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All Journal Medical Journal of Indonesia Indonesian Journal of Cardiology
Dwiputra, Bambang
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Health Professions Medicine & Pharmacology

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Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure Rezeki, Arindya; Widyantoro, Bambang; Rossimarina, Vienna; Dwiputra, Bambang; Danny, Siska Suridanda; Sukmawan, Renan; Santoso, Anwar
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.1380

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear. Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients. Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects. Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320). Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.
Consensus Statements on the Use of High-Sensitivity Troponin I as the Assessment of Cardiac Risk in Apparently Healthy Population in Indonesia Ambari, Ade Meidian; Ng, Sunanto; Rejeki, Vidya Gilang; Rina Artha, I Made Junior; Raynaldo, Abdul Halim; Alsagaff, Mochamad Yusuf; Wicaksono, Sony Hilal; Dwiputra, Bambang; Desandri, Dwita Rian
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1544

Abstract

Cardiovascular disease (CVD) is a growing burden in Indonesia, making primary prevention of utmost importance. High sensitivity cardiac troponin I (hsTnI) has been known as one of the biomarkers of choice for diagnosing acute myocardial infarction. Nonetheless, recent studies indicate that hsTnI assay has potential as a predictor of cardiac risk in asymptomatic individuals. An advisory board consisting of renowned cardiologists from the Indonesian Heart Association was convened in Jakarta in March 2023. The meeting aimed to explore the appropriate use of hsTnI for cardiovascular (CV) risk stratification in apparently healthy adults in Indonesia. The board reviewed relevant literature and developed key consensus statements, including hsTnI cut-off for identifying high-risk asymptomatic patients, the proposed algorithm, and monitoring after aggressive risk factor control. This article presents the resulting consensus statements to provide clinicians with a practical tool for planning primary prevention strategies. Furthermore, it is expected to raise awareness and advocacy among stakeholders in the healthcare infrastructure regarding the use of hsTnI as a guide for assessing CV risk in Indonesia.
Protokol Latihan BEST yang Disesuaikan dalam Rehabilitasi Gagal Jantung Triangto, Kevin; Radi, Basuni; Siswanto, Bambang Budi; Tambunan, Tresia Fransiska Ulianna; Heriansyah, Teuku; Harahap, Alida Rosita; Kekalih, Aria; Ambari, Ade Meidian; Dwiputra, Bambang; Desandri, Dwita Rian; Katsukawa, Hajime; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1738

Abstract

Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Outcome Analysis and Determinants of Major Adverse Cardiac Events in Young Adults After Coronary Artery Bypass Graft Surgery Who Participated in Early Phase II Cardiac Rehabilitation Program: A single-centre study Radi, Basuni Radi; Intan, Ryan Enast; Dwiputra, Bambang; Desandri, Dwita R; Ambari, Ade Meidian
Jurnal Kardiologi Indonesia Vol 45 No 4 (2024): Online First - Indonesian Journal of Cardiology April-June 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1727

Abstract

Background: Cardiac rehabilitation (CR) program is proven to reduce mortality risk after coronary artery bypass surgery (CABG). Our study aimed to investigate the determinants of survival in young adult patients after CABG. Method: This was a single-centre, longitudinal study with a survival analysis method from MACE of consecutive patients under 55 years old who underwent CABG and participated in the early phase II CR program between January 2017 and December 2018. The major adverse cardiac events (MACE) rates were determined over a 2-year follow-up time. Cox regression and Kaplan-Meier analysis were used to determine the predictors of the events based on the data registry. Result: 279 patients who fulfilled the inclusion criteria were recruited in this study. MACE happened to 23 (8.45%) of them (3 patients died, 20 patients were hospitalised). Patients who dropped out (12%) from the CR program had a higher risk of developing events (HR 3.86, 95% CI 1.36-10.99). Of those who completed the CR program (245 patients), beta-blocker usage, chronotropic index, resting heart rate, and functional capacity after the CR program independently correlated with MACE. Six-minute walk distance (6-MWD) 376 meters was a significant predictor (p=0.001), with a shorter mean survival time of 6 months. Conclusion: The early phase II CR program after CABG in young adult patients reduced the risk for cardiovascular mortality, major adverse events, and related readmission. It also increased the survival rate and mean survival time for participants who completed the CR program compared to dropouts. Optimum beta blocker medication, chronotropic index, resting heart rate, and functional capacity after the CR program are essential predictors of survival after CABG in young adults.
Co-Authors Alsagaff, Mochamad Yusuf Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Anwar Santoso Aria Kekalih Arityanti, Dean Badai Bhatara Tiksnadi Bambang Budi Siswanto Bambang Widyantoro Basuni Radi Cholid Tri Tjahjono Desandri, Dwita R Desandri, Dwita Rian Erwan, Nabila Erina Febrianora, Mega Fitra, Maha Harahap, Alida Rosita Hasan, Harris Hergaf, Indah Widyasari Intan, Ryan Enast Irsad Andi Arso, Irsad Andi Katsukawa, Hajime Krevani, Citra Kiki Makes, Indira Kalyana Muhammad Ridwan Qhabibi, Faqrizal Ria Radi, Basuni Radi Raynaldo, Abdul Halim Rejeki, Vidya Gilang Renan Sukmawan Rezeki, Arindya Rina Artha, I Made Junior Rita Hamdani Rossimarina, Vienna Siska Suridanda Danny Sunanto Ng Susilowati, Eliana Syaoqi, Muhammad Tambunan, Tresia Fransiska Ulianna Tarsidin, Najmi Fauzan Teuku Heriansyah, Teuku Triangto, Kevin Wicaksono, Sony Hilal Yasmine Fitrina Siregar