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All Journal Jurnal Ilmu Kedokteran dan Kesehatan Folia Medica Indonesiana
Handayani, Riana
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Pentingnya Deteksi Dini Kelainan Jantung Pada Penderita Hipertensi Melalui Pemeriksaan Ekokardiografi: Pembelajaran Dari Penyaringan Massa Nasruddin, Sigit Pratama Iustitia; Handayani, Riana; Mulia, Erwin; Masfufah, Indy; Ransun, Terrance; Chandrasatria, Rony Mario; Meriedlona, Nuka; Krisnawati, Dwi; Endamatriza, Gadih Ranti; Trisnawati, Niputu Alit; Yulistiawati, Novitri; Tanto, Ines Vidal; Iyos, Rekha Nova; Fattimah, Eliza Techa; Krisnandi, Charles; Nurhayati, Senja
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 9 (2024): Volume 11 Nomor 9
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i9.17364

Abstract

Hipertensi merupakan penyebab utama penyakit kardiovaskular dan kematian dini di seluruh dunia. Perubahan patofisiologi jantung akibat hipertensi terjadi secara diam-diam tanpa menimbulkan gejala. Deteksi dini dalam bentuk skrining dapat membantu mengidentifikasi kelompok berisiko tinggi guna mengurangi morbiditas, mortalitas, dan biaya kesehatan. Penelitian ini bertujuan untuk mengevaluasi prevalensi perubahan ekokardiografi pada pasien hipertensi. Penelitian Cross-Sectional ini menggunakan data program skrining massal pada 21 Mei 2023, di Rumah Sakit Harapan Bunda, Lampung Tengah, Indonesia. Kriteria inklusi meliputi orang dewasa berusia ≥18 tahun yang sebelumnya sudah terdiagnosis hipertensi. Kriteria eksklusi mencakup subjek dengan riwayat kelainan ekokardiografi yang sudah terdeteksi sebelumnya. Dari 600 peserta, 388 subjek memenuhi kriteria inklusi/eksklusi. Dari keseluruhan subjek, 50% mengidap hipertensi stadium 1, 27% hipertensi stadium 2, dan 23% hipertensi stadium 3. Abnormalitas jantung ditemukan pada 56% subjek, dengan 98% pasien memiliki abnormalitas TAPSE, 83% memiliki kelainan katup, 78% memiliki RMWA, 45% memiliki abnormalitas dimensi ruang jantung, dan 13% pasien memiliki ejeksi fraksi <40%. Tingginya prevalensi kerusakan organ target jantung secara diam-diam menunjukkan nilai potensial skrining ekokardiografi dalam mengidentifikasi gangguan jantung pada pasien dengan riwayat hipertensi meskipun tanpa gejala.
A NETWORK META-ANALYSIS: EFFICACY AND SAFETY OF ROTATIONAL ATHERECTOMY, ORBITAL ATHERECTOMY, AND INTRAVASCULAR LITHOTRIPSY COMPARISONS FOR NODULAR CORONARY LESIONS IN PERCUTANEOUS CORONARY INTERVENTION Handayani, Riana; Oktaviono, Yudi Her; Suryawan, I Gde Rurus; Susilo, Hendri; Aziz, Karimah Khitami; Erwan, Nabila Erina
Folia Medica Indonesiana Vol. 61, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Percutaneous Coronary Intervention (PCI) has continued to evolve since its introduction in 1977. Currently, 12% of all PCI procedures for coronary artery stenosis involve Calcified Nodules (CN). CN is defined as nodular calcification that protrudes into the lumen of the coronary artery. In this era, improving the feasibility and success of PCI is essential through the use of advanced techniques, innovative approaches, and specialized devices in coronary interventions. These techniques include Rotational Atherectomy (RA), Orbital Atherectomy (OA), and Intravascular Lithotripsy (IVL). Comparisons of RA, OA, and IVL are still being extensively studied in terms of their effectiveness and safety in treating complex lesions such as CN. Given the high costs of these devices, this Network Meta-Analysis (NMA) was conducted to evaluate and compare the efficacy and safety of RA, OA, and IVL based on recent studies. The primary analysis in this study was performed using MetaInsight V6.1.1, presenting odds ratios (OR) based on a Bayesian Network Meta-Analysis and ranking the interventions according to the Surface Under the Cumulative Ranking Curve (SUCRA). The primary outcomes assessed were efficacy and safety. Efficacy was defined as the procedural success rate, and safety as the overall safety rate of each procedure. Secondary outcomes included periprocedural complications (dissection, perforation, slow flow/no-reflow, cardiac tamponade, and device failure), as well as the incidence of major adverse cardiovascular events (MACE) within 30 days. The analysis revealed a statistically significant difference in efficacy between IVL and RA, favoring IVL (OR 2.66, 95% CrI: 1.27, 6.16). However, no statistically significant differences were observed in other primary or secondary outcomes among RA, OA, and IVL. Based on SUCRA rankings, OA was the most effective in preventing MACE, while RA showed the lowest risk of periprocedural complications. Nevertheless, this network meta-analysis has several limitations due to the uncertainty of the available data. Further research, including randomized controlled trials (RCTs) or larger cohort studies with direct comparisons of all three techniques (closed-loop designs), is warranted to validate these findings.
Co-Authors Aziz, Karimah Khitami Chandrasatria, Rony Mario Endamatriza, Gadih Ranti Erwan, Nabila Erina Erwin Mulia Fattimah, Eliza Techa Krisnandi, Charles KRISNAWATI, DWI Masfufah, Indy Meriedlona, Nuka Nasruddin, Sigit Pratama Iustitia Nurhayati, Senja Rekha Nova Iyos, Rekha Nova Suryawan, I Gde Rurus Susilo, Hendri Tanto, Ines Vidal Terrance Ransun Trisnawati, Niputu Alit Yudi Her Oktaviono, Yudi Her Yulistiawati, Novitri