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All Journal Heart Science Journal The Journal of Society Medicine (JSOCMED)
Siregar, Abdullah Afif
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Monocyte to High-Density Lipoprotein Ratio (MHR) as A Predictor of Major Cardiovascular Events in Acute Myocardial Infarction Patients with ST-Segment Elevation in Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Central General Hospital Nikensari, Grace; Nasution, Ali Nafiah; Siregar, Abdullah Afif
Journal of Society Medicine Vol. 3 No. 5 (2024): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.140

Abstract

Introduction: IMA-EST is a cardiovascular disease with high mortality and morbidity. Therefore, tools (markers) to efficiently predict mortality rates are essential to reduce these rates for effective management. Since most of the available literature suggests that MHR value can be used as a predictor of MACE, we are interested in examining MHR as a predictor of MACE in IMA-EST patients undergoing primary PCIMethods: This type of study was an observational analytic study with the research design used is an ambispective cohort. namely assessing the role of MHR Ratio as a predictor of prognosis after primary MACE in IMAEST patients. This study was conducted at HAM Hospital Medan from April-June 2023. Patients who met the inclusion and exclusion criteria were assessed for laboratory parameters such as triglyceride levels and calculated MHR index, then MACE was observed in patients who underwent primary IKP. The MACE assessed was cardiovascular death, malignant arrhythmia, cardiogenic shock, and acute heart failure during hospitalisation and 30 days post-treatment either through control at the polyclinic or by telephone and interview. Results: A total of 55 samples were obtained. The GRACE Score and MHR parameters have an area under the ROC curve > 0.7. The MHR parameter had a sensitivity of 69.2% and specificity of 64.3% and a p value <0.05. Based on ROC curve analysis, the cut-off-point parameter for estimating predictors of MVC was 22.48. The GRACE Score coefficient is 0.466 with a significance value (p value) of 0.001 that there is a correlation between the GRACE Score parameters and MHR parameters. Conclusion: High monocyte counts have an association of low HDL-C levels in the development of atherosclerosis and MACE.
Relationship Between Neutrophil-Lymphocyte Ratio Value And Severity of Mitral Stenosis Due to Rheumatic Heart Disease in Outpatients at H. Adam Malik General Hospital Medan Achmad, Aziz; Safri, Zainal; Haykal, Teuku Bob; Siregar, Abdullah Afif; Akbar, Nizam Zikri; Ardini, Tengku Winda; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Journal of Society Medicine Vol. 3 No. 12 (2024): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v3i12.183

Abstract

Introduction: Mitral stenosis (MS) is a heart valve disease characterized by narrowing of the mitral valve, commonly caused by rheumatic heart disease. Accurate evaluation of MS severity is crucial for management, with echocardiography being the gold standard. The Neutrophil-Lymphocyte Ratio (NLR), reflecting inflammation, may correlate with MS severity. This study aims to assess the relationship between NLR values and MS severity due to rheumatic heart disease. Method: This cross-sectional study was conducted at H. Adam Malik General Hospital Medan from January 2023 until the required sample size was achieved. Patients diagnosed with MS by echocardiography based on the American Society of Echocardiography (ASE) criteria were included. Echocardiographic parameters such as mitral valve area (MVA) and mean pressure gradient (MV mean PG), along with blood NLR values, were analyzed for associations. Statistical significance was set at P < 0.05. Results: Significant differences in NLR values were observed between mild-to-moderate MS (1.93; 0.82–10.64) and severe MS (3.56; 1.81–13.08) (P = 0.0001, Mann-Whitney test). An NLR threshold of 2.91 predicted severe MS with 82% sensitivity and 81.8% specificity (P = 0.0001; AUC 0.856; 95% CI 0.772–0.940). Conclusion: NLR strongly correlates with MS severity and serves as a reliable predictor for severe MS in patients with rheumatic heart disease. NLR offers a simple, cost-effective tool for assessing MS severity, complementing echocardiography in clinical practice.
Early detection of subclinical rheumatic heart disease through echocardiographic screening: a study in North Sumatra, Indonesia Ardini, Tengku Winda; Ilyas, Kamal Kharazzi; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Napitupulu, Bertha Gabriella; Batubara, Gio Justisia; Sarastri, Yuke; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Siregar, Yasmine Fitrina; Dewita, Auliya; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.10

Abstract

BACKGROUND: Given the urgent need to address the significant morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is a growing interest in exploring cost-effective screening approaches, such as handheld echocardiography.OBJECTIVES: The purpose of this study was to ascertain the prevalence of RHD in North Sumatra, Indonesia.METHODS: This descriptive observational study was conducted within the population of North Sumatra from 2022 to 2023. Junior high school students aged 12 to 15 years were included from randomly selected schools in Langkat, Tebing Tinggi, and Labuhan Batu. Data collection encompassed various parameters, including social demographic information, parental characteristics, environmental factors, household details, anthropometric measurements, physical assessments, auscultation findings, and echocardiographic data. The data were analyzed descriptively.RESULTS: In our study, a total of 692 children were examined, with an average age of 12.9 years and a standard deviation of 1.1 years, among whom 42.5% were male. Utilizing echocardiographic evaluations, we identified RHD in four children, yielding a prevalence rate of 0.6%. Further examination of these cases revealed that the majority, accounting for three individuals (75%), exhibited borderline RHD, while one child (25%) presented with definite RHD.CONCLUSION: In our study population, the prevalence of RHD was 0.6%. A broader echocardiographic screening program is necessary to determine the overall prevalence of RHD, assess the disease burden, and identify individuals earlier to prevent adverse outcomes.
Association between frontal QRS-T angle and thrombus burden in patients with ST-elevation myocardial infarction: A single-center cross-sectional study Azmi, Muhammad; Nasution, Ali Nafiah; Lubis, Hilfan Ade Putra; Siregar, Abdullah Afif; Habib, Faisal; Sitepu, Andika
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.13

Abstract

BACKGROUND: ST-Elevation Myocardial Infarction (STEMI) is one of the leading causes of global morbidity and mortality, with burden of thrombus as an influential factor of clinical outcomes. OBJECTIVES: The purpose of this study was to evaluate the relationship between frontal QRS-T (fQRST) angle and thrombus burden in STEMI patients. METHODS: A cross-sectional study was carried out at Haji Adam Malik General Hospital, Medan, between January 2024 and July 2024. STEMI patients who underwent coronary angiography were included. The fQRST angle was measured using a 12-lead electrocardiogram (ECG), the thrombus burden was graded according to the Thrombolysis in Myocardial Infarction (TIMI) grading system. Statistical analysis included Spearman's correlation and Receiver Operating Characteristic (ROC) curve analysis. RESULTS: 108 STEMI patients were included in the study. The fQRST angle was strongly positively correlated with thrombus burden (r = 0.61–0.80, p < 0.05). Patients with more thrombus burden had larger fQRST angles compared to patients with less thrombus burden. Additionally, diabetes mellitus and symptom delay exceeding 12 hours were highly correlated with higher thrombus burden (p < 0.05), whereas infarct-related artery (IRA) location was not significantly associated (p > 0.05). ROC curve demonstrated that the fQRST angle had an AUC of 0.88 (p = 0.001) At the optimal cut-off value of 61°, the sensitivity and specificity were 88.3% and 87.5% (95% CI of 88.5%–98.2).
Co-Authors Achmad, Aziz Akbar, Nizam Zikri Andra, Cut Aryfa Ardini, Tengku Winda Batubara, Gio Justisia Dewita, Auliya Habib, Faisal Ilyas, Kamal Kharazzi Ketaren, Andre Pasha Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Muhammad Azmi, Muhammad Napitupulu, Bertha Gabriella Nasution, Ali Nafiah Nikensari, Grace Raynaldo, Abdul Halim Safri, Zainal Sarastri, Yuke Sitepu, Andika Teuku Bob Haykal Yasmine Fitrina Siregar