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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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Renal Function and Left Ventricular Ejection Fraction in Diabetic Patients with Acute Heart Failure Hutapea, Mery Natalia; Hasan, Refli; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Haykal, Teuku Bob; Sarastri, Yuke; Ardini, Tengku Winda; Ketaren, Andre Pasha; Purba, Joy Wulansari; Akbar, Nizam Zikri; Andra, Cut Aryfa
Sumatera Medical Journal Vol. 9 No. 1 (2026): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v9i1.22989

Abstract

Background: Acute heart failure (AHF) in patients with type 2 diabetes mellitus (T2DM) is frequently complicated by renal dysfunction, which may aggravate cardiac impairment. Serum creatinine may reflect this cardio–renal interaction, but its association with left ventricular ejection fraction (LVEF) in AHF patients with T2DM remains unclear. Objective: To investigate the correlation between serum creatinine and left ventricular ejection fraction (LVEF) in patients with acute heart failure (AHF) and type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study of 52 hospitalized AHF patients with T2DM. Clinical data, serum creatinine, A1C, and echocardiographic LVEF (assessed by two independent consultants) were collected. Correlation and multivariable linear regression analyses were performed. Results: The patients were middle-aged and predominantly male. Mean LVEF was 33.2 ± 9.1%, and mean serum creatinine was 1.58 ± 0.31 mg/dL. Higher serum creatinine levels were strongly associated with lower LVEF. Glycemic status (A1C) and urea levels also showed negative associations with LVEF. After adjustment, serum creatinine and A1C remained independent predictors of reduced LVEF. Conclusion: In AHF patients with T2DM, higher serum creatinine and A1C levels are independently associated with reduced LVEF, underscoring the cardio-renal-metabolic interplay in this population and highlighting the need for integrated management strategies.
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.
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 Hutapea, Mery Natalia 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 Purba, Joy Wulansari 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 Sarastri, Yuke Sembiring, Rosita Sheila Dhiene Putri Siahaan, Basten Jeremiah Siallagan, Delpiana Sinaga, Akbar Siregar, Abdullah Afif 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