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All Journal CRJIM (Clinical and Research Journal in Internal Medicine)
Kakiay, Ferdinandus Stevanus
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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The Effect of Fasting Blood Glucose (FBG) on Troponin I and Clinical Outcomes in Acute Coronary Syndrome (ACS) : A Retrospective Analysis: A Retrospective Observational Study Abshori, Nuril Farid; Ahdi, Iwal Reza; Kakiay, Ferdinandus Stevanus
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.08

Abstract

Background: In the early phase of Acute Coronary Syndrome (ACS), simple parameters such as fasting blood glucose (FBG) and cardiac troponin I (cTnI) may provide prognostic information. However, evidence regarding their relationship remains inconsistent, particularly in the Indonesian population. Objective: To investigate the correlation and association between FBG and cTnI in patients with ACS at Karsa Husada Hospital, Batu, Indonesia. Methods: This retrospective observational study included 75 hospitalized ACS patients. Clinical and laboratory data were collected from medical records. Troponin values were log10-transformed. Statistical analyses included Spearman correlation, stepwise linear regression per 10 mg/dL increase in FBG, categorical FBG classification (<100, 100–125, ≥126 mg/dL), trend testing, and restricted cubic spline modeling. Fully adjusted models incorporated age, sex, diabetes, estimated glomerular filtration rate, systolic blood pressure, and heart rate. Results: The median age was 62 years, and 64% were male. FBG showed a weak, non-significant correlation with cTnI (rₛ = 0.19; p = 0.12). After adjustment, each 10 mg/dL increase in FBG was associated with an 8.6% higher cTnI level (β = 0.036; 95% CI −4.5% to +23.6%; p = 0.20). Compared with normal FBG, hyperglycemia (≥126 mg/dL) was associated with a 50.6% higher cTnI level, although this was not statistically significant (p = 0.60), and no significant linear trend was observed (p-trend = 0.55). Spline analysis revealed no significant non-linearity (p = 0.72), and no interaction by diabetes status (p = 0.67). Conclusion: In this ACS population, higher FBG tended to be associated with higher cTnI levels; however, the relationship attenuated and lost significance after adjustment. FBG may serve as an additional risk marker rather than a primary determinant of myocardial injury in the early phase. Keywords: fasting blood glucose, troponin I, acute coronary syndrome, hyperglycemia
Diagnostic Delay in advanced Gastroesophageal Adenocarcinoma presenting as Chronic Neurogenic Dysphagia: Gastroesophageal Adenocarcinoma and Chronic Neurogenic Dysphagia Abshori, Nuril Farid; Kakiay, Ferdinandus Stevanus; Ahdi, Iwal Reza; Patikawa, Febria Rizky
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.15

Abstract

Advanced adenocarcinoma of the esophagogastric junction (AEGJ) may mimic benign or neurogenic swallowing disorders, leading to delayed diagnosis. We report a 65-year-old man with a two-year history of progressive dysphagia initially attributed to neurogenic causes following an ischemic stroke. The patient developed recurrent vomiting, epigastric pain, and significant weight loss (16 kg). On admission, he appeared cachectic (BMI 16.7 kg/m²) with anemia (Hb 7.7 g/dL) and hypoalbuminemia (2.4 g/dL). Contrast-enhanced CT revealed an infiltrative mass involving the distal esophagus and gastric fundus with lymphadenopathy, while endoscopy showed a friable obstructive lesion confirmed as adenocarcinoma on biopsy. A feeding jejunostomy was performed for nutritional optimization prior to oncologic therapy. The diagnostic delay resulted from anchoring bias, in which dysphagia was misinterpreted as neurogenic rather than structural. This case emphasizes the importance of early endoscopic evaluation in elderly patients with chronic progressive dysphagia, weight loss, or anemia, and highlights the need for clinician awareness of cognitive biases to prevent late-stage presentation and improve clinical outcomes.
Co-Authors Abshori, Nuril Farid Ahdi, Iwal Reza Patikawa, Febria Rizky