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All Journal Buletin Farmatera Indonesian Journal of Cardiology Sumatera Medical Journal Heart Science Journal Cardiovascular and Cardiometabolic Journal (CCJ) Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED) Medistra Medical Journal (MMJ)
Sitepu, Andika
Departemen Jantung Dan Pembuluh Darah, Fakultas Kedokteran Universitas Sumatera Utara
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Description of Clinical Severity, Laboratory Results, and ECG of COVID-19 Patients Who Received Doses I and II of the COVID-19 Vaccine at Haji Adam Malik General Hospital from April to August 2021 Shafira Pramesi Putri; Andika Sitepu; Yuke Sarastri; Setia Putra Tarigan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 4 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i4.11000

Abstract

Introduction: COVID-19 patients with comorbidities (hypertension or cardiovascular disease) have a high mortality rate and are at high risk of showing severe symptoms of COVID-19. One of the preventions to avoid COVID-19 is to vaccinate against COVID-19. The COVID-19 vaccine has proven safe and effective in patients with comorbidities because the vaccine can prevent severe symptoms of COVID-19. Aim: To describe the clinical severity, laboratory results, and ECG of COVID-19 patients with cardiovascular comorbidities who received the first and second doses of COVID-19 vaccination at Haji Adam Malik General Hospital from April to August 2021. Methods: A descriptive retrospective study using a cross-sectional study design. Total sampling was used, which fits the inclusion and exclusion criteria. Results: Out of the 71 COVID-19 patients with cardiovascular comorbidities, the majority were found to be male patients (57.7%), aged ≥ 65 years (22.5%), with comorbid hypertension (84.5%), and had received vaccine dose II (97.2%). Most patients had mild symptoms (47.9%), abnormal ECG results (73.2%), and varied laboratory results. Conclusion: Most patients had received the second COVID-19 vaccine, showing moderate symptoms of COVID-19, abnormal ECG results, and varied laboratory results.
Prevalence of Valvular Heart Disease and Pulmonary Hypertension in Children in Rantau-Prapat City, North Sumatra, Indonesia Haykal, Teuku Bob; Sitepu, Andika; Ilyas, Kamal Kharrazi
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 4 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i4.14333

Abstract

Background: Valvular heart disease and pulmonary hypertension (PH) are two distinct but often interconnected cardiac conditions that can affect children and encompass abnormalities of the heart's valves such as the aortic, mitral, tricuspid, and pulmonary valves, and can present with symptoms such as chest pain, fatigue, and dyspnea. In contrast, PH refers to elevated blood pressure in the pulmonary arteries. Routine screening for these conditions is needed for prompt diagnosis and management. This study was conducted to obtain data on children with valvular heart disease or PH who participated in the Community Service Program of the Department of Cardiology and Vascular Disease, Universitas Sumatera Utara. Method: This study was a descriptive study conducted through a cross-sectional study design. Data was collected from interviews and on-the-spot examination with validated measurement tools. Data was analyzed using SPSS version 26. Categorical variables were presented using frequency (n) and percentage (%), and numerical variables with normally distributed data were presented with mean and standard deviation (SD). In non-normally distributed data, numerical variables were presented using the median and interquartile range. Results: There were 157 children included in this study. Most subjects were female (n=94, 59.9%) in the age range 12 to 16 years old. Most subjects (n=152, 96.8%) had normal mitral valves, three subjects had anterior mitral valve prolapse (1.9%), one subject (0.6%) had anterior mitral valve thickening and one subject (0.6%) had mild mitral regurgitation. 10 subjects (5.7%) had pulmonary regurgitation. Two subjects had tricuspid regurgitation (1.2%). No subjects had any aortic abnormalities. No subjects had a PH. Conclusion: In the children population in Rantau-Prapat City, most subjects with valve abnormalities had mitral and pulmonary valve abnormalities. No subjects had aortic valve abnormalities or PH.
Acute Kidney Injury as Predictor of Major Adverse Cardiac Event (MACE) in 3 Months after Admission of Acute Heart Failure Patients in Haji Adam Malik General Hospital Medan Chan, Muhammad Ikhsan; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Hasan, Harris; Sarastri, Yuke; Sitepu, Andika
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 5 No. 2 (2024): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v5i02.2024.82-94

Abstract

Highlights: 1. This study provides novel evidence that acute kidney injury (AKI) is a strong predictor of major adverse cardiovascular events (MACE) in patients with acute heart failure, highlighting the critical need for early detection and intervention to improve outcomes. 2. This research underscores the importance of incorporating kidney function assessment into the comprehensive management of acute heart failure patients. - Background: Acute heart failure is a condition with high morbidity and mortality. Decreased renal function after hospitalization is a predictor of longer hospitalization and increased mortality. Patients with acute renal failure, especially injury or failure grade, have a worse long-term prognosis compared to patients without acute renal failure, which will lead to MACE. Major adverse cardiovascular events are a combination of non-fatal stroke, non-fatal myocardial infarction, or cardiovascular death. Material and Methods: This study was a retrospective cohort study of 159 patients with acute heart failure at HAM General Hospital from April 1, 2023 to December 31, 2023. Electrocardiographic, laboratory, and echocardiographic data were collected. Patients were categorized according to RIFLE classification and monitored to see MACE in the samples. Bivariate tests were performed to see the correlation between samples. Furthermore, Kaplan-Meier curves were analyzed to see the survival rate. Results: Total subjects were 159 patients consisting of 98 acute heart failure patients with AKI and 61 heart failure patients without AKI. There was a correlation between heart failure patients who developed acute renal failure and the number of days of hospitalization (p = 0.000), in hospital mortality (p = 0.002), rehospitalization in less than 3 months (p = 0.000), and mortality in less than 3 months (p = 0.001). Conclusion: Acute kidney injury has a correlation with MACE so that it can be a predictor of major cardiovascular events in patients with acute heart failure.
PERBANDINGAN SKOR HARKIT DENGAN SKOR SOCIETY OF THORACIC SURGEONS (STS) DALAM MEMPREDIKSI TINGKAT MORTALITAS PASIEN PASKA OPERASI KATUP DI RUMAH SAKIT UMUM PUSAT HAJI ADAM MALIK MEDAN Lubis, Ainil Wardah; Sitepu, Andika; Intan, Tengku Kemala; Tanjung, Ika Citra Dewi
Jurnal Kardiologi Indonesia Vol 45 No 1 (2024): January - March, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1615

Abstract

Background: Valvular heart disease is a major contributor to increased mortality. The HARKIT score has been validated to predict mortality after specific valve surgery and the STS score to predict mortality rates in patients after cardiac surgery. Haji Adam Malik General Hospital Medan has never used the HARKIT score and the STS score to predict mortality in patients with post valve surgery. Methods: A cross-sectional study from January 2022-April 2023 at Haji Adam Malik General Hospital Medan. The data used is obtained from patient medical record who had heart valve surgery. The data were analyzed with descriptive statistics and presented the form of frequency distribution. Comparison of the HARKIT score with the STS score to predict mortality rates were analyzed using chi-square test. Results: Among 63 patients who underwent valve surgery, 8 patients died after surgery. The HARKIT score system has good analytical power and very strong discriminant (H-L test P=0.646; AUC=0.916; 95% CI=0.794-1.000), while the STS score has poor analytical power (H-L test P=0.002) but has moderate discriminant (AUC=0.798; 95% CI=0.632-0.964). Conclusion: The HARKIT score is more accurate than the STS score in predicting the mortality rate of post-valve surgery patients at Haji Adam Malik General Hospital Medan.
Infark miokardium dengan arteri koroner non obstruktif (MINOCA) dengan komplikasi ventrikel takikardi : LAPORAN KASUS dr Nicholas Prananda Sembiring; dr. Andika Sitepu, Sp.JP(K), FIHA, FAsCC, FAPSC, M.H.(Kes); FIHA; FAsCC; FAPSC
Medistra Medical Journal (MMJ) Vol 1 No 2 (2024): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/mmj.v1i2.2125

Abstract

Disini kami menyajikan seorang pasien dengan keluhan nyeri dada khas infark selama 2 hari dan menjalar ke punggung bagian belakang. Pada pemeriksaan saat ini, EKG awal menunjukkan elevasi segmen ST (>0,5 mm) di hampir semua sadapan. Pasien didiagnosis menderita STEMI anteroseptal akut dan syok kardiogenik. Pasien kemudian dilakukan pemeriksaan angiografi koroner yang dilaporkan hasilnya normal, tanpa lesi yang signifikan dan tidak ada tanda-tanda penyakit arteri koroner obstruktif, diseksi koroner, bridging atau emboli pada arteri koroner. Berdasarkan temuan di atas, kami menganggap pasien ini sebagai infark miokardium dengan arteri koroner non obstruktif (MINOCA). Kondisi pasien di perparah dengan adanya VT disertai dengan ketidakstabilan hemodinamik sehingga pasien harus di kardioversi. Pasien segera dirujuk setelah 2 hari pengobatan. Defibrilasi telah dilakukan dua kali pada pasien ini. MINOCA biasanya terjadi pada pasien yang lebih muda dan wanita, yang mungkin memiliki risiko kejadian kardiovaskular lebih rendah dibandingkan pasien dengan CAD obstruktif. Penyebab paling umum dari MINOCA diwakili oleh penyakit plak koroner, diseksi koroner, emboli pada arteri koroner, spasme mikrovaskuler koroner, kardiomiopati Takotsubo, miokarditis, tromboemboli koroner, bentuk lain dari infark miokard tipe 2 dan MINOCA dengan etiologi yang tidak pasti. Diperlukan pemeriksaan lebih lanjut seperti resonansi magnetik jantung (CMR) untuk menegakkan diagnosis lebih baik. Studi elektrofisiologi juga di pertimbangkan pada pasien ini dikarenakan pasien sudah berulang mengalami VT.
Wellens's Syndrome, Kenali karena setara dengan stemi: laporan kasus Br Ginting, Kristivani; Andika Sitepu; FIHA; FASCC; FAPSC
Medistra Medical Journal (MMJ) Vol 1 No 2 (2024): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/mmj.v1i2.2110

Abstract

Acute coronary syndrome (ACS) is one of the leading causes of acute chest pain, requiring emergency care and eventual hospitalization. Wellens’ syndrome is one such example, which in ACS patients is a catastrophic event often accompanied by extensive anterior myocardial infarction and high mortality rates. Wellens’ syndrome is a pattern of T-wave changes seen in the anterior (V2-V3) leads on critical stenosis of the left anterior descending (LAD) coronary artery. We reported a 65-year-old man admitted to our emergency facility because of intermittent chest pain that had been experienced for the past 2 days. An initial ECG performed in the emergency room while pain free showed sinus rhythm with biphasic T waves in V2–4 which is typical of Wellen's Syndrome. Chest x-ray shows cardiomegaly. Cardiac enzyme examination showed an increase in CKMB and Troponin T levels of 18.40 U/L and 560 ng/L respectively. The echocardiography (ECHO) demonstrated a hypokinesis of the anteroseptal with left ventricular ejection fraction (LVEF) of 47 %. Cardiac catheterization showed total occlusion in the mid-LAD and other coronary arteries had non-significant lesions. He then underwent balloon angioplasty and placement of a stent in the proximal and mid LAD with a good result. Wellen’s syndrome often represents a pre-infarction state of myocardial infarction. Early recognition of these ECG features is crucial to identify these high-risk clients, and the definitive evaluation and treatment is cardiac catheterization with intervention to relieve the LAD obstruction.
Relationship between Coronary Artery Calcium Score (CACS) and Diastolic Dysfunction in Patients with Stable Coronary Heart Disease at Adam Malik General Hospital Medan Putra, Muhammad Hafiz Mahruzza; Hasan, Refli; Sitepu, Andika; Hasan, Harris; Ketaren, Andre Pasha; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi
Journal of Society Medicine Vol. 4 No. 6 (2025): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.221

Abstract

Introduction: Coronary artery calcium score (CACS) is a specific indicator of coronary atherosclerosis that plays a role in assessing the degree of calcification in atherosclerosis. Diastolic function is the first aspect of cardiac function to be impaired in ischemic heart disease. This study aims to determine the relationship between calcium scoring and diastolic dysfunction. Methods: This analytical observational study with cross-sectional design evaluated the relationship between coronary artery calcium score (CACS) and left ventricular diastolic function in patients with stable CAD. Data were collected retrospectively from medical records at RSUP H. Adam Malik Medan during Nov 2023-Nov 2024. CACS was assessed using coronary CT scan, while left ventricular diastolic function was measured by echocardiography. Data analysis used chi-square test, Mann-Whitney U test, and ROC curve analysis to evaluate CACS threshold in predicting diastolic dysfunction. Results: Among 158 analyzed samples, 113 patients had diastolic dysfunction. A calcium score ≥100 was found in 46.2% of patients, showing 1.318 times higher risk of diastolic dysfunction versus those with scores <100 (p = 0.006; 95% CI 1.083–1.605). ROC analysis showed CACS had moderate predictive ability for diastolic dysfunction with AUC of 0.647 (p = 0.004). A calcium score threshold of 45 had 65.5% sensitivity and 62.2% specificity in detecting diastolic dysfunction. Type 2 diabetes mellitus, urea, and creatinine levels were also significantly associated with diastolic dysfunction (p < 0.05). Conclusion: Calcium score shows a significant relationship with diastolic dysfunction in stable CAD patients and can predict diastolic dysfunction in patients undergoing coronary CT scan.
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).
Correlation between iron profile and severity of coronary artery lesion in patients with non-ST segment elevation myocardial infarction Syarifuddin, Fairuz; Andika Sitepu; Abdullah Afif Siregar; Zulfikri Mukhtar; Cut Aryfa Andra; Teuku Bob Haykal; Harris Hasan
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.2025.006.04.12

Abstract

BACKGROUND: Excessive iron has been shown to increase the atherosclerosis process through the help of non-transferrin-bound iron (NTBI). OBJECTIVE: This study aimed to ascertain the association between iron profile and the severity of coronary artery lesions in patients with acute non-ST segment elevation myocardial infarction (NSTEMI).  METHOD: This observational analytical study with a cross-sectional design was conducted from February to September 2024 at Adam Malik General Hospital. NSTEMI patients planned for coronary angiography were examined for iron profile, including serum iron, total iron binding capacity (TIBC), and transferrin saturation. Coronary artery lesion severity was evaluated using the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score.  RESULTS: This study involved 72 subjects. The results showed there were no correlations between serum iron levels and SYNTAX scores (p = 0.891) and transferrin saturation with SYNTAX scores (p = 0.545). Nevertheless, TIBC and SYNTAX score were negatively correlated (p = 0.004) with a weak correlation coefficient (r = -0.334).  CONCLUSION: TIBC levels are inversely correlated with the severity of coronary artery lesions. However, transferrin saturation and serum iron have not been shown to correlate with the severity of coronary artery lesions.
High-Degree AV Block in STEMI with Metabolic Disorders: Who is the Prime Suspect? Sinulingga, Brigitta Olivia; Sitepu, Andika
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/az5zac60

Abstract

Background: ST-elevation myocardial infarction (STEMI) is typically associated with a single culprit lesion. However, cases involving dynamic progression or multiple simultaneous infarct-related arteries are rare but carry significantly higher risks, particularly when accompanied by malignant arrhythmias and electrical instability. Case Illustration: A 33-year-old male, active smoker and casual drinker, presented with acute chest pain, dyspnea, and nausea. He was initially diagnosed with inferior STEMI and transient ventricular tachycardia at the referring hospital. Upon transfer, his ECG evolved to show inferior-anterior STEMI with complete atrioventricular block. Shortly after arrival, he experienced cardiac arrest and was successfully resuscitated. Coronary angiography revealed dual culprit lesions: total occlusion of both the right coronary artery (RCA) and the left anterior descending artery (LAD). PCI was performed with drug-eluting stent placement in the RCA, and balloon angioplasty with thrombus aspiration and intracoronary eptifibatide in the LAD. Revascularization achieved TIMI III flow.Discussion: Despite successful PCI, the patient suffered recurrent cardiac arrests in the catheterization lab and ICU, ultimately dying from cardiac arrest. This case illustrates the rare but catastrophic progression of STEMI into a dual-vessel event with severe electrical and hemodynamic complications in a young patient. Conclusion: Dual culprit lesions in STEMI can evolve rapidly and unpredictably, particularly in the presence of malignant arrhythmias. Early recognition, rapid intervention, and aggressive hemodynamic support are essential to improve survival in these high-risk cases.
Co-Authors Abdullah Afif Siregar Abdullah Afif Siregar Abimanyu, Roni Ahmad Handayani Aldino Satria Adhitya Alfuadi, T. Rifki Mirza Ali Nafiah Nasution Andra, Cut Aryfa Andra, Cut Aryfa Br Ginting, Kristivani Chan, Muhammad Ikhsan Cut Aryfa Andra Dhilion, Har Rawishwar Singh dr Nicholas Prananda Sembiring Faisal Habib FAPSC FASCC FIHA Habib, Faisal Harris Hasan Harris Hasan Hasan, Harris Hasan, Refli Haykal, T. Bob Ilyas, Kamal Kharrazi Intan, Tengku Kemala Jaya Suganti Ketaren, Andre Pasha Lubis, Ainil Wardah Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Muhammad Azmi, Muhammad Mukhtar, Zulfikri Nasution, Ali Nafiah Putra, Muhammad Hafiz Mahruzza Ratna Mariana Tamba Raynaldo, Abdul Halim Sarastri, Yuke Setia Putra Tarigan Shafira Pramesi Putri Siahaan, Basten Jeremiah Sinulingga, Brigitta Olivia Siregar, Abdullah Afif Steven Winardi Syarifuddin, Fairuz Tamba, Ratna Mariana Tanjung, Ika Citra Dewi Teuku Bob Haykal Wirtanto, Ardy Putra Yuke Sarastri Zulfikri Mukhtar