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Prognostic Value of Tricuspid Annular Plane Systolic Excursion (TAPSE), Right Ventricular Fractional Area Changes (RV FAC) and Pulses Tissue Doppler S' Wave (PTD S') at 30 Days after Care of Acute Miocardial Infarction Patients in Haji Adam Malik Hospital Ilhami, Fadli; Nasution, Ali Nafiah; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 5 (2023): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i5.65

Introduction: Echocardiography is a reliable and simple method of hemodynamic monitoring that can be used on every IMA patient. Tricuspid Annular Plane Systolic Excursion (TAPSE), Right Ventricular Fractional Aera Changes (RV FAC), and Pulses Tissue Doppler S' Wave (PTD S') are the three main parameters of ventricular electrocardiography. The purpose of this study is to understand the reliability of the right ventricle function prognostic indicators TAPSE, PTD S', and RV FAC with regard to the MACE at 30 days following the occurrence of the AMI in RSUP H. Adam Malik Medan Method: This study is an ambispective observational analytic study with sampling carried out at one time (cross-sectional study) on 88 AMI patients at the HAM Hospital who were treated from March 2022 to June 2022 and performed echocardiography in the first 24 hours and measured TAPSE, PTD S' and RV FAC. And followed for 30 days to see the MACE in patients. Bivariate test was conducted to assess the correlation between variables. To determine which independent variables were more effective at predicting MACE, a multivariate logistic regression test was then run. The effectiveness of the independent factors in predicting MACE was also assessed using ROC analysis. Results: The total subjects were 88 AMI patients consisting of 39 (44.3%) patients who experienced MACE and 49 (55.6%) patients who didn’t. The prognostic values of TAPSE, PTDS' and RV FAC on MACE at 30 days were related by bivariate analysis with P Value 0.001 but only PTD S’ showed logistic regression results that were consistent with P Value < 0.001. Based on ROC analysis obtained by PTD S' can predict MACE with AUC = 0.894 Conclusion: Echocardiographic measurement PTD S’ has a good prognostic value to predict MACE within 30 days in AMI patients.

Association between Systemic Inflammatory Immunity Index and Intracoronary Thrombus Burden in Acute Myocardial Infarction with ST Segment Elevation (IMA EST) Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Hospital Dhilion, Har Rawishwar Singh; Nasution, Ali Nafiah; Sitepu, Andika
Journal of Society Medicine Vol. 3 No. 2 (2024): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i2.122

Introduction: Acute coronary syndrome (ACS) account for 30% of deaths worldwide. High peri-procedural intracoronary thrombus burden is a strong predictor of poor outcome. Inflammation plays an important role in the pathogenesis of intracoronary thrombus formation. The systemic inflammatory immunity index represents the immune responses to inflammation, which consist of neutrophilia, thrombosis and decreased lymphocytes. The previous study showed that systemic inflammatory immunity index predicted high intracoronary thrombus burden in STEMI patients. This study aimed to evaluate systemic inflammatory immunity index in predicting the incidence of high intracoronary thrombus burden in STEMI patients. Method: This research is a retrospective analytical observational study on 95 patients diagnosed with ACS in the period 1 January 2022-31 March 2023 at H. Adam Malik General Hospital, Medan. All patients involved had undergone primary percutaneous coronary intervention. Patient characteristics, risk factors, laboratory results and coronary angiography were recorded from the patient's medical record. Results: There was a significant relationship between the systemic inflammatory immunity index value and the incidence of high intracoronary thrombus burden in STEMI patients (P < 0.001). The systemic inflammatory immunity index cut off point value > 1108 has a sensitivity of 89.4% and a specificity of 89.7% which has a better accuracy in predicting high intracoronary thrombus burden in STEMI patients. Conclusion: Systemic inflammatory immunity index has a good accuracy to predict high intracoronary thrombus burden in STEMI patients.

Correlation of P Wave Dispersion and Quality of Life of Heart Failure Due to Coronary Heart Disease Patient in Haji Adam Malik General Hospital Hillary, Lastri; Nasution, Ali Nafiah; Lubis, Anggia Chairuddin
Journal of Society Medicine Vol. 3 No. 4 (2024): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i4.138

Introduction: P wave dispersion is a more sensitive cardiovascular marker which obtained by the ECG to elaborate structural and electrophysiological abnormalities in patients. This study aims to elucidate P wave dispersion prevalence in heart failure due to coronary heart disease patients and the correlation with their quality of life. Method: This analytical cross-sectional study is done in RSUP Haji Adam Malik in 133 patients with heart failure from May to June 2023. Patients had undergone clinical evaluation, physical examination, 12-lead electrocardiography (ECG), and then were given the MLFHQ to assess the quality of their lives. Data were analyzed using fischer-exact test, with p value less than 0.05 considered to be significant. Results: From the total of 133 sample of patients, there were 55 (43.2%) patients with positive p wave dispersion, among them 2 had low quality of life, 25 had moderate quality of life, and 28 had good quality of life. With mean of PWD is 27.9±15.1 ms. The group of patient with negative p wave dispersion 78 had moderate and good quality of life. P value is less than 0.01. It’s concluded that there was a positive correlation between p wave dispersion and quality of life of heart failure patients in Haji Adam Malik general hospital Conclusion: There is positive correlation between p wave dispersion and quality of life of heart failure due to coronary heart disease patients in Haji Adam Malik general hospital.

Monocyte to High-Density Lipoprotein Ratio (MHR) as A Predictor of Major Cardiovascular Events in Acute Myocardial Infarction Patients with ST-Segment Elevation in Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Central General Hospital Nikensari, Grace; Nasution, Ali Nafiah; Siregar, Abdullah Afif
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.v3i5.140

Introduction: IMA-EST is a cardiovascular disease with high mortality and morbidity. Therefore, tools (markers) to efficiently predict mortality rates are essential to reduce these rates for effective management. Since most of the available literature suggests that MHR value can be used as a predictor of MACE, we are interested in examining MHR as a predictor of MACE in IMA-EST patients undergoing primary PCIMethods: This type of study was an observational analytic study with the research design used is an ambispective cohort. namely assessing the role of MHR Ratio as a predictor of prognosis after primary MACE in IMAEST patients. This study was conducted at HAM Hospital Medan from April-June 2023. Patients who met the inclusion and exclusion criteria were assessed for laboratory parameters such as triglyceride levels and calculated MHR index, then MACE was observed in patients who underwent primary IKP. The MACE assessed was cardiovascular death, malignant arrhythmia, cardiogenic shock, and acute heart failure during hospitalisation and 30 days post-treatment either through control at the polyclinic or by telephone and interview. Results: A total of 55 samples were obtained. The GRACE Score and MHR parameters have an area under the ROC curve > 0.7. The MHR parameter had a sensitivity of 69.2% and specificity of 64.3% and a p value <0.05. Based on ROC curve analysis, the cut-off-point parameter for estimating predictors of MVC was 22.48. The GRACE Score coefficient is 0.466 with a significance value (p value) of 0.001 that there is a correlation between the GRACE Score parameters and MHR parameters. Conclusion: High monocyte counts have an association of low HDL-C levels in the development of atherosclerosis and MACE.

Comparison of Syntax II Score And Grace Score As Predictors of Major Cardiovascular Events 30 Days after Treatment in STEMI Undergoing PPCI Abimanyu, Roni; Sitepu, Andika; Nasution, Ali Nafiah
Journal of Society Medicine Vol. 3 No. 6 (2024): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i6.150

Introduction: IMA-EST is still the main cause of morbidity and mortality in Coronary Artery Disease (CAD) and PPCI is still the main treatment method for IMA-EST patients. Even though PPCI has been undergone, patients are reported to still experience mortality and morbidity both in hospital and after discharged. The SYNTAX II score uses clinical, laboratory and anatomical parameters that are believed to be better than the GRACE score to predict mortality and morbidity. Method: This study is an observational analytic with a retrospective cohort design in STEMI patients who underwent PPCI at HAM General Hospital from January 2023 to June 2023. Patients who were diagnosed with STEMI and underwent with PPCI had their GRACE score and SYNTAX II score calculated and followed for 30 days. SYNTAX-II Score’s cut-off point, sensitivity and specificity as well as predictive possibilities in predicting adverse outcomes were determined. Then bivariate analysis was carried out on each SYNTAX-II Score and GRACE score. Results: The study subjects totaled 73 people with an average age of 56.05 ± 10.07 years. The incidence of MACE 30 days after treatment in our sample was 23.3%. It was found that the SYNTAX II score could well predict occurrence of MACE 30 days after treatment (cut off 33,75, AUC 0.861; 0.773 – 0.949; sensitivity 94.1%; specificity 69.6%, PPV 94.1% and NPV 67.6). The result of the bivariate analysis of the SYNTAX-II Score were: P < 0,0001; OR: 18,353; 95%; CI: 2,566 – 131,241and the results of the GRACE Score were: P < 0,006; OR 5,854; 95%; CI: 1,442 – 23,764. Conclusion: The SYNTAX II score is better to predict occurrence of MACE 30 days after treatment in STEMI patients who undergoing PPCI compared to the GRACE score.

Validasi Skor PEACH sebagai Prediktor Mortalitas Selama Rawatan Paska Operasi Penyakit Jantung Bawaan Pada Dewasa di Rumah Sakit Umum Pusat Haji Adam Malik Medan Zebua, Juang Idaman; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Hasan, Harris; Akbar, Nizam Zikri
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1546

Introduction: Congenital heart disease (CHD) is an abnormality in the structure and function of the heart that is acquired while still intrauterine where the incidence of CHD worldwide is estimated at around 8 cases per 1,000 live births. Even though the development of the medical science is currently advanced, there are still CHD patients who are lately diagnosed and found when the patient is an adult so it requires surgical interventions. The PEACH score is a score that can predict postoperative in-hospital mortality in adults CHD patients. This study aims to validate the PEACH score. Methods: This is a retrospective cohort study of 52 adult patients with CHD who underwent surgery at Haji Adam Malik General Hospital from January 2019 to April 2023. Validation was analyzed using a calibration and discrimination test to the PEACH score in predicting postoperative in-hospital mortality. Result: The incidence of in-hospital mortality was 8 (15.4%) patients. There is a relationship between the PEACH score group and the incidence of mortality (p=0.006). The results of the calibration test using the Hosmer and Lameshow analysis and the discrimination test using the Receiver Operating Characteristic analysis showed good validation (p=0.85; AUC=0.83). Conclusion: The PEACH score is valid for predicting postoperative in-hospital mortality in adult congenital heart disease at Haji Adam Malik General Hospital.

Prevalence of Congenital Heart Disease and Pediatric Rhythm Disorder or Arrhythmia in Children in Rantau-Prapat City, North Sumatra, Indonesia Lubis, Anggia Chairuddin; Nasution, Ali Nafiah; Lubis, Hilfan Ade Putra
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 4 (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.v5i4.14332

Background: Cardiovascular diseases (CVD) are responsible for the leading cause of a 30% global mortality rate and are a major contributor to reducing the quality of life. Approximately 25% of the cardiovascular mortality rate is caused by sudden cardiac deaths and cardiac arrhythmias are one of the causes of sudden cardiac deaths. Besides that, Congenital Heart Disease (CHD) also contributes mortality rate in children. Long-term experience has provided evidence that systematic screening, with 12-lead ECG, after history and physical examination, is effective in identifying individuals with potentially lethal cardiovascular disease for early intervention. However, in Indonesia screening for heart abnormalities and rhythm disorder in children has not yet been systematically established. Method: This study was a descriptive study conducted through a cross-sectional study design. The primary objective was to assess the congenital heart disease (CHD) and Arryhtmia prevalence in children in Rantau City. Data was collected from interviews and on-the-spot examination with validated measurement tools. Data was analyzed using SPSS version 26. Categorical variables were presented using frequency (n) and percentage (%), and numerical variables with normally distributed data were presented with mean and standard deviation (SD). In non-normally distributed data, numerical variables were presented using the median and interquartile range. Results: There were 157 children included in this study. Most subjects were female (n=94, 59.9%) in the age range of 12 to 16 years old. Most subjects (n=129, 82.2%) had normal sinus rhythm. The only rhythm disorder that was found in this study was sinus tachycardia (n=28, 17,8%). One subject (0,9%) had congenital heart disease, which was a secundum atrial septal defect. Conclusion: In the children population in Rantau-Prapat city, the most common arrhythmia found in children was sinus tachycardia. The atrial septal defect was the only congenital heart disease found.

Early detection of subclinical rheumatic heart disease through echocardiographic screening: a study in North Sumatra, Indonesia Ardini, Tengku Winda; Ilyas, Kamal Kharazzi; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Napitupulu, Bertha Gabriella; Batubara, Gio Justisia; Sarastri, Yuke; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Siregar, Yasmine Fitrina; Dewita, Auliya; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Heart Science Journal Vol 5, No 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.10

BACKGROUND: Given the urgent need to address the significant morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is a growing interest in exploring cost-effective screening approaches, such as handheld echocardiography.OBJECTIVES: The purpose of this study was to ascertain the prevalence of RHD in North Sumatra, Indonesia.METHODS: This descriptive observational study was conducted within the population of North Sumatra from 2022 to 2023. Junior high school students aged 12 to 15 years were included from randomly selected schools in Langkat, Tebing Tinggi, and Labuhan Batu. Data collection encompassed various parameters, including social demographic information, parental characteristics, environmental factors, household details, anthropometric measurements, physical assessments, auscultation findings, and echocardiographic data. The data were analyzed descriptively.RESULTS: In our study, a total of 692 children were examined, with an average age of 12.9 years and a standard deviation of 1.1 years, among whom 42.5% were male. Utilizing echocardiographic evaluations, we identified RHD in four children, yielding a prevalence rate of 0.6%. Further examination of these cases revealed that the majority, accounting for three individuals (75%), exhibited borderline RHD, while one child (25%) presented with definite RHD.CONCLUSION: In our study population, the prevalence of RHD was 0.6%. A broader echocardiographic screening program is necessary to determine the overall prevalence of RHD, assess the disease burden, and identify individuals earlier to prevent adverse outcomes.

Relationship Between Left Atrium Reservoir Strain and One-Year Mortality After Surgery in Patients with Severe Primary Mitral Regurgitation Undergoing Mitral Valve Replacement at Haji Adam Malik General Hospital, Medan Abimanyu, Roni; Ketaren, Andre Pasha; Nasution, Ali Nafiah
Journal of Society Medicine Vol. 4 No. 2 (2025): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i2.200

Introduction: Severe primary Mitral Regurgitation (MR) is a public health program that continues to grow. Echocardiography is still a tool to assess the severity and prognostic of mitral valve disease. LASr assessment has the benefit of assessing the prognostic in patients who have undergone mitral valve replacement surgery. This study aimed to determine the relationship between LASr and mortality one year after surgery for severe primary MR undergoing valve replacement surgery Methods: This study is an analytic study with a cross-sectional design on 55 subjects with severe primary MR who met the inclusion and exclusion criteria at Haji Adam Malik General Hospital. LASr was measured before surgery and followed by the incidence of mortality one year after mitral valve replacement surgery. Data were analyzed univarite and bivariate as well by correlation tests to assess the relationship between LASr and one-year mortality in severe primary MR undergoing valve replacement surgery Results: The study subject totaled 55 patients with an average age of 39,35 ± 12,59 years, 28 patients (50.9%) were male and 11 patients (20%) experienced mortality. The main cause of mitral valve abnormalities in this study was rheumatic, namely 39 cases (70.9%). The LASr threshold value was found to be 18.8 (sensitivity: 90.9%; specificity: 70.5%). (AUC: 0.851; P = 0.0001 and 95% CI (0.751 – 0.952). Conclusion: LASr has a significant correlation to predict one-year mortality in patients with severe primary mitral regurgitation undergoing mitral valve replacement surgery.

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