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All Journal Smart Medical 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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Risk Factor–Weighted Clinical Probability for Predicting Obstructive Coronary Artery Disease in Patients Presenting with Unstable Angina Batubara , Gio Justisia; Hasan , Refli; Nasution , Ali Nafiah; Hasan, Harris; Lubis, Anggia Chairuddin; Andra, Cut Aryfa
Journal of Society Medicine Vol. 5 No. 3 (2026): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i3.271

Abstract

Introduction: Determining the optimal invasive strategy for patients with unstable angina remains challenging, often resulting in unnecessary coronary angiography. Existing risk scores, including the GRACE and TIMI scores, were not designed to predict obstructive coronary artery disease. This study evaluated the predictive performance of a risk factor–weighted clinical likelihood model. Methods: This retrospective analytical cohort study included 150 patients with low-to intermediate-risk unstable angina who underwent coronary angiography at a tertiary hospital. Predictive accuracy was assessed using receiver operating characteristic analysis and compared with the Diamond Forrester, Fladseth, guideline-based criteria, GRACE, and TIMI scores. Obstructive disease was defined as significant stenosis or physiologically relevant lesions. Results: The prevalence of obstructive coronary disease was 60%. The model demonstrated superior discrimination, with an area under the curve of 0.885, which exceeded that of the comparator models. At a threshold score, 42.7% of angiographies were safely deferred, with a negative predictive value of 76.6%. Calibration improved after model adjustment. Conclusion: The risk factor–weighted clinical likelihood model provides a robust prediction of obstructive coronary artery disease in patients with unstable angina. This may support objective decision-making and enable a more selective invasive strategy, thereby reducing unnecessary procedures while maintaining diagnostic safety.
The Correlation Between Interleukin-6 (IL-6) Levels and the Extent of Coronary Lesions Based on SYNTAX Scores in Patients with Acute Coronary Syndrome (ACS) Siallagan, Delpiana; Loesnihari, Ricke; Hasan, Refli
Smart Medical Journal Vol 7, No 1 (2024): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i1.80649

Abstract

Introduction: Atherosclerosis plays an important role in the pathogenesis of acute coronary syndrome (ACS). Inflammation plays a causal role in atherosclerosis. There are many inflammatory markers related to ACS, including C-reactive protein (CRP), homocysteine, matrix metal loproteinases, interleukin (IL)-6, IL-8, and IL-27. IL-6 is the sign of synthesis of acute phase proteins. Recently, the clinical trials related to ACS showed that IL-6 may be an indicator of increased risk for ACS.  An Interleukin-6 (IL-6) examination is can be used  to assess risk factors for acute coronary syndrome (ACS). Interleukin-6 is a marker of local inflammation of coronary plaque and peripheral blood circulation which increases the occurrence of coronary heart disease causing plaque instability and rupture. The SYNTAX scoring system has   correlation assessed through angiography assessing the complexity of the severity of coronary artery stenosis. This study aims to determine the between Interleukin-6 (IL-6) levels and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome (ACS).Methods: This is a cross-sectional study of 45 patients with acute coronary syndrome (ACS) who were treated at H. Adam Malik General Hospital, Medan (February 2023 – May 2023). IL-6 levels were examined using the Electrochemiluminescent Immunoassay (ECLIA) method using Cobas e 411. The extent of the coronary lesion was calculated based on the SYNTAX score from coronary angiography which was calculated by two invasive cardiologist as suggested before using an online calculator. We used the Spearman correlation test and Mann Whitney test to analyze the data.Results: There were 39 male subjects (86.7%) total.  The mean age of the subjects was 54.89 ± 10.3 years old. Most of the subjects experienced STEMI in total 28 people (62.2%). The Median IL-6  levels was  19.22 pg/mL  while the median of SYNTAX score level was 13.00. By using cross-sectional study and the spearman correlationa test, there is a significant correlation between IL-6 and the SYNTAX score with the correlation value obtained r = 0.343 (p = 0.021).Conclusion: There is a significant relationship between IL-6 and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome. 
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 Batubara , Gio Justisia 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 Nasution , Ali Nafiah Nasution, Ali Nafiah 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 Ricke Loesnihari Rusda, Muhammad Safri, Zainal Sarastri, Yuke Sembiring, Rosita Sheila Dhiene Putri Siahaan, Basten Jeremiah Siallagan, Delpiana Sinaga, Akbar Siregar, Jelita Siregar, Muhammad Harmen Reza Sitepu, Andika Sumbayak, Novra Christy Grace Tamba, Ratna Mariana Tanjung, Yulisa Astari Taufik Sungkar, Taufik Taufik, Yasdika Imam Teti Hariani Pane Teuku Bob Haykal Yusrina Saragih Zainal Safri Zainal Safri Zulfikri Mukhtar Zulfikri Mukhtar