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All Journal Indonesian Journal of Cardiology Heart Science Journal Narra J
Pranata, Raymond
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Pratama, Fahmi Bagus; Pranata, Raymond
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.1294

Abstract

Background Although the GRACE risk score is widely accepted as an established scoring system to predict in-hospital mortality in acute coronary syndrome (ACS) patients, this scoring system still depends on electrocardiography and laboratory findings to determine the results. Therefore, we aim to retrospectively evaluate the association between the CHADS2 and CHA2DS2-VASc score as an anamnesis-only mediated scoring system and in-hospital mortality in hospitalized ACS patients. Methods This retrospective cohort study analyzed data of ACS patients from the ACS registry in Dr. Hasan Sadikin Central General Hospital from 2018 to 2021. The outcome of this study was in-hospital mortality. The association between these scoring system and in-hospital mortality were evaluated using binary logistic regression analysis. Receiver operating characteristics (ROC) analysis was also performed to assess the success rate of this scoring system in predicting in-hospital mortality. Results A total of 1339 patients were included in this study, and 162 (12.1%) of them died in the hospital. High CHA2DS2-VASc score group (cut-off >2) was significantly associated with higher risk of in-hospital mortality before (OR=2.56 [1.75,3.75]; p<0.001) and after adjustment of several confounding factors (OR=3.39 [1.73,6.64]; p<0.001). Meanwhile, the high CHADS2 score (cutoff >2) was only significantly increased the risk of in-hospital mortality in univariate analysis (OR=2.05[1.47,2.87];p<0.001), but was not significantly associated with in-hospital mortality after multivariate analysis (OR=1.31 [0.92,1.86];p=0.129). ROC analysis revealed that predictive accuracy of CHA2DS2-VASc score was significantly greater compared to CHADS2 score (AUC: 0.653 vs 0.609, p<0.001). However, the predictive value of CHA2DS2-VASc score was significantly lower than the GRACE risk score (AUC: 0.789 vs 0.653, p<0.001). Conclusion Our study showed that the CHA2DS2-VASc score >2 was significantly and independently associated with higher in-hospital mortality in ACS patients compared to the CHA2DS2-VASc score of 1 or lower. Despite its lower predictive accuracy compared to the GRACE risk score, CHA2DS2-VASc score can still be used in practical situations as an alternative scoring system in predicting in-hospital mortality in ACS patients, especially in primary health care settings located in rural areas that lack the diagnostic facilities.
Association between triglyceride-glucose index and hypertension: A systematic review and meta-analysis Lukito, Antonia A.; Kamarullah, William; Huang, Ian; Pranata, Raymond
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.951

Abstract

The triglyceride-glucose (TyG) index is a simple and reliable indicator of insulin resistance, which is an important contributor to the development of hypertension. The aim of this meta-analysis was to determine the dose-response association between the TyG index and the incidence of hypertension. An extensive search was conducted through several databases, including PubMed, EMBASE, ScienceDirect, and Scopus until June 1, 2024. The TyG index was used as the exposure, and the incidence of hypertension was measured throughout the TyG index intervals. The effect estimates were presented as odds ratios (OR) in both the unadjusted and adjusted models. Adjusted OR were carried out from all included studies to eliminate the possibility of confounding factors being involved in the incidence of hypertension. A total of 108.936 participants (mean age: 48.2 years old, male sex: 47%, mean body mass index: 23.9 kg/m2) from 14 observational studies were included. The TyG index in the most eminent category was related to a higher risk of hypertension in both unadjusted (OR: 2.59, 95%CI: 2.03–3.31, p<0.001; I2: 97.1%, p<0.001) and adjusted model (OR: 1.74, 95%CI: 1.39–2.19, p<0.001; I2: 92.2%, p<0.001). Dose-response meta-analysis for the adjusted OR showed that the linear association analysis was not significant per 0.1 increase in the TyG index. The dose-response curve became increasingly steeper at the TyG index above 8.5. In conclusion, the TyG index was shown to be strongly linked with hypertension in a non-linear dose-response manner.
Long term radial artery occlusion following distal or proximal transradial artery access in invasive cardiovascular procedures Saboe, Aninka; Ibrahim, Maulana; Pranata, Raymond; Dewi, Triwedya Indra; Yahya, Achmad Fauzi
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.2025.006.02.10

Abstract

Background: Radial artery occlusion (RAO) is one of the most common consequences of transradial artery access (TRA) in invasive cardiovascular procedures; therefore, alternative approaches, such as distal radial artery access (DRA), emerged. This study compares proximal and distal radial access for long-term RAO. Objectives: This study compares long-term RAO incidence with proximal and distal radial access following invasive cardiovascular procedures. Material and Methods: This is a retrospective cohort study. The subjects comprised patients with heart disease who underwent invasive cardiovascular procedures using radial access at Dr. Hasan Sadikin General Hospital Bandung between July 2017 and December 2020. The patients were categorized into two groups based on their access type: proximal and distal. The incidence of long-term RAO was evaluated through Doppler ultrasound at least one-year post-TRA. Results: The study included 107 patients (proximal = 72 patients; distal = 35 patients). The mean age was 58.2 ± 8.26 years, with a predominance of male patients (79.4%) and smokers (65.4%). The majority of procedures were interventional (58.2%). Baseline characteristics were comparable between the two groups, except for selecting the access side, which was more prevalent on the left side in the distal group. Long-term RAO occurred in 8 patients (7.48%), with 7 cases (9.72%) in the proximal group and 1 case (2.86%) in the distal group (p=0.269). Conclusion: The study findings reveal no significant difference in the incidence of long-term RAO between proximal and distal radial access in invasive cardiovascular procedures.
Co-Authors Achmad Fauzi Yahya, Achmad Fauzi Dewi, Triwedya Indra Huang, Ian Ibrahim, Maulana Kamarullah, William Lukito, Antonia A. Pramudyo, Miftah Pratama, Fahmi Bagus Putra, Iwan Cahyo Santosa Saboe, Aninka