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All Journal Global Medical and Health Communication Health Notions Cardiovascular and Cardiometabolic Journal (CCJ)
Achmad Lefi
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine Universitas Airlangga, Surabaya, Indonesia - Dr. Soetomo General Hospital Surabaya
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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 1 
Relationship Between Risk Factors of Coronary Heart Disease on The Amount of Lesioned Coronary Artery Monitrya Nababan; Achmad Lefi; Djohar Nuswantoro
Health Notions Vol 3, No 12 (2019): December
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn31208

Abstract

Objective: To determine the relationship of coronary heart disease traditional risk factors to the number of lesioned coronary arteries and calculate the relative risk. Methods: This study used an analytical research design with a retrospective cohort study design using patient catheterization report data. Data analysis was performed using the chi square test and relative risk in 449 individuals. Results: Based on the analysis results obtained p value 0.05 indicating no relationship between risk factors for coronary heart disease with the number of coronary arteries the lesions based on sex, history of hypertension and history of smoking. Conclusion: There is a relationship between age, history of diabetes mellitus, history of dyslipidemia and the number of coronary arteries that are lesions in patients with coronary heart disease and there is no relationship between sex, history of hypertension and smoking history with the number of coronary arteries that are lesions in patients with coronary heart disease. Keywords: single vessel disease; multivessel disease; coronary artery disease; risk factors CAD
Clinical Characteristics and Number of Valve Lesion in Rheumatic Heart Disease Severity Saskia Ratna Desita; Achmad Lefi; Mahrus Rahman; Yudi Her Oktaviono
Global Medical & Health Communication (GMHC) Vol 9, No 1 (2021)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (547.148 KB) | DOI: 10.29313/gmhc.v9i1.6609

Abstract

Rheumatic heart disease (RHD) occurs due to sequelae in the form of damage to the heart valves from the failure of acute rheumatic fever (ARF) therapy. Heart valve damage can cause various complications such as congestive heart failure, arrhythmias, pulmonary hypertension, atrial fibrillation, endocarditis, which can cause death. The study aimed to assess the association between clinical characteristics and valve lesion and rheumatic heart disease severity. The study was an analytic observational with a cross-sectional design of 73 patients with definite RHD from September 2019 to March 2020 in Dr. Soetomo Regional General Hospital. The majority of patients were female (80%, p=0.235) 30–39 years old (34%, p=0.157). The mean age was 42.08±12.16 years. The majority of patients have low socioeconomic status (78%, p=0.025) and rural dwelling location (70%, p=0.138) over three-quarters of patients living with more than four people in the same house (75%). Multivalvular lesions (90%, p=0.003) and severe RHD (77%) were present predominantly. In conclusion, low socioeconomic status and multivalvular lesions are associated with rheumatic heart disease severity. KARAKTERISTIK KLINIS DAN JUMLAH LESI KATUP PADA DERAJAT KEPARAHAN PENYAKIT JANTUNG REUMATIKPenyakit jantung reumatik (PJR) adalah penyakit yang terjadi akibat gejala sisa berupa kerusakan katup jantung dari kegagalan terapi demam reumatik akut (DRA). Kerusakan katup jantung pada PJR dapat menimbulkan berbagai komplikasi seperti gagal jantung kongesti, aritmia, hipertensi pulmonal, atrial fibrilasi, dan endokarditis yang dapat menyebabkan kematian. Penelitian ini bertujuan mencari hubungan karakteristik klinis dan jumlah lesi katup dengan derajat keparahan PJR. Penelitian ini merupakan analitik observasional menggunakan pendekatan cross-sectional. Sampel penelitian ini adalah pasien yang terdiagnosis definitif PJR berdasar atas ekokardiografi pada bulan Sepetember 2019–Maret 2020 di RSUD Dr. Soetomo Surabaya. Didapatkan 73 pasien sesuai dengan kriteria inklusi. Mayoritas pasien berjenis kelamin perempuan (80%; p=0,235), dengan kelompok usia 30–39  (34%; p=0,157). Usia rerata 42,08±12,16 tahun. Sebagian besar pasien berstatus sosial ekonomi rendah (78%, p=0,025) dan lokasi tinggal pedesaan (70%; p=0,138). Lebih dari tiga perempat pasien tinggal dengan ≤4 orang di satu atap (75%). Lesi multivalvular (90%; p=0,003) dan PJR berat (77%) ditemukan secara dominan. Simpulan, status sosial ekonomi rendah dan lesi katup multivalvular berhubungan dengan derajat keparahan penyakit jantung reumatik.
Correlation of Neutrophyl-Lymphocyte Ratio, Vessel Score based on Sullivan Scoring System, and Troponin in Acute Coronary Syndrome Patients Chelssi Gloria Tessari; Achmad Lefi; Yetti Hernaningsih
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 2 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i2.2022.75-86

Abstract

Acute Coronary Syndrome (ACS) is one of the highest causes of death globally, with the number of deaths reaching more than 9 million people in 2016. Therefore, a fast and accurate ACS diagnosis is needed. This study aimed to determine the relationship between the neutrophil-lymphocyte ratio, the number of coronary artery lesions evaluated by angiography, and troponin I in ACS patients Material and Methods: This research is an analytic observational with a retrospective cross-sectional design. Sampling was carried out using a total sampling technique and obtained 87 samples that met the inclusion and exclusion criteria for the 2019-2020 period at Dr. Soetomo Regional General Hospital Surabaya. The correlation between the number of coronary artery lesions and the neutrophil-lymphocyte ratio to troponin I levels were respectively analyzed using chi-square and spearman-rho with SPSS ver. 25. Results: The results showed a moderately significant correlation between the neutrophil-lymphocyte ratio and troponin I levels (p =0.003, rs = 0.319). While the correlation analysis between the number of coronary artery lesions and the vessel score on troponin I showed insignificant results (p = 0.525), which means that the number of coronary artery lesions was not correlated with troponin I. Conclusion: This study concludes a significant correlation with moderate correlation between the neutrophil-lymphocyte ratio and troponin I. However, there is no significant correlation between the number of coronary artery lesions assessed by the Sullivan and troponin I levels.
High-Dose Nitroglycerin Bolus and Non-Invasive Ventilation Prevent Intubation or ICU Admission on Hypertensive Emergency and Acute Pulmonary Edema: Sympathetic Crashing Acute Pulmonary Edema (SCAPE) Treatment on STEMI Patient: A Case Report Mahendra Eko Saputra; Achmad Lefi; Makhyan Jibril Al Farabi; Pandit Bagus Tri Saputra; Ariikah Dyah Lamara
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 4 No. 2 (2023): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v4i2.2023.99-104

Abstract

Highlight: 1. SCAPE could lead to respiratory failure when not treated promptly. 2. High-dose NTG and NIV support can be used as an alternative treatment to overcome hypertensive emergency and pulmonary edema, thus preventing the need for endotracheal intubation and ICU admission. - Background: A marked elevation in blood pressure that causes acute heart failure and fluid accumulation in the lungs is known as sympathetic crashing acute pulmonary edema (SCAPE). Here, we present a SCAPE patient with severe respiratory failure who was successfully treated with high-dose nitroglycerin (NTG) bolus and non-invasive ventilation (NIV). Case summary: A 48-year-old male was referred to our center with typical chest pain and dyspnea. Physical and additional examination found hypertensive emergency (196/66 mmHg), acute pulmonary edema, and acute heart failure, accompanied by anterior STEMI and severe respiratory failure (P/F ratio of 72) in need of intubation. He was given 2 mg intravenous NTG bolus twice supported with NIV, diuretics followed by the primary percutaneous coronary intervention (PCI) stenting in mid left anterior descending (LAD). The patient recovered from acute pulmonary edema, and the P/F ratio improved from 72 to 321 without intubation. Discussion: SCAPE could lead to respiratory failure requiring intubation and intensive care unit (ICU) admission when not treated promptly. The administration of large doses of NTG and NIV was safe and resulted in a speedy improvement in symptoms. Conclusion: SCAPE can be resolved without invasive procedures, using high-dose NTG and NIV support to overcome hypertensive emergency and pulmonary edema.
Co-Authors Ariikah Dyah Lamara Chelssi Gloria Tessari Mahendra Eko Saputra Mahrus A Rahman, Mahrus A Makhyan Jibril Al Farabi Monitrya Nababan Nuswantoro, Djohar Pandit Bagus Tri Saputra Saskia Ratna Desita Sony Wibisono Thomas Jatiman Yetti Hernaningsih Yudi Her Oktaviono, Yudi Her