Garuda - Garba Rujukan Digital

The Role of Neutrophil-Lymphocyte Ratio (NLR) as a Predictor of Successful Thrombolysis in Patients with STEMI at RSUP Dr. Sardjito Rahadiyani, IDA Swasty; Dinarti, Lucia Kris; Hartopo, Anggoro Budi
Acta Interna The Journal of Internal Medicine Vol 12, No 2 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98238

Background. Coronary atherosclerosis is a major cause of ST-elevation acute myocardial infarction (STEMI). Many factors influence the pathophysiology of atherosclerosis formation, and one of the most important is inflammation. Neutrophils have an important role in the progression and instability of atherosclerotic plaques that lead to acute coronary syndromes, while lymphopenia is caused by an increase in endogenous cortisol that occurs during acute stress in acute coronary syndromes. The neutrophil-lymphocyte ratio (NLR) is a combination of inflammatory markers, integrating the two roles of leukocyte subtypes with their respective pathways into one predictor factor that can be applied to the outcome stratification of patients with STEMI undergoing thrombolytic therapy.Objectives. To identify the role of NLR as a predictor of successful thrombolysis in patients with STEMI and knowing the NLR cut-off point that can act as a predictor of successful thrombolysis in patients with STEMI.Method. This study was a retrospective cohort study. The research subjects were patients who were first diagnosed with STEMI in the ER/ICCU Dr. Sardjito Hospital and who met the inclusion and exclusion criteria, from January 1, 2016, to November 30, 2020. The independent variable in this study was the NLR at admission. The dependent variable in this study was the success of thrombolysis. Characteristic data in this study are presented in the form of categorical data. Bivariate statistical analysis with Chi-Square test. The prognostic value for success of thrombolysis was analyzed using the Receiver Operating Characteristic curve to determine the NLR limit value, followed by calculating the Relative Risk (RR). Variables having p<0.25 were continued in multivariate analysis.Result. A total of 162 subjects met the inclusion and exclusion criteria. Overall, the success of thrombolysis was 81.5%. NLR values are in the range of 6 to 13 with a median value of 6.38. ROC NLR analysis on the success of thrombolysis obtained a cut-off of 10.16 fL. From the bivariate analysis for all possible predictors, 6 predictors had logistical significance (p<0.25) namely NLR, gender, age, BMI, onset, and Killip. From multivariate analysis, statistically significant independent predictors of thrombolysis success were NLR (p=0.007, OR 3.44), onset (p=0.003, OR 4.13), and Killip (p=0.009, OR 6.76).Conclusion. A low NLR can be used as a predictor of successful thrombolysis in STEMI patients at RSUP Dr. Sardjito, with 3.44 times higher compared to the high NLR.

Tekanan darah sistolik, indeks kardiak dan sindrome Eisenmenger merupakan prediktor kematian pada pasien hipertensi arteri pulmonal terkait penyakit jantung bawaan: analisis dari register COHARD-PH Rochmat, Muflihatul Baroroh; Setianto, Budi Yuli; Anggrahini, Dyah Wulan; Dinarti, Lucia Kris; Hartopo, Anggoro Budi
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1623

Background: Pulmonary arterial hypertension (PAH) is a complication of left-to-right intracardiac shunt congenital heart disease (LtR-shunt CHD). There are several known predictors of mortality in PAH patients, however predictors of mortality in LtR-shunt CHD-associated PAH need to be validated. Objectives: We aimed to investigate the predictors of mortality among adult LtR-shunt CHD-associated PAH patients. Methods: This research was a retrospective cohort study that included adult patients with LtR-shunt CHD-associated PAH retrieved from the COHARD-PH registry. Several baseline variables were selected as potential predictors of mortality, namely (1) clinical data: WHO-functional class, SaO2, 6-min walking distance, systolic blood pressure, and Eisenmenger syndrome; (2) laboratory data: hemoglobin and NT-pro BNP levels; (3) echocardiography data: pericardial effusion, defect size, and TAPSE; and (4) hemodynamic data: right atrial pressure, cardiac output and index, SvO2, and flow ratio. The mortality outcome was assessed from the cohort registry. Results: A total of 124 subjects with LtR-shunt CHD-associated PAH were included. Sixteen subjects (12.9%) died during the follow-up period. The baseline variables which showed significant association with mortality were lower systolic blood pressure, Eisenmenger syndrome, higher NT-pro BNP level, and lower cardiac output. The multivariable analysis showed that systolic blood pressure <100 mmHg (OR 10.99; 95% CI 2.54-47.51, p=0.001), cardiac index <2.5 L/min/m2 (OR 8.13; 95% CI: 1.59-42.28, p=0.011) and Eisenmenger syndrome (OR 3.87; 95%CI: 1.06-14.07) were the independent predictors for mortality. Conclusions: The systolic blood pressure <100 mmHg, cardiac index <2.5 L/min/m2, and Eisenmenger syndrome were independent predictors of mortality among adults with LtR-shunt CHD-associated PAH.

Interventricular septal dissection in a patient with atrial septal defect and pulmonary hypertension Personaldi, Personaldi; Dinarti, Lucia Kris; Marsam, Real Kusumanjaya; Mumpuni, Hasanah
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.19

Background: Interventricular septal dissection (IVSD) is a sporadic disorder. Previous literature has reported cases of IVSD caused by sinus valsalva aneurysms, post-myocardial infarction patients, congenital abnormalities, or post-thoracic trauma. However, no prior literature has reported IVSD cases caused by an atrial septal defect (ASD) accompanied by pulmonary hypertension. This case report aims to initiate the discussion of recognizing the association between ASD-PH and IVSD. Case presentation: A 48-year-old female with ASD was brought to Dr. Sardjito General Hospital with complaints of fatigue. In 2013, the patient experienced attacks of hemoptysis, which was then revealed to be caused by an increase in pulmonary pressure. Transthoracic echocardiography (TTE) examination results concluded that the patient had a high probability of pulmonary hypertension (PH), secundum atrial septal defect (ASD), which was 22-25 mm in diameter, a bidirectional shunt, and mid-apical interventricular septum dissection with flow. The patient underwent a right heart catheterization examination on September 3rd, 2015, at Dr. Sardjito General Hospital and was confirmed with pulmonary hypertension. The patient underwent computed topography (CT) scan with contrast on March, 2024, for evaluation, where we found a rupture of the interventricular septal muscle. Conclusion: The incidence of interventricular septal dissection is rare. Various causes are suspected, such as sinus of Valsalva rupture, post-myocardial infarction events, or associated congenital abnormalities. From this report, we present an IVSD case that is concurrent with ASD-PH. ASD and pulmonary hypertension, through combination of myocardial injury and hypertension, can cause interventricular septal dissection.

Interventricular septal dissection in a patient with atrial septal defect and pulmonary hypertension Personaldi; Dinarti, Lucia Kris; Marsam, Real Kusumanjaya; Mumpuni, Hasanah
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.19

Background: Interventricular septal dissection (IVSD) is a sporadic disorder. Previous literature has reported cases of IVSD caused by sinus valsalva aneurysms, post-myocardial infarction patients, congenital abnormalities, or post-thoracic trauma. However, no prior literature has reported IVSD cases caused by an atrial septal defect (ASD) accompanied by pulmonary hypertension. This case report aims to initiate the discussion of recognizing the association between ASD-PH and IVSD. Case presentation: A 48-year-old female with ASD was brought to Dr. Sardjito General Hospital with complaints of fatigue. In 2013, the patient experienced attacks of hemoptysis, which was then revealed to be caused by an increase in pulmonary pressure. Transthoracic echocardiography (TTE) examination results concluded that the patient had a high probability of pulmonary hypertension (PH), secundum atrial septal defect (ASD), which was 22-25 mm in diameter, a bidirectional shunt, and mid-apical interventricular septum dissection with flow. The patient underwent a right heart catheterization examination on September 3rd, 2015, at Dr. Sardjito General Hospital and was confirmed with pulmonary hypertension. The patient underwent computed topography (CT) scan with contrast on March, 2024, for evaluation, where we found a rupture of the interventricular septal muscle. Conclusion: The incidence of interventricular septal dissection is rare. Various causes are suspected, such as sinus of Valsalva rupture, post-myocardial infarction events, or associated congenital abnormalities. From this report, we present an IVSD case that is concurrent with ASD-PH. ASD and pulmonary hypertension, through combination of myocardial injury and hypertension, can cause interventricular septal dissection.

Cost-Effectiveness of Antithrombotic Agents for STEMI Zulpadly, M Fiqri; Thobari, Jarir At; Dinarti, Lucia Kris
Jurnal Farmasi Sains dan Komunitas (Journal of Pharmaceutical Sciences and Community) Vol 21, No 2 (2024)
Publisher : Sanata Dharma University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24071/jpsc.006073

In Indonesia, the prevalence of Acute Coronary Syndrome (ACS) continues to rise annually and remains high. Aspirin and adenosine diphosphate receptor inhibitors are recommended as part of the dual antiplatelet therapy that is recommended by the standard guidelines for managing ACS. Ticagrelor, a new treatment option for ACS, has been made available during the current period of Indonesia's National Health Insurance. Ticagrelor is more effective, but it costs more. Objective: In patients with ST-Elevation Myocardial Infarction (STEMI), the goal of this study was to compare how much ticagrelor and clopidogrel cost when compared to one another with relative ratio (RR) analysis and 95% confidence interval (CI) with p

Effectiveness of mHealth on self-care profile and blood pressure among patients with hypertension in Indonesia: A single-blind randomized controlled trial Widyastuti, Chatarina Setya; Dinarti, Lucia Kris; Aulawi, Khudazi; Lazuardi, Lutfan
Belitung Nursing Journal Vol. 11 No. 3 (2025): May - June
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3760

Background: Self-management is essential for controlling blood pressure and requires consistent effort. Mobile health (mHealth) applications can support patients in independently managing hypertension and maintaining better control over their blood pressure. Objective: This study aimed to evaluate the effectiveness of MaRiTensi mobile application in improving knowledge, motivation, self-efficacy, and self-care among patients with hypertension, as well as in lowering blood pressure. Methods: A two-arm randomized controlled trial with a single-blind evaluator was conducted among 108 patients with hypertension, recruited from a private hospital and two health centers in Yogyakarta, Indonesia. The 12-week study was implemented from October 2023 to April 2024. Participants were randomly assigned to the intervention group, which used the MaRiTensi app, or the control group, which received usual care. Primary outcomes—knowledge, self-care, self-efficacy, and motivation—were measured using a validated questionnaire, while the secondary outcome—blood pressure—was assessed through clinical measurement. Ninety-nine participants completed the study and were included in the analysis. Repeated measures ANOVA was used to evaluate within-group changes over time. Intergroup comparisons were analyzed using the chi-square test, independent t-test, or Mann–Whitney U test. Results: No significant baseline differences were found between the two groups (p >0.05). Significant improvements were observed in knowledge, self-care, and systolic and diastolic blood pressure in both groups (p <0.01). Self-efficacy significantly improved only in the intervention group (p <0.01). No significant changes in motivation were observed over time in either group (p >0.05). Significant between-group differences were found at the first evaluation for self-care (p = 0.005; d = 0.58), self-efficacy (p = 0.011; d = 0.52), motivation (p = 0.026; d = 0.44), systolic pressure (p = 0.039; d = 0.42), and diastolic pressure (p = 0.009; d = 0.54), and at the second evaluation for self-care (p = 0.024; d = 0.46). Conclusions: MaRiTensi may effectively improve self-care, self-efficacy, and blood pressure control among patients with hypertension, although it showed limited impact on knowledge and motivation. The application shows promise as a nursing intervention, but further research is needed to assess its long-term effectiveness and sustainability. Trial Registry Number: NCT06049862 [ClinicalTrials.gov]

Congenital heart disease screening program in elementary schools: a research-based policy Dinarti, Lucia Kris; Hartopo, Anggoro Budi; Hadwiono, Muhammad Reyhan; Wiradhika, Abdul Majid Halim; Meliala, Andreasta; Putri, Likke Prawidya; Fajarwati, Prahesti; Anggrahini, Dyah Wulan
BKM Public Health and Community Medicine Vol 39 No 01 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v39i01.5783

Purpose: CHD is a condition where heart abnormalities develop before birth and can lead to severe complications such as heart failure and premature death, especially among younger adults. Delayed diagnosis and treatment worsen the situation for CHD patients. Early screening can prevent CHD and ensure timely interventions. This study discusses the latest advancements in CHD screening for primary school children and the valuable insights gained from the program. Method: The CHD screening program in Yogyakarta province involved three stages: consolidation, implementation, and incorporation. During the consolidation stage, key decision-makers in the province and local health offices were involved. Primary healthcare workers and primary school teachers were trained to deliver the screening during the implementation stage. Stakeholders, health workers, and teachers were invited to discuss the results, and the Provincial Governor's office was engaged during the incorporation stage. Results: In 2018–2019, 18 CHDs were identified from 6,116 school-age children in 4 districts in Indonesia. The screening program was led by academics in the Universitas Gadjah Mada through 3 stages: consolidation, implementation, and incorporation. Strong collaboration with local stakeholders has contributed to the program's success in engaging 130 schools, 60 community health centers, and 190 health workers. Several opportunities for improvement are: strengthening the capacity and number of health providers at health centers to screen CHDs using 12-lead electrocardiography, addressing patients' reluctance to visit the health facility due to the COVID-19 pandemic, and motivating parents to have their children checked. Conclusion: CHD screening using 12-lead electrocardiography and auscultation should be part of primary school health screenings. Academics can train health workers, and local governments can provide funding and prepare health facilities for follow-up treatment.

Title

Found 7 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 7 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 7 Documents
Search