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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Majalah Kedokteran Sriwijaya Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Ferry Usnizar
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Pengaruh Lama Hipertensi Terhadap Penyakit Jantung Koroner di Poliklinik Kardiologi RSUP. Dr. Mohammad Hoesin Palembang 2012 Ira Dwi Novriyanti; Ferry Usnizar; Irwan Irwan
JURNAL KEDOKTERAN DAN KESEHATAN Vol 1, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Penyakit Jantung Koroner (PJK) merupakan penyebab kematian utama di dunia. Menurut World Health Organization (WHO) tahun 2008, diperkirakan 7,3 juta penduduk dunia meninggal akibat PJK. Angka kematian akibat PJK di Indonesia juga terus meningkat dari tahun ke tahun. Hipertensi merupakan faktor risiko penting terjadinya PJK. Deteksi dini dan perawatan hipertensi yang efektif dapat menurunkan angka kematian. Penelitian ini bertujuan untuk mengetahui pengaruh lama hipertensi terhadap PJK di Poliklinik Kardiologi RSUP Dr. Mohammad Hoesin Palembang.Penelitian ini merupakan penelitian observasional analitik dengan desain cross sectional. Sampel penelitian adalah 107 dari 13.396 pasien penyakit jantung hipertensi di Poliklinik Kardiologi RSUP Dr. Mohammad Hoesin Palembang tahun 2012. Hasil penelitian menunjukkan proporsi PJKsebesar 44,9%. Penderita PJK paling banyak adalah laki-laki (72,9%) dan kelompok usia 45–64 tahun (75,0%). Penderita PJK paling sering dijumpai dengan keluhan nyeri dada (43,8%) dan lama hipertensi 11–15 tahun (47,9%). Sebagian besar pasien menderita hipertensi derajat 1 (47,9%). Kebanyakan pasien memiliki kadar total kolesterol (41,7%), kolesterol LDL (29,2%), kolesterol HDL (41,7%), trigliserida (43,8%), dan gula darah sewaktu (81,3%) yang normal. Hasil analisis menggunakan uji Chi-square menunjukkan ada hubungan antara lama hipertensi dengan PJK (p=0,028) dan lama hipertensi 11–15 tahun berisiko 2,957 kali menderita PJK dibandingkan lama hipertensi 1–10 tahun.Terdapat pengaruh lama hipertensi terhadap PJK, semakin lama hipertensi maka semakin tinggi risiko terjadinya PJK.
Kadar CK-MB Pasien Penyakit Jantung Koroner Yang Dirawat Inap di Bagian Penyakit Dalam RS. Muhammad Hoesin Palembang Berdasarkan Waktu Pengambilan Darah M. Novran Chalik; Ferry Usnizar; Tri Suciati
Majalah Kedokteran Sriwijaya Vol 46, No 3 (2014): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v46i3.2708

Abstract

Penyakit jantung koroner merupakan penyebab pertama seluruh kematian di Indonesia.Berdasarkan cardiac biomarker, PJK dibagi menjadi dua, yaitu IMA dan non-IMA. Pemeriksaan penanda biokimia jantung, yaitu enzim CK-MB merupakan suatu cara untuk mendeteksi infark miokard akut (IMA) secara cepat dan tepat. Penelitian ini bertujuan untuk mengetahui kadar CK-MB  pasien penyakit jantung koroner yang dirawat-inap di bagian penyakit dalam RSMH Palembang periode Januari-Desember 2012 berdasarkan waktu pengambilan darah.Penelitian ini merupakan penelitian deksriptif observasional terhadap 56 pasien PJK di Bagian Penyakit Dalam RSMH Palembang. Sampel penelitian diambil dari data rekam medis pasien rawat-inap yang mendapatkan tes CK-MB pada  periode Januari-Desember 2012.Pasien PJK terbanyak berjenis kelamin pria (66,1%), kelompok usia 45 sampai dengan 64 tahun (69,6%), dan yang menderita IMA (80,4%) lebih banyak daripada non-IMA (19,6%). Rata-rata kadar CK-MB mulai meningkat pada jam ke-3, mencapai kadar puncak pada jam ke-21, dan kembali ke nilai normal pada jam ke-48. Kadar CK-MB ditemukan lebih tinggi pada pasien pria dibandingkan wanita dan pada pasien kelompok usia 65 sampai dengan diatas 75 tahun dibandingkan kelompok usia di bawah 44 sampai dengan 64 tahun.Rata-rata kadar CK-MB mulai meningkat pada jam ke-3, mencapai puncak pada jam ke-21, dan kembali normal pada jam ke-48. Pasien berjenis kelamin pria dan kelompok usia 65 sampai dengan di atas 75 tahun memiliki kadar CK-MB lebih tinggi.
Reperfusion Arrhythmia in Acute Myocardial Infarction Setiadi, Teguh; Taufik Indrajaya; Ali Ghanie; Ferry Usnizar; Erwin Sukandi; Syamsu Indra; Erwin Azmar; Rukiah Chodilawati; Imran Soleh; Yudhie Tanta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 12 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i12.894

Abstract

Management of reperfusion in acute myocardial infarction is an important component of myocardial cell survival to minimize the area experiencing infarction and improve patient clinical outcomes. However, this reperfusion also contributes to myocardial injury which is preceded by the ischemic process. One of the injuries related to the ischemia-reperfusion process in the myocardium is reperfusion arrhythmia. Reperfusion arrhythmias from several studies can begin to occur in the first minutes after restoration of obstructed coronary flow. The features of reperfusion arrhythmia can include accelerated idioventricular rhythm, ventricular tachycardia, ventricular fibrillation, and other arrhythmias. The mechanism of reperfusion arrhythmia can be excess calcium in the cells, oxidative stress due to an increase reactive oxygen species, energy metabolism disorders, and neutrophil accumulation. Excessive intracellular calcium and other mechanisms cause a delay in the depolarization of previously ischemic cells. This reperfusion arrhythmia requires special attention because it can disrupt hemodynamics and patient outcomes after reperfusion procedures. Knowledge of the mechanisms of reperfusion arrhythmias will guide clinicians to provide better management during and after reperfusion procedures.
Novel Insights into the Pathophysiology of Coronary Slow Flow Phenomenon: The Role of Triglycerides-Glucose Index and Electrocardiogram Risk Score in Subclinical Atherosclerosis Kusuma, Singgih; Erwin Sukandi; Taufik Indrajaya; Ferry Usnizar; Irfannuddin
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1228

Abstract

Background: Coronary slow flow phenomenon (CSFP) is characterized by delayed distal coronary vessel opacification without significant epicardial coronary stenosis. The underlying mechanisms of CSFP remain unclear, but subclinical atherosclerosis is a likely contributor. This study investigated the relationship between the Triglycerides-Glucose Index (TyG), Electrocardiogram Risk Score (ERS), and carotid intima-media thickness (CIMT) in CSFP patients. Methods: This cross-sectional study involved 31 patients diagnosed with CSFP at Dr. Mohammad Hoesin General Hospital Palembang. CSFP was determined based on coronary blood flow slowdown on angiography. Data collection included anamnesis, physical examination, laboratory tests, echocardiography, and CIMT measurement. Statistical analysis was performed using SPSS 27. Results: The majority of CSFP patients were male (51.6%) with a mean age of 50.87 ± 13.94 years. Dyslipidemia was the most prevalent risk factor (77.4%), followed by hypertension (35.5%), smoking (22.6%), and diabetes mellitus (6.5%). Statistical analysis revealed significant positive correlations between TyG index and CIMT (r = 0.445, p = 0.012), and between ERS and CIMT (r = 0.476, p = 0.007). Conclusion: TyG and ERS indices are positively correlated with CIMT in CSFP patients. These indices may be useful tools for cardiovascular risk evaluation and early identification of high-risk patients for subclinical atherosclerosis and potential CSFP.
The Impact of Intravascular Imaging (IVUS/OCT) Guidance on Preventing In-Stent Restenosis and Improving Long-Term Clinical Outcomes in Complex PCI: A Meta-Analysis Lian Lanrika Waidi Lubis; Taufik Indrajaya; Ferry Usnizar; Erwin Sukandi; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1369

Abstract

Background: Percutaneous coronary intervention (PCI) in patients with complex coronary artery disease is associated with a higher risk of adverse events, including in-stent restenosis (ISR). Intravascular imaging, using either intravascular ultrasound (IVUS) or optical coherence tomography (OCT), has been proposed to optimize stent implantation and improve outcomes, but its definitive role requires comprehensive evidence synthesis. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Major electronic databases (PubMed, EMBASE, Cochrane CENTRAL) were searched from January 2014 to May 2025 for RCTs comparing intravascular imaging-guided PCI with angiography-guided PCI in patients undergoing complex procedures. The primary efficacy endpoint was Major Adverse Cardiovascular Events (MACE), a composite of cardiac death, target-vessel myocardial infarction, and clinically-driven target lesion revascularization. The key secondary endpoint was angiographic ISR. A random-effects model was used to calculate pooled Risk Ratios (RRs) and 95% Confidence Intervals (CIs). Results: Seven RCTs, enrolling a total of 9,150 patients, met the inclusion criteria. The median follow-up was 24 months. Intravascular imaging guidance was associated with a significant reduction in the risk of MACE (RR: 0.66; 95% CI: 0.55-0.79; p<0.0001) compared to angiography guidance, with moderate heterogeneity (I²=52%). The risk of angiographic ISR was also significantly lower in the imaging-guided group (RR: 0.49; 95% CI: 0.38-0.63; p<0.0001). Furthermore, imaging guidance led to a significant reduction in cardiac death (RR: 0.55; 95% CI: 0.38-0.80) and clinically-driven target lesion revascularization (RR: 0.54; 95% CI: 0.42-0.69). Conclusion: This meta-analysis provides definitive evidence that the use of intravascular imaging (IVUS or OCT) to guide complex PCI significantly reduces the incidence of long-term major adverse cardiovascular events and in-stent restenosis. These findings support the routine adoption of intravascular imaging as the standard of care to optimize outcomes in this high-risk patient population.
The Impact of Intravascular Imaging (IVUS/OCT) Guidance on Preventing In-Stent Restenosis and Improving Long-Term Clinical Outcomes in Complex PCI: A Meta-Analysis Lian Lanrika Waidi Lubis; Taufik Indrajaya; Ferry Usnizar; Erwin Sukandi; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1369

Abstract

Background: Percutaneous coronary intervention (PCI) in patients with complex coronary artery disease is associated with a higher risk of adverse events, including in-stent restenosis (ISR). Intravascular imaging, using either intravascular ultrasound (IVUS) or optical coherence tomography (OCT), has been proposed to optimize stent implantation and improve outcomes, but its definitive role requires comprehensive evidence synthesis. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Major electronic databases (PubMed, EMBASE, Cochrane CENTRAL) were searched from January 2014 to May 2025 for RCTs comparing intravascular imaging-guided PCI with angiography-guided PCI in patients undergoing complex procedures. The primary efficacy endpoint was Major Adverse Cardiovascular Events (MACE), a composite of cardiac death, target-vessel myocardial infarction, and clinically-driven target lesion revascularization. The key secondary endpoint was angiographic ISR. A random-effects model was used to calculate pooled Risk Ratios (RRs) and 95% Confidence Intervals (CIs). Results: Seven RCTs, enrolling a total of 9,150 patients, met the inclusion criteria. The median follow-up was 24 months. Intravascular imaging guidance was associated with a significant reduction in the risk of MACE (RR: 0.66; 95% CI: 0.55-0.79; p<0.0001) compared to angiography guidance, with moderate heterogeneity (I²=52%). The risk of angiographic ISR was also significantly lower in the imaging-guided group (RR: 0.49; 95% CI: 0.38-0.63; p<0.0001). Furthermore, imaging guidance led to a significant reduction in cardiac death (RR: 0.55; 95% CI: 0.38-0.80) and clinically-driven target lesion revascularization (RR: 0.54; 95% CI: 0.42-0.69). Conclusion: This meta-analysis provides definitive evidence that the use of intravascular imaging (IVUS or OCT) to guide complex PCI significantly reduces the incidence of long-term major adverse cardiovascular events and in-stent restenosis. These findings support the routine adoption of intravascular imaging as the standard of care to optimize outcomes in this high-risk patient population.
Beyond Cholesterol: The Independent Roles of Inflammation and Renal Dysfunction in Carotid Atherosclerosis Among Indonesian Elders Rukiah Chodilawati; Taufik Indrajaya; Ferry Usnizar; Sudarto; Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1386

Abstract

Background: Atherosclerosis remains a leading cause of mortality in aging populations, driven by a complex interplay of metabolic and inflammatory factors. While dyslipidemia is a cornerstone of risk, the contributions of systemic inflammation, marked by high-sensitivity C-reactive protein (hsCRP), and declining renal function are increasingly recognized. This study aimed to elucidate the independent associations of hsCRP, dyslipidemia, and renal function with the presence of carotid atherosclerosis in an understudied elderly Indonesian population. Methods: We conducted a single-center, case-control study at a tertiary hospital in Palembang, Indonesia, from January to June 2024. One hundred participants aged ≥60 years were enrolled from the geriatric outpatient clinic. Cases were defined by the presence of carotid plaque, identified via B-mode Doppler ultrasound, and defined according to international consensus criteria. Controls had no evidence of plaque. We performed multivariate logistic regression to identify independent predictors of atherosclerosis, including hsCRP, lipid parameters, and estimated glomerular filtration rate (eGFR). Results: After multivariable adjustment, three factors emerged as significant, independent predictors of carotid atherosclerosis. High total cholesterol (≥200 mg/dL) was the most powerful predictor, associated with a more than seven-fold increased odds of plaque (Adjusted Odds Ratio [aOR]: 7.38; 95% Confidence Interval [CI]: 2.87–18.94; p<0.001). Elevated hsCRP (≥2 mg/L) (aOR: 3.38; 95% CI: 1.33–8.59; p=0.005) and abnormal eGFR (≤90 mL/min/1.73m²) (aOR: 3.36; 95% CI: 1.10–10.22; p<0.001) were also robustly associated with atherosclerosis, each conferring over a three-fold increase in odds. Conclusion: In this elderly Indonesian study, dyslipidemia remains a dominant risk factor for carotid atherosclerosis. However, systemic inflammation (high hsCRP) and mild renal dysfunction (abnormal eGFR) are also powerful, independent contributors. These findings highlight the multifactorial nature of atherosclerosis and underscore the importance of a comprehensive risk assessment that extends beyond traditional lipid profiling to include markers of inflammation and renal health.
Beyond Cholesterol: The Independent Roles of Inflammation and Renal Dysfunction in Carotid Atherosclerosis Among Indonesian Elders Rukiah Chodilawati; Taufik Indrajaya; Ferry Usnizar; Sudarto; Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1386

Abstract

Background: Atherosclerosis remains a leading cause of mortality in aging populations, driven by a complex interplay of metabolic and inflammatory factors. While dyslipidemia is a cornerstone of risk, the contributions of systemic inflammation, marked by high-sensitivity C-reactive protein (hsCRP), and declining renal function are increasingly recognized. This study aimed to elucidate the independent associations of hsCRP, dyslipidemia, and renal function with the presence of carotid atherosclerosis in an understudied elderly Indonesian population. Methods: We conducted a single-center, case-control study at a tertiary hospital in Palembang, Indonesia, from January to June 2024. One hundred participants aged ≥60 years were enrolled from the geriatric outpatient clinic. Cases were defined by the presence of carotid plaque, identified via B-mode Doppler ultrasound, and defined according to international consensus criteria. Controls had no evidence of plaque. We performed multivariate logistic regression to identify independent predictors of atherosclerosis, including hsCRP, lipid parameters, and estimated glomerular filtration rate (eGFR). Results: After multivariable adjustment, three factors emerged as significant, independent predictors of carotid atherosclerosis. High total cholesterol (≥200 mg/dL) was the most powerful predictor, associated with a more than seven-fold increased odds of plaque (Adjusted Odds Ratio [aOR]: 7.38; 95% Confidence Interval [CI]: 2.87–18.94; p<0.001). Elevated hsCRP (≥2 mg/L) (aOR: 3.38; 95% CI: 1.33–8.59; p=0.005) and abnormal eGFR (≤90 mL/min/1.73m²) (aOR: 3.36; 95% CI: 1.10–10.22; p<0.001) were also robustly associated with atherosclerosis, each conferring over a three-fold increase in odds. Conclusion: In this elderly Indonesian study, dyslipidemia remains a dominant risk factor for carotid atherosclerosis. However, systemic inflammation (high hsCRP) and mild renal dysfunction (abnormal eGFR) are also powerful, independent contributors. These findings highlight the multifactorial nature of atherosclerosis and underscore the importance of a comprehensive risk assessment that extends beyond traditional lipid profiling to include markers of inflammation and renal health.
Novel Insights into the Pathophysiology of Coronary Slow Flow Phenomenon: The Role of Triglycerides-Glucose Index and Electrocardiogram Risk Score in Subclinical Atherosclerosis Kusuma, Singgih; Erwin Sukandi; Taufik Indrajaya; Ferry Usnizar; Irfannuddin
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1228

Abstract

Background: Coronary slow flow phenomenon (CSFP) is characterized by delayed distal coronary vessel opacification without significant epicardial coronary stenosis. The underlying mechanisms of CSFP remain unclear, but subclinical atherosclerosis is a likely contributor. This study investigated the relationship between the Triglycerides-Glucose Index (TyG), Electrocardiogram Risk Score (ERS), and carotid intima-media thickness (CIMT) in CSFP patients. Methods: This cross-sectional study involved 31 patients diagnosed with CSFP at Dr. Mohammad Hoesin General Hospital Palembang. CSFP was determined based on coronary blood flow slowdown on angiography. Data collection included anamnesis, physical examination, laboratory tests, echocardiography, and CIMT measurement. Statistical analysis was performed using SPSS 27. Results: The majority of CSFP patients were male (51.6%) with a mean age of 50.87 ± 13.94 years. Dyslipidemia was the most prevalent risk factor (77.4%), followed by hypertension (35.5%), smoking (22.6%), and diabetes mellitus (6.5%). Statistical analysis revealed significant positive correlations between TyG index and CIMT (r = 0.445, p = 0.012), and between ERS and CIMT (r = 0.476, p = 0.007). Conclusion: TyG and ERS indices are positively correlated with CIMT in CSFP patients. These indices may be useful tools for cardiovascular risk evaluation and early identification of high-risk patients for subclinical atherosclerosis and potential CSFP.
Co-Authors Ali Ghanie Erwin Azmar Erwin Sukandi Imran Soleh Ira Dwi Novriyanti Irfannuddin Irfannuddin Irsan Saleh Irwan Irwan Kusuma, Singgih Lian Lanrika Waidi Lubis M. Novran Chalik Rukiah Chodilawati Sudarto Syamsu Indra Taufik Indrajaya Teguh Setiadi Tri Suciati Yudhie Tanta