CVCU) di RSUP Haji Adam Malik Siahaan, Basten Jeremiah; Hasan, Refli; Sitepu, Andika
Jurnal Kardiologi Indonesia Vol 43 No 4 (2022): Indonesian Journal of Cardiology: October - December 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1261

Abstract

Background: Approximately 85% of all in-hospital deaths occur in Cardiovascular Care Unit (CVCU) where M-CARS will be an important starting point for development of CVCU-specific mortality risk prediction models. Aim: This research aims to assess M-CARS validation to assess mortality during treatment in CVCU patients at Haji Adam Malik (HAM) General Hospital. Methods: This research is a prospective research that examines M-CARS score validity as a predictor of intra-hospital mortality in patients treated at CVCU HAM General Hospital Medan from September 2021 - January 2022. If correlation test results show a significant relationship, cut-off value M-CARS score will be taken using ROC (Receiver Operating Characteristic) curve analysis, then analysis of M-CARS score diagnostic value will be carried out according to cut-off value obtained to predict mortality during hospitalization. Then Hosmer-Lemeshow test was carried out to assess suitability of logistic regression on risk prediction assessment within population that being assessed. Results: M-CARS had a very good discriminatory ability (AUC 0.93) to predict intrahospital mortality. The calibration value using Hosmer Lemeshow test (R2 = 0.982; p = 1.516; p>0.05) shows that there is no significant difference between observed and expected mortality rate by two scoring systems therefore considered as accurate. Conclusion: M-CARS is valid to be used in assessing risk of mortality events during CVCU treatment at H. Adam Malik Hospital Medan. Keywords: Mortality, Cardiovascular Care Unit, Mayo Cardiac Intensive Care Unit Admission Risk Score, Braden Score.
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