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Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients Wasyanto, Trisulo; Meilus, Budi Patria; Yasa, Ahmad
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Myeloperoxidase (MPO) levels have been shown to have prognostic values for death events in acute myocardial infarction (AMI) patients. Increased levels of high sensitive troponin I (hs Trop I) are associated with poorer prognosis in AMI patients. This study aimed to determine the association between levels of MPO and hs troponin I at admisson on myocardial contractility in AMI patients.Subjects and Method: This was a prospective observational analytic study, conducted at Dr. Moewardi General Hospital, Surakarta, from November1, 2018 to January 31, 2019. The study subjects were patients who were diagnosed with AMI. A total of 23 patients were included in this study; 15 patients with ST elevation myocardial infarction (STEMI) and 8 with non ST elevation myocardial infarction (NSTEMI). The dependent variable was myocardial contractility. The independent variables were MPO and hs Trop I. Blood tests for MPO and hs Trop I was measured at admission and the left ventricular ejection fraction (LVEF) was measured when predischarge by the Simpson method to examine myocardial contractility. The data were analyzed by Pearson correlation run on SPSS 22. Results: hs Trop I (r= -0.53; p= 0.009) and MPO (r= -0.15; p=0.487) decreased LVEF.Conclusion: Hs Trop I at admission has a correlation with myocardial contractility, and no correlation of MPO at admission with myocardial contractility in AMI patients.Keywords: Myeloperoxidase, High sensitive Troponin I, Acute myocardial infarctionCorrespondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: trisulo.wasyanto@gmail.com.Indonesian Journal of Medicine (2020), 05(04): 265-271https://doi.org/10.26911/theijmed.2020.05.04.01.

Biopsychosocial Analysis of Factors on COVID-19 Screening Awareness of Infertile Couples in Assisted Reproductive Technology Budihastuti, Uki Retno; Laqif, Abdurahman; Melinawati, Eriana; Prakosa, Teguh; Udiyanto, Hermawan; Priyanto, Heru Priyanto; Darto, Darto; Rantasari, Affi Angelia; Wasyanto, Trisulo; Anggraeni, Asih; Wijayanti, Agung Sari
Journal of Maternal and Child Health Vol. 6 No. 5 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: The development of screening methods for infertility patients during the Coronavirus-2019 (COVID-19) pandemic provides new challenges in the adaptation of children's want programs in the era of the COVID-19pandemic. Several screening methods have been developed but various factors affect the awareness of couples to want to do COVID-19 screening. This study aimed to analyze biopsychosocial factors associated with awareness of COVID-19 screening in infertile couples. Subjects and Method: A cross-sectional study conducted at The Sekar Polyclinic of Dr. Moewardi Regional General Hospital during the COVID-19 pandemic. A number of 60 infertile couple of reproductive age who underwent the ART program was selected by random sampling. The dependent variable was awareness for COVID-19 screening. The independent variables were anxiety, knowledge, age, and length of infertility. The data were obtained from medical record and questionnaire and analyzed by a multiple logistic regression. Results: Anxiety (OR= 26; 95% CI; p<0.001) and above-average knowledge levels (OR=16; 95% CI; p<0.001) affected awareness for COVID-19 screening. While the age and length of infertility do not affect awareness for COVID-19 screening (p >0.05). Conclusion: Anxiety and above-average knowledge levels affect awareness for COVID-19 screening.

The Sub-Analysis of HFmrEF and HFrEF Group in CORE-HF Registry : When being Good is Not Enough Wasyanto, Trisulo; Irnizarifka, Irnizarifka; Chau, Titus H.; Arifianto, Habibie
Jurnal Kardiologi Indonesia Vol 44 No 1 (2023): Indonesian Journal of Cardiology: January - March 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1545

Background : As the prevalence of heart failure (HF) kept rising each year, the burden caused by it also escalating, especially in terms of economic burden. This is urging the physician to quickly tackle the problem. Although HFrEF medications were developing vastly, the outcome of HF in real world still varies. This indicates another approach is still needed to manage HFrEF/HFmrEF comprehensively. This paper is aimed to give an overview of HFrEF and HFmrEF epidemiological data, based on CORE-HF real world data. Methods : The CORE-HF is a single-center, prospective-cohort registry, which enrolls all patients with chronic HF, that were recruited consecutively from the outpatient Sebelas Maret HF Clinic. Both enrollment and follow-up have been performed since January 2018 until December 2022. Variables recorded consists of baseline characteristics, risk factors, subjective indicators, objective diagnostic assessments, therapies, and outcomes (readmission and mortality). Results : The population of this registry was younger (58.7 ± 12.14) compared to other HF registries, with more multi comorbidities. The number of HFrEF patient was higher than HFmrEF (77.7% vs 22.3%), with clinically higher mortality rate (7.2% in the 1st year and 18.2% in the next year). Although triple therapy initiation and uptitration were excellent in number, the mortality rate during second year of follow-up was higher than other registries. We found non-compliant behavior to be responsible for those results. Conclusion : Based on CORE-HF sub-analysis of the HFrEF and HFmrEF groups, adherence to HF guidelines is the main but not the only key leading to lower mortality and rehospitalization. Our data provide satisfying low hard outcomes, but solving the non-compliance behavior and optimizing the non-pharmacological approach should be done comprehensively by the HF team.This article has a related Erratum.

Role of Copeptin in predicting of Major Adverse Cardiovascular Events (MACE) during Hospitalization on Acute Myocardial Infarction Patients Wasyanto, Trisulo; Raynantha, I Putu; Yasa, Ahmad
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Copeptin has been considered as a potential biomarker for AMI which also give information regarding the prognostic of the Acute myocardial infarction (AMI). The aim of this study is to understand the role of copeptin as a predictor of major adverse cardiovascular events (MACE) during hospitalization in AMI patients.Subjects and Method: This was a cohort analytical study conducted at Dr. Moewardi Hospital, Surakarta, from March to May 2021. The dependent variable was MACE. The independent variable was the copeptin level. We observe the MACE during hospitalization and analyze the cut-off point value for optimal copeptin levels to predict the occurrence of MACE using the receiver operating characteristic (ROC) curve. Linear multiple regression was conducted to predict determinants of MACE in hospitalization patients.Results: 52 patients recruited in this research (44 males, 8 females). During hospitalization, MACE occurred in 52% of these subjects, with the respective proportions for acute heart failure, cardiogenic shock, arrhythmias, cardiopulmonary resuscitation, and mortality of 28%, 10%, 8%, 4%, and 2%. The ROC curve showed that the cut-off point of copeptin was 2,141.50 pg/mL and area under curve (AUC) value of 0.710 with sensitivity of 75.0%, specificity of 68.80% and accuracy of 71.15%. Hence, the AUC values and accuracy present fair results for predicting MACE during hospitalization in AMI patients.Conclusion: Copeptin has a role as a predicttor of MACE during hospitalization in AMI patients.Keywords: copeptin, mayor adverse cardiovascular events, acute myocardial infarctionCorrespondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java. Email: trisulo.wasyanto@gmail.com.Indonesian Journal of Medicine (2021), 06(02): 230-238https://doi.org/10.26911/theijmed.2021.06.02.12.

Anticoagulant Management of Mechanical Heart Valve Patients During Perioperative Surgery: A Case Report Wasyanto, Trisulo; Yudhistira, Yoga; Anggraini, Nutria; Yasa, Ahmad; Irnizarifka, Irnizarifka
Indonesian Journal of Medicine Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.4.667

Background: Patients with mechanical heart valves require lifelong oral anticoagulation. It will be a dilemma if a patient with a mechanical heart valve has surgery. This case report aims to discuss how to interrupt oral anticoagulants and bridging therapy in patients with mechanical heart valves who will be undergoing non-cardiac surgery. Case Report: A 26-year-old pregnant woman, G1P0A0, aterm with a mechanical mitral valve, will have elective Sectio Caesarian Transperitonealis (SCTP) surgery and Intra Uterine Device (IUD) insertion. The patient had a history of mitral valve replacement surgery (MVR) in 2014 and was routinely treated with 4 mg of warfarin at night. From the examination, blood pressure was 120/80 mmHg, heart rate was 90 beats per minute, and pulse rate was 90 beats per minute. The ECG examination found sinus rhythm with 1st-degree atrioventricular block, right axis deviation, 90 beats per minute, and left atrial enlargement. We decided to have oral anticoagulant interruption and bridging therapy by stopping warfarin three days before surgery. When the international normalized ratio (INR) falls <2, patients are given heparin injections (UFH) with an APTT target of 1.5-2.0 times from basic APTT. When the patient was about to be operated on, UFH was stopped 6 hours before surgery and resumed 12 hours after surgery. Warfarin was given one day postoperatively. Patients were adjusted to the dose of UFH according to the target. This patient had no thromboembolic events or bleeding before, during, or after surgery. The patient was allowed to be an outpatient and was given home therapy with Warfarin 5 mg at night. Results: We report a case of a 26-year-old female patient with a mechanical mitral valve who was going to undergo elective SCTP surgery and an IUD insertion. Patients at high risk of thrombo¬embolism due to surgery with a high risk of bleeding. Bridging therapy was performed using UFH. In the perioperative period, the patient did not experience thromboembolic events, and bleeding before, during, and after surgery could be well controlled. Conclusion: Perioperative management of patients with mechanical heart valves must be done carefully. Interruption of oral anticoagulants should be carefully considered considering the risk of thromboembolism and bleeding during the perioperative period. Guidelines recommend that in patients with mechanical heart valves, anticoagulation interruption for minor surgeries is avoided. Whereas in patients with major surgery, it is necessary to do bridging therapy with fast-acting anticoagulants such as UFH or LMWH. Keywords: mechanical heart valve, anticoagulant interruption, perioperative, bridging therapy Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: trisulo.wasyanto@staff.uns.ac.id. ORCID ID: 0000-0001-9900-0497. Mobile: +62811294225.

Pulmonary Hypertension in Pregnancy: A Case Report Wasyanto, Trisulo; Anggraini, Nutria Widya Purna
Indonesian Journal of Medicine Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.4.683

Background: Pulmonary Hypertension (PH) is a disease characterized by distressing symptoms and decreased life expectancy due to the narrowing of the blood vessels of the lungs, which often leads to right heart failure. The prevalence of PH in women is 97 cases per million, with 64% of the main causes of PH in pregnancy congenital heart defects, resulting in a very high maternal and fetal mortality rate. Case Report: A 38-year-old G4P1A2 31-week gestational age complained of shortness of breath for 5 days. Physical examination revealed blood pressure was 107/62 mmHg, Heart Rate was 98 beats per minute, respiration 40x per minute, and SpO2 88% with NRM 10 Lpm. The heart examination obtained heart sound I -II regular and a systolic murmur was heard between the left 2nd ribs. Abdominal examination was single fetus, intrauterine, breech presentation, His (+), fetal heart rate 160 beats per minute. vaginal toucher 2 cm in labour. ultrasound examination singles fetal, transverse lies, with an estimated fetal weight of 1600 grams. Echocardiography finding: ASD II L to R shunt with LV EF 60%(T), 62% (S), dilated RA-RV, TR severe, MR mild, High Probability of Pulmonary Hypertension. The patient was diagnosed with Dyspnea, Pulmonary edema caused by cardiogenic, ASD II, High probability of PH, NYHA IV, and Breech presentation in labor. Decided to perform a caesarian section and sterilization. The Male baby was born with 1570 grams Apgar Score 3-5-7. post operation patient was admitted to ICU. Twelve hours after the operation the patient had decreased control and became a PH crisis then the patient was declared dead. Results: The death of the patient, in this case, was caused by cardiogenic shock due to Pulmonary Hypertension Crisis. Conclusion: Early diagnosis along with collaborative and comprehensive management of pulmonary hypertension is needed for good maternal and fetal outcomes. Keywords: pulmonary hypertension, pregnancy, heart disease. Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: trisulo.wasyanto@staff.uns.ac.id. Mobile: +62811294225.

The Sub-Analysis of HFmrEF and HFrEF Group in CORE-HF Registry : When being Good is Not Enough Wasyanto, Trisulo; Irnizarifka, Irnizarifka; Chau, Titus H.; Arifianto, Habibie
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2031

In “The Sub-Analysis of HFmrEF and HFrEF Group in CORE-HF Registry: When being Good is Not Enough” (Indonesian Journal of Cardiology, 44(1), 10-6. https://doi.org/10.30701/ijc.1545), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1545. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1545

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