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Troubleshooting for Kinked Coronary Catheter: How to Manage? ; A Case Series Noverike, Nikhen; Satrijo, Budi; Widito, Sasmojo; Kurnianingsih, Novi; Abusari, Muchamad
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.7

Background: Catheter entrapment and knotting are two problems that might arise during coronary angiography, regardless of the method used. It is not uncommon for the catheter shaft to become kinked during diagnostic or interventional procedures. Still, if the manipulation fails, an invasive retrieval method is usually necessary for cases with extensive catheter kinking.Case Illustration: We present two cases illustrating how different angiography approaches could lead to severe catheter kinking. Because of the significant tortuosity of the vasculature, even a gentle opposite rotation maneuver and the antegrade advancement of multiple guidewires failed to untwist the guide catheter. Once a twisted catheter has been identified via fluoroscopy, the twist can be eased by gently twisting the catheter in the opposite direction. It is not always easy. It could lead to using other interventional techniques such as snare, balloon, or surgical procedures. In our cases, we used a snare to snag the catheter's tip and untied the loop's knot. This prevented the need for unscheduled surgical intervention. We evaluated from angiography. There were no further complications. The patients were released from the hospital the following day.Conclusion: Although a kinked catheter could become entrapped, various approaches can be taken to deal with this difficulty and prevent the need for surgical intervention.

Benefits of Low Dosage of Colchicine Administration on Decreasing Rehospitalization and Mortality within 30 Days in Post-Acute Coronary Syndrome Patients with ST-Segment Elevation Undergoing Percutaneous Coronary Intervention Satrijo, Budi; Ashari, Yordan Wicaksono; Rohman, Mohammad Saifur; Anjarwani, Setyasih; Tjahjono, Cholid Tri
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.6

Background: The role of inflammation in myocardial infarction and post-infarction MI remodeling has become a concern for the development of treatment in the last decade. Colchicine can prevent increased inflammation during acute injury.Objective: This study focused on the role of colchicine as an on-top medical treatment, hoping it can reduce mortality and short-term rehospitalization in patients with STEMI.Methods: 347 AMI patients (18-80 year old adults) who visited RSUD dr. Saiful Anwar Malang, between February 2022 and January 2023, participated in this prospective, randomized, double-blinded, placebo-controlledexperiment. Patients were split into two groups and given either a placebo orÂ colchicine 0.5 mg daily for a month. Standard medical therapy was administered concurrently to both groups as an approachable guideline. The study endpoints were mortality and rehospitalization rates.Result: After one month of follow-up, there was a reduction in rehospitalization due to cardiovascular causes (2 [1.3%] vs. 4 [2.7%], HR 3.42 [1.36-8.56], p<0.05), which was significant in the treatment group compared to the control group. Also, there was a reduction in all-cause mortality, but not statistically significant (2 [1,3% v 3 [2,0%], HR 3,38 [0,53-7,48], p>0,05). In the treated group, there was also a lower non-cardiovascular rehospitalization rate compared to placebo, but not significant (4 [2.6%] vs. 7 [4.7], HR 0.42 [0.15-1.02], p<0.05).Conclusion: The administration of low-dose colchicine for one month has shown benefits in reducing rehospitalization in patients with STEMI who receive PCI therapy.

Colchicine attenuates chemical hypoxia-induced pyroptosis through downregulation of nuclear factor kappa B and caspase-1 in cardiomyocytes Satrijo, Budi; Rohman, Mohammad S.; Aulanni'am, Aulanni'am; Sujuti, Hidayat; Lestari, Bayu
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.2245

Myocardial infarction (MI) is the leading cause of mortality worldwide. During MI, cardiomyocyte necrosis and inflammation are crucial in the post-MI cardiac remodeling process, including pyroptosis. Although colchicine is a well-known anti-inflammatory drug that has been clinically studied in the context of MI, its role in cardiac pyroptosis remains unclear. The aim of this study was to investigate the role of colchicine in pyroptosis in vitro, using CoCl2-induced H9c2 cells. Prior to the primary experiment, the hypoxic model in H9c2 cells was optimized by evaluating hypoxia-inducible factor-1 alpha (HIF-1α) expression and viability in cells exposed to various concentrations of CoCl2 at different time intervals. Subsequently, an in vitro hypoxia model was established by treating H9c2 cells with CoCl2 (600 µM), with or without colchicine (1 µM), for 3 hours. Flow cytometry was used to measure the expression of nuclear factor-kappa beta (NF-κB), interleukin 18 (IL-18), caspase-1, and HIF-1α in pyroptotic cells. Immunofluorescence was used to assess caspase-1 localization and its colocalization with propidium iodide during late-stage pyroptosis. Our data indicated that CoCl2-induced hypoxia significantly upregulated NF-κB, caspase-1, and IL-18 expression, and increased pyroptotic cell death in H9c2 cells. Colchicine treatment attenuated these effects, leading to a marked reduction in NF-κB, caspase-1, and IL-18 expression in hypoxic cells. Colchicine treatment significantly decreased the number of late pyroptotic cells. The protective effect of colchicine was more pronounced in late hypoxia (24-hour) setting compared to early hypoxia (3-hour). These findings suggest that colchicine attenuates cardiac pyroptosis in hypoxic H9c2 cells, as evidenced by the significant downregulation of key proteins involved in this pathway, including NF-κB, caspase-1, and IL-18. This protective effect appeared to be more effective in late hypoxia.

Cardioprotective effects of colchicine: Targeting pyroptosis and inflammation in myocardial infarction Satrijo, Budi; Mohammad Saifur Rohman; Aulanni'am Aulanni'am; Hidayat Sujuti; Bayu Lestari; Rislan Faiz Muhammad
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.8

Myocardial infarction (MI) is a significant contributor to global morbidity and mortality. The outcome of MI is associated with the inflammatory response triggered by ischemic or necrotic cells. Pyroptosis is a type of programmed cell death that can exacerbate cardiac injury following MI. This study reviewed the potential therapeutic effects of colchicine in regulating cardiac pyroptosis in response to MI. Primarily, colchicine inhibits tubulin polymerization and microtubule formation, disrupting inflammasome advancement and the subsequent secretion of various pro-inflammatory mediators. In particular, colchicine disrupts the NLRP3 inflammasome assembly process by blocking ASC recruitment into the complex, suggesting its potential to mitigate the inflammatory response related to cardiac pyroptosis. Additionally, colchicine binds to P2X7 receptors, reducing ATP-induced microtubule and pore formation, which attenuates reactive oxygen species and IL-1β production. A clinical trial involving colchicine showed positive outcomes in lowering the occurrence of major cardiovascular events in individuals with coronary artery disease (CAD). Nonetheless, additional studies are required to ascertain the ideal dosage, timing, and long-term effects of colchicine in the infarcted myocardium before it can be routinely recommended for post-MI treatment. In conclusion, colchicine's modulation of the inflammatory response and inhibition of pyroptosis highlight its potential as a cardioprotective agent for MI management.

Pendekatan Terkini Dan Masa Depan Pada Penyakit Jantung Koroner Prematur Firdaus, Achmad Jauhar; Satrijo, Budi
Jurnal Klinik dan Riset Kesehatan Vol 5 No 1 (2025): Edisi Oktober 2025
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.05.1.6

Coronary artery disease is one of the most frequent cardiovascular diseases and has consistently ranked as the leading cause of death globally for the past three decades. During that period, trends regarding coronary artery disease in young adults have exhibited a complicated interaction of rising incidence and mortality rates in particular populations. Coronary artery disease encompasses a broad range of symptoms and is particularly concerning when it develops at a young age, typically before 55 years in men and 60 years in women. The disease spectrum varied from asymptomatic conditions to chronic symptoms known as chronic coronary syndrome and acute symptoms known as acute coronary syndrome. Multiple recommendations and consensus have been established concerning the approaches to these spectrums, although there is less discourse on precisely addressing the young population's specific requirements. This extensive analysis offers insights into premature coronary artery disease and the multidimensional approach based on the latest guidelines and the novel approach using the help of artificial intelligence and machine learning, emphasizing early detection and diagnosis across the whole clinical spectrum.

The Relationship of Heart Rate Recovery Post Exercise Stress Test To Syntax Values In Patients With Stable Coronary Artery Disease Iskandar, Iskandar; Anjarwani, Setyasih; Tjahjono, Cholid Tri; Satrijo, Budi; Swastika Putri, Valerinna Yogibuana
Heart Science Journal Vol. 3 No. 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improv
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.4

Background:The prognostic usefulness of abnormal heart rate recovery (HRR) as a predictor of death has been discovered. Abnormal HRR results from inadequate vagal activation after exercise. The association between HRR and angiography in CAD (coronary artery disease) has been studied, however the conclusions are still being contested due to a lack of data. The purpose of this study is to see if HRR after an EST (exercise stress test) may predict the severity of syntax values in individuals with stable CAD at Saiful Anwar Hospital Malang (RSSA).Â Methods:This study is an analytic observational study with a retrospective cross sectional design. It was held in Saful anwar, Malang Hospital during January 2017â€“December 2019, including 366 patients. All patients underwent exercise stress test for CAD screening and coroner angiography.Â Those were divided into two groups, which included syntax scoreÂ Â < 23 (n=148) and syntax score â‰¥ 23 (n= 218).Â Result:Â Chi-square analysis was used toÂ analyze the relationship correlation between HRR1, HRR2 and Syntax Score, and was used to compared between HRR1 (heart rate recovery first minutes), HRR2 (heart rate recovery second minute) and Syntax Score group. The confounding factor was adjusted with multivariate logistic regression analysis and AUC curve. There was a significant negatif correlation between abnormal HRR1 and HRR2 after exercise and Syntax score, with strong correlation (HRR1 ; OR = -2.11, p = 0.00 AUC :90,8%, HRR2 ; OR = -1,6, p = 0,48, AUC : 70,4%).Â Â Conclusion:Â Abnormal first and second minutes of HRR afterÂ exercise stress testÂ in stable CAD patient have a higher incidence of high Syntax Score (>1) than stable CAD patient with normal HRR.Â Keywords:Â Coronary artery disease (CAD), Heart rate recovery (HRR), Syntax.Â

Acute Hemodynamic Index as a Predictor of In-Hospital Mortality in Mechanical Ventilated Acute Decompensated Heart Failure Patients Kurniawan, Dea Arie; Anjarwani, Setyasih; Rizal, Ardian; Satrijo, Budi; Yogibuana, Valerinna
Heart Science Journal Vol. 4 No. 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.4

Background: The likelihood of a poor clinical outcome is significantly increased in patients with acute decompensated heart failure. Mechanical ventilation was necessary for 23% of ADHF patients receiving treatment. The simple parameters of blood pressure and heart rate have good accuracy and repeatability. The development of the Acute Hemodynamic Index allowed for the calculation of pulse pressure and heart rate to be used as a basis for predicting intrahospital mortality.Methods: The medical records of patients who received care at CVCU RSSA were used in this retrospective, single-center study. ROC analysis and multivariate regression analysis were used to evaluate the prognostic performance of AHI. Statistical significance was determined by the P value of 0.05 or lower.Results: 252 patients with heart failure and low ejection fraction had their data analyzed. Hospital mortality is 82 percent. The cut-off was 4.19 mmHg/bpm, which was the AHI value. 68.8% of patients with fatal illnesses had low AHIs ( 4.19 mmHgbpm). AHI > 4.19 mmHgbpm patients have a 9-fold increased risk of dying in the hospital than patients with low AHI. AUC: 0.825 [0.743-0.907]; sensitivity: 0.814; specificity: 0.689; AUC: 0.825 [0.743-0.907; p = 0.000]; demonstrate the high predictive power of AHI.Conclusion: AHI has a strong degree of association with the likelihood of dying in the hospital from acute decompensated heart failure.

Early Management of Shock Condition in STEMI Patient Nugraha, Yudha Tria; Anjarwani, Setyasih; Satrijo, Budi; Rohman, Mohammad Saifur
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.9

Background: Acute myocardial infarction is one of the emerging cardiovascular events worldwide. Infarcts of the inferior wall were present between one-third and half of the patients with RV involvement. The worse outcome was strongly associated with cardiogenic shock, and 7% of cases were caused by RV failure.Objective: This study aimed to describe the diagnosis and management of cardiogenic shock in STEMICase presentation: A male in his 40s was brought to our hospital 12 hours after the onset of persistent epigastric pain. He had a history of hypertension and a family history of diabetes Mellitus. Diagnostic procedures included blood tests, ECG, X-rays, coronary angiogram, and echocardiography. He underwent PCI to implant DES in his proximal RCA, which had 100% occlusion. The patient was admitted to the intensive cardiovascular care unit for 30 hours and died due to various complications.Conclusion: Current case was very complicated and seriously life-threatening. After acute myocardial infarction, Important problems kept coming up one after the other, and they all affected each other. Patients with cardiogenic shock must be found quickly and treated quickly and aggressively.

Troubleshooting for Kinked Coronary Catheter: How to Manage? ; A Case Series Noverike, Nikhen; Satrijo, Budi; Widito, Sasmojo; Kurnianingsih, Novi; Abusari, Muchamad
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.7

Background: Catheter entrapment and knotting are two problems that might arise during coronary angiography, regardless of the method used. It is not uncommon for the catheter shaft to become kinked during diagnostic or interventional procedures. Still, if the manipulation fails, an invasive retrieval method is usually necessary for cases with extensive catheter kinking.Case Illustration: We present two cases illustrating how different angiography approaches could lead to severe catheter kinking. Because of the significant tortuosity of the vasculature, even a gentle opposite rotation maneuver and the antegrade advancement of multiple guidewires failed to untwist the guide catheter. Once a twisted catheter has been identified via fluoroscopy, the twist can be eased by gently twisting the catheter in the opposite direction. It is not always easy. It could lead to using other interventional techniques such as snare, balloon, or surgical procedures. In our cases, we used a snare to snag the catheter's tip and untied the loop's knot. This prevented the need for unscheduled surgical intervention. We evaluated from angiography. There were no further complications. The patients were released from the hospital the following day.Conclusion: Although a kinked catheter could become entrapped, various approaches can be taken to deal with this difficulty and prevent the need for surgical intervention.

Benefits of Low Dosage of Colchicine Administration on Decreasing Rehospitalization and Mortality within 30 Days in Post-Acute Coronary Syndrome Patients with ST-Segment Elevation Undergoing Percutaneous Coronary Intervention Satrijo, Budi; Ashari, Yordan Wicaksono; Rohman, Mohammad Saifur; Anjarwani, Setyasih; Tjahjono, Cholid Tri
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.6

Background: The role of inflammation in myocardial infarction and post-infarction MI remodeling has become a concern for the development of treatment in the last decade. Colchicine can prevent increased inflammation during acute injury.Objective: This study focused on the role of colchicine as an on-top medical treatment, hoping it can reduce mortality and short-term rehospitalization in patients with STEMI.Methods: 347 AMI patients (18-80 year old adults) who visited RSUD dr. Saiful Anwar Malang, between February 2022 and January 2023, participated in this prospective, randomized, double-blinded, placebo-controlledexperiment. Patients were split into two groups and given either a placebo orÂ colchicine 0.5 mg daily for a month. Standard medical therapy was administered concurrently to both groups as an approachable guideline. The study endpoints were mortality and rehospitalization rates.Result: After one month of follow-up, there was a reduction in rehospitalization due to cardiovascular causes (2 [1.3%] vs. 4 [2.7%], HR 3.42 [1.36-8.56], p<0.05), which was significant in the treatment group compared to the control group. Also, there was a reduction in all-cause mortality, but not statistically significant (2 [1,3% v 3 [2,0%], HR 3,38 [0,53-7,48], p>0,05). In the treated group, there was also a lower non-cardiovascular rehospitalization rate compared to placebo, but not significant (4 [2.6%] vs. 7 [4.7], HR 0.42 [0.15-1.02], p<0.05).Conclusion: The administration of low-dose colchicine for one month has shown benefits in reducing rehospitalization in patients with STEMI who receive PCI therapy.

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