Miftah Pramudyo
Department Of Cardiology And Vascular Medicine Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung

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Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry Juzar, Dafsah Arifa; Muzakkir, Akhtar Fajar; Ilhami, Yose Ramda; Taufiq, Nahar; Astiawati, Tri; R A, I Made Junior; Pramudyo, Miftah; Priyana, Andria; Hakim, Afdhalun; Anjarwani, Setyasih; Endang, Jusup; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1406

Abstract

Background Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. Methods IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. Results Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients. Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). Conclusion Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy. This article has a related Erratum.
The Efficacy of Phosphodiesterase-5 Inhibitors on Pulmonary Vascular Resistance in Patients with Single Ventricle Physiology Rhinza Seputra Simanjuntak; Miftah Pramudyo; Frisky Ronald Tua Marbun; Rheza Felari Simanjuntak; Tatyana Sianipar
The International Journal of Medical Science and Health Research Vol. 16 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/vph0ng76

Abstract

Introduction: Patients with single ventricle physiology often undergo the Fontan procedure, creating a circulation highly dependent on low pulmonary vascular resistance (PVR) for long-term success. Phosphodiesterase-5 (PDE-5) inhibitors are used as targeted pulmonary vasodilators to improve these hemodynamics. This systematic review aims to evaluate the efficacy of PDE-5 inhibitors on PVR and associated clinical outcomes in this specific patient population. Methods: Following the PRISMA 2020 guidelines, a comprehensive search was conducted across multiple databases, including PubMed and Google Scholar, using PICO-based keywords. Eligibility screening of abstracts and full-text articles was performed to include randomized controlled trials and cohort studies. After a rigorous selection process, 34 relevant studies were included in the final qualitative synthesis. Results: The analysis revealed consistent hemodynamic improvements. A significant reduction in PVR or its related indices was explicitly reported in 11 studies , while 20 studies noted a decrease in pulmonary artery pressure. These benefits translated to improved clinical outcomes, with 11 studies demonstrating enhanced exercise capacity and 13 studies reporting increased oxygen saturation. The safety profile was highly favorable, as 25 studies reported no significant adverse events. However, significant statistical heterogeneity was detected among studies (I²=94%). Conclusion: PDE-5 inhibitors are a safe and effective therapy for improving short-term hemodynamics, exercise capacity, and oxygenation in patients with single ventricle physiology. While the evidence strongly supports their use, it is limited by substantial heterogeneity and a lack of long-term data. Large-scale, standardized randomized controlled trials are imperative to establish definitive long-term benefits and formulate optimal clinical guidelines.  
Profile and Pregnancy Outcome in Preeclampsia with and Without Cardiac Abnormalities Complication Aqilah, Nurjihan Syarifah; Pribadi, Adhi; Cool, Charlotte Johanna; Aziz, Muhammad Alamsyah; Pramudyo, Miftah; Astuti, Astri; Putra, Ridwan Abdullah
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.742

Abstract

Introduction: This study was conducted to determine the profile of maternal characteristics and outcomes, as well as neonatal outcomes of mothers giving birth with preeclampsia and complications of cardiac abnormalities compare to preeclampsia without complications of cardiac abnormalities.Methods: This study used a descriptive cross-sectional research method with purposive sampling.Results: Out of 78 samples, there were 10 pregnant women with cardiac abnormalities. The predominant age is in the 18 - 35 years range at 51 (65.4%) samples. Comorbidities found were eclampsia 8 (10.3%) and HELLP syndrome 3 (3.8%). There was no maternal mortality. The major method of delivery was perabdominal in preeclampsia with cardiac abnormalities 10(100.0%). The neonatal outcome obtained APGAR scores of 7-10 as many as 57 (73.1%) babies, 8 (10.2%) babies with score 4-6, and 13 (16.7%) babies with score 0-3. There were 16 (20.5%) babies born with SGA, 58 (74.4%) with AGA, and 4 (5.1%) with LGA. Most neonatal born with normal APGAR score (58 babies or 74.4%). In the PE group with heart defects, there was 1 (10.0%) baby with severe asphyxia as in stillbirth. While in preeclampsia without cardiac abnormalities 11 (16.2%) babies were born with severe asphyxia and 8 (10.2%) stillbirths.Conclusion: The maternal outcomes were (1) comorbidities of eclampsia and HELLP syndrome, (2) the majority of delivery methods being caesarean section., and in neonatal outcomes, most babies were born with normal APGAR score and appropriate gestational age (AGA).Profil dan Luaran Kehamilan pada Preeklamsia dengan dan Tanpa Komplikasi Kelainan JantungAbstrakPendahuluan: Penelitian ini dilakukan untuk mengetahui profil karakteristik dan luaran maternal, serta luaran neonatal ibu melahirkan dengan preeklamsia dengan komplikasi kelainan jantung dan preeklamsia tanpa komplikasi kelainan jantung.Metode: Penelitian ini menggunakan metode penelitian deskriptif potong lintang dan pengambilan sampel penelitian purposif.Hasil: Dari 78 sampel, didapatkan 10 ibu hamil dengan kelainan jantung. Usia paling banyak ada pada rentang usia 18 - 35 tahun 51(65.4%) sampel. Penyakit pernyerta didapatkan eklamsia 8(10.3%) dan sindrom HELLP 3(3.8%). Tidak ditemukan kematian ibu. Metode persalinan terbanyak yaitu perabdominal pada PE dengan kelainan jantung 10(100.0%). Hasil luaran neonatal kelahiran bayi tunggal, didapatkan skor APGAR 7-10 sebanyak 57(73.1%) bayi, 8(10.2%) bayi dengan skor 4-6, dan 13(16.7%) bayi dengan skor 0-3. Terdapat 16(20.5%) bayi lahir dengan SGA, 58(74.4%) dengan AGA, dan 4(5.1%) dengan LGA. Hasil luaran neonatal terbanyak dengan kondisi APGAR normal (58 bayi atau 74.4%). Pada kelompok PE dengan kelainan jantung ditemukan 1(10.0%) bayi dengan luaran asfiksia berat begitu pun dengan stillbirth. Sedangkan pada PE tanpa kelainan jantung sebanyak 11(16.2%) lahir dengan asfiksia berat dan 8(10.2%) stillbirth.Kesimpulan: Luaran kehamilan yang ditemukan yaitu (1) penyakit penyerta berupa eklamsia dan sindrom HELLP, (2) metode persalinan terbanyak yaitu caesarean section, dan hasil luaran neonatal terbanyak adalah dengan kondisi APGAR normal dan AGA.Kata kunci: Luaran kehamilan; Luaran neonatal; Preeklamsia dengan kelainan jantung
Study of Machine Learning Algorithm on Phonocardiogram Signals for Detecting of Coronary Artery Disease Mandala, Satria; Pramudyo, Miftah; Rizal, Ardian; Fikry, Maurice
Indonesian Journal on Computing (Indo-JC) Vol. 5 No. 3 (2020): December, 2020
Publisher : School of Computing, Telkom University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34818/INDOJC.2020.5.3.536

Abstract

Several methods of detecting coronary artery disease (CAD) have been developed, but they are expensive and generally use an invasive catheterization method. This research provides a solution to this problem by developing an inexpensive and non-invasive digital stethoscope for detecting CAD. To prove the effectiveness of this device, twenty-one subjects consisting of 11 CAD patients and 10 healthy people from Hasan Sadikin Hospital Bandung were selected as validation test participants. In addition, auscultation was carried out at four different locations around their chests, such as the aorta, pulmonary, tricuspid, and mitral. Then the phonocardiogram data taken from the stethoscope were analyzed using machine learning. To obtain optimal detection accuracy, several types of kernels such as radial basis function kernel (RBF), polynomial kernel and linear kernel of Support Vector Machine (SVM) have been analyzed. The experimental results show that the linear kernel outperforms compared to others; it provides a detection accuracy around 66%. Followed by RBF is 56% and Polynomial is 46%. In addition, the observation of phonocardiogram signals around the aorta is highly correlated with CAD, giving an average detection accuracy for the kernel of 66%; followed by 44% tricuspid and 43% pulmonary.
Association Between Cardiovascular Risk Factors and CAD Severity by CAD-RADS Categories and Comprehensive CTA Score Raharjo, Pradana Pratomo; Purnomowati, Augustine; Kusumawardhani, Nuraini Yasmin; Astuti, Astri; Achmad, Chaerul; Pramudyo, Miftah; Karwiky, Giky; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4173

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide, including in Indonesia. Risk factors (RFs) play an important role in both pathogenesis and management of cardiovascular (CV) diseases. Coronary computed tomography angiography (CTA) is a reliable non-invasive diagnostic method. Coronary Artery Disease Reporting and Data System (CAD-RADS) categories and comprehensive CTA score describes CAD severity on coronary CTA and provides additional prognostic value.Objective: To explore the link between traditional cardiovascular risk factors and CAD severity based on CAD-RADS and comprehensive CTA scores.Methods: This retrospective, single-center study was conducted at a tertiary hospital using data from the Cardiovascular Imaging Database of the hospital from January 2020 to June 2022. Data meeting the inclusion and exclusion criteria were analyzed using ordinal and binary regressions.Results: A total of 423 patients' data were analyzed. Ordinal regression revealed significant links between age ≥ 65 years, male gender, hypertension, diabetes, and higher CAD severity based on both CAD-RADS and comprehensive CTA scores. Binary regression showed that older age and male gender were independently associated with CAD-RADS ≥ 3 and comprehensive CTA score ≥ 6. Diabetes was linked to CAD-RADS ≥ 3, and hypertension was tied to a comprehensive CTA score ≥ 6. The number of risk factors showed a trend toward CAD severity (p=0.069) and a significant link with comprehensive CTA score (p=0.012).Conclusion: There is a significant association between traditional cardiovascular risk factors and CAD severity as quantified by both CAD-RADS and comprehensive CTA score.
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 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2013

Abstract

In “Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study” (Indonesian Journal of Cardiology, 44(1), 17-27. https://doi.org/10.30701/ijc.1294), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1294. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error. DOI of original article: https://doi.org/10.30701/ijc.1294
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Danny, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2036

Abstract

In “Management of Decongestion in Acute Heart Failure: Time for a New Approach?” (Indonesian Journal of Cardiology, 43(2), 77-89. https://doi.org/10.30701/ijc.1381), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1381. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1381
Mexiletine in the treatment of LQT2, LQT3, and acquired LQTS: ameta-analysis Dhiya Ihsan Ramadhan; Mohammad Iqbal; Charlotte Johanna Cool; Chaerul Achmad; Miftah Pramudyo; Hawani Sasmaya Prameswari; Mohammad Rizki Akbar
Jurnal Kardiologi Indonesia Vol 47 No 2 (2026): April - June, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2234

Abstract

In “Mexiletine in the treatment of LQT2, LQT3, and acquired LQTS: a meta-analysis” (Indonesian Journal of Cardiology, 46(2), 71-79. https://doi.org/10.30701/ijc.1835), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1835. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error. DOI of original article: https://doi.org/10.30701/ijc.1835