Articles
<![CDATA[On-admission serum soluble CD40 ligand level predicts subsequent myocardial damage in acute myocardial infarction ]]>
<![CDATA[Putrika Prastuti Ratna Gharini, Budi Yuli Setianto Anggoro Budi Hartopo]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 04 (2008) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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<![CDATA[Background: Platelet activation plays an important role in plaque rupture and thrombus formation. Activated platelets release soluble CD40 ligand (sCD40LI. It has coagulation and inflammation properties. Enhanced sCD40L activity has been found in acute myocardial infarction, especially in ST-elevation myocardial infarction. The impact of this enhancement on the degree of myocardial damage remains uncertain, although evidence suggests association between sCD40L level and high burden coronary thrombus.Objective: The aim of this study was to find out whether serum sCD40L level on-admission is predictive of subsequent myocardial damage following acute myocardial infarction.Methods: This study was a cross-sectional study. We consecutively enrolled patients with acute myocardial infarction admitted to ICCU Dr. Sardjito Hospital with onset < 24 hours. Blood collection for analysis of sCD40L was withdrawn on-admission before revascularization and heparinization. Serial measurement of creatine kinase (CK-MBllevel in first 24 hours of admission was conducted, the highest level was considered a peak level that reflected myocardial damage. Troponin I was measured in single sample during 72 hours of admission. The association between serum sCD40L and peak CK-MB level was analyzed with Pearson correlation test. Statistical significancy was determined by p value < 0.05.Result: We enrolled 54 consecutive subjects, among them 37 subjects was STEM!. There was a significantly positive correlation between on-admission sCD40L and peak CK-MB level (r = 0.320 ; p value = 0.0201. Nonetheless, sCD40L did not correlate with troponin I level. In STEM I, this correlation was stronger (r = 0.424; p value = 0.0101 and even more stronger in patients with STEMI who underwent revascularization therapy (r = 0.515 ; p value = 0.0291.Conclusion: On-admission serum sCD40L level is predictive of subsequent myocardial damage following acute myocardial infarctionKey words: soluble CD40 ligand - platelet activation - acute myocardial infarction - peak CK-MB myocardial damage]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Setianto, Budi Yuli]]>;
<![CDATA[Sari, Julia]]>;
<![CDATA[Hartopo, Anggoro Budi]]>;
<![CDATA[Gharini, Putrika Prastuti Ra]]>
<![CDATA[ Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Acta Interna The JOurnal of Internal Medicine ]]>
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<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently.Several studies reported that young patients have distinct clinical characteristics as compare with olderpatients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronarysyndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensivecardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admittedwith acute coronary syndrome. We divided the patients as young ACS (age ⤠45 years) and older ACS(age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrumsfrom both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was consideredsignifi cantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Mostyoung ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not differentfrom that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50%vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did notdiffer from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. Theyoung ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15%vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65).Thirty percent of young ACS patients presented with Killip class II or higher, however there were nosignifi cant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinicalpresentation and spectrums between young ACS and older ACS patients. The need for preventionprogram in both groups should not be difference.Keywords: ACSâ youngâ olderâ clinical presentation.]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Setianto, Budi Yuli]]>;
<![CDATA[Sari, Julia]]>;
<![CDATA[Hartopo, Anggoro Budi]]>;
<![CDATA[Ra Gharini, Putrika Prastuti]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Acta Interna The Journal of Internal Medicine ]]>
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<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ⤠45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACSâ youngâ olderâ clinical presentation.]]>
<![CDATA[CORRELATIONS BETWEEN SERUM LEVEL OF MATRIX METALLOPROTEINASE-9 (MMP-9) AND SERUM LEVEL OF TROPONIN-I IN PATIENT WITH ACUTE CORONARY SYNDROME (ACS) ]]>
<![CDATA[Ruchanihadi, Ruchanihadi]]>;
<![CDATA[Setianto, Budi Yuli]]>;
<![CDATA[Hariawan, Hariadi]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine ]]>
Publisher : <![CDATA[Acta Interna The Journal of Internal Medicine ]]>
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<![CDATA[ABSTRACTBackground. The pathophysiology of acute coronary syndromes (ACS) is now accepted as the rupture or erosion of an atherosclerotic plaque, initially occurs at the shoulder of the plaque and is followed by intra-plaque thrombosis then spread to the vascular lumen and cause total partial vascular occlusion. MMP-9 is an extracellular matrix degrading enzyme that plays a crucial role in the breakdown of the fibrous cap of plaque and subsequent rupture in the pathogenesis of ACS. Cardiac troponins are currently the most sensitive and specific biochemical markers of myocytes necrosis.Objective. To know the correlation between serum level MMP-9 and serum level of Troponin-I in patients with ACSMethod. Study design was cross sectional. Data were collected by consecutive sampling from patients in ICCU board of RSUP Dr. Sardjito Yogyakarta, in June 2008-August 2010. A questionnaire was used to collect information from patient. After admission, peripheral venous blood was drawn once and measuring concentration of serum level of MMP-9 and Troponin-I before definitive thrombolysis. Data are expressed as means ± standard deviation (SD). Correlation between serum level of MMP-9 and serum level of Troponin-I were assessed using Spearmanâs rank correlations test. A value of p<0.05 was considered statistically significant.Result. There were 139 patients with ACS and comprising 63 patients with STEMI, 27 patients with NSTEMI, and 49 patients with UAP. Means±SD of Troponin-I from all of samples was 9.49±10.47 ng/dL. Mean±SD of MMP-9 from all of samples was 1296.06±729.97 ng/dL. There were significant correlations between MMP-9 and Troponin-I in patients with ACS (r=0.34, p=0.000).Conclusion. There were significant correlations between MMP-9 and Troponin-I in ACS patients in ICCU RSUP Dr. Sardjito Yogyakarta. Keywords: ACS, MMP-9, Troponin-I]]>
<![CDATA[Non-ST elevation of acute myocardial infarction caused by probable acute stent thrombosis after drug eluting stent implantation: a case report ]]>
<![CDATA[Bagus Andi Pramono, Budi Yuli Setianto]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012) ]]>
Publisher : <![CDATA[Universitas Gadjah Mada ]]>
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<![CDATA[Nowadays, one of the modalities in performing reperfusion in coronary artery disease ispercutaneous coronary intervention. Before drug eluting stent era, the problem that occurs themost among interventional cardiologists is restenosis. After drug eluting stent era, restenosiscan be reduced significantly. Unfortunately, it further develops another problem, that is calledstent thrombosis. Mechanism of stent thrombosis is related to vascular response, thrombosis,coagulation, and clinical factors. Based on our experience, non-ST elevation acute myocardialinfarction is caused by probable acute stent thrombosis after drug eluting stent implantation.Therefore, the prevention and therapeutic approaches should be put first in our priority becauseit can provide a serious complication.]]>
<![CDATA[Distal embolization durante percutaneous coronary intervention: a case report ]]>
<![CDATA[Betty Dwi Lestari, Budi Yuli Setianto]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 01 (2011) ]]>
Publisher : <![CDATA[Universitas Gadjah Mada ]]>
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<![CDATA[Distal embolization is an acute complication of percutaneous coronary intervention (PCI). Distal embolization ofplaque and thrombus material is considered as a major cause of insufficient reperfusion despite a fully patent infarctrelatedartery, apart from ischemic microvascular damage and reperfusion-induced regional inflammatory responses.In a recent study, angiographic evidence of distal embolization was associated with an 8-fold increase in 5-yearmortality.We reported on our experience with distal embolization durante PCI which lead the patient developed STElevationMyocardial Infarct (STEMI) inferior and posterior accompanied with severe chest pain and was treated inthe Intesive Coronary Care Unit (ICCU). Distal embolization is the case that we should be put into our awarenessbecause it can worse the after procedural outcome.Key words: distal embolization-percutaneous coronary intervention-insufficient reperfusion- myocardial ischemiaangiographic]]>
<![CDATA[CORRELATIONS BETWEEN SERUM LEVEL OF MATRIX METALLOPROTEINASE-9 (MMP-9) AND SERUM LEVEL OF TROPONIN-I IN PATIENT WITH ACUTE CORONARY SYNDROME (ACS) ]]>
<![CDATA[Ruchanihadi Ruchanihadi]]>;
<![CDATA[Budi Yuli Setianto]]>;
<![CDATA[Hariadi Hariawan]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine ]]>
Publisher : <![CDATA[Faculty of Medicine Universitas Gadjah Mada ]]>
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DOI: 10.22146/acta interna.3865
<![CDATA[ABSTRACTBackground. The pathophysiology of acute coronary syndromes (ACS) is now accepted as the rupture or erosion of an atherosclerotic plaque, initially occurs at the shoulder of the plaque and is followed by intra-plaque thrombosis then spread to the vascular lumen and cause total partial vascular occlusion. MMP-9 is an extracellular matrix degrading enzyme that plays a crucial role in the breakdown of the fibrous cap of plaque and subsequent rupture in the pathogenesis of ACS. Cardiac troponins are currently the most sensitive and specific biochemical markers of myocytes necrosis.Objective. To know the correlation between serum level MMP-9 and serum level of Troponin-I in patients with ACSMethod. Study design was cross sectional. Data were collected by consecutive sampling from patients in ICCU board of RSUP Dr. Sardjito Yogyakarta, in June 2008-August 2010. A questionnaire was used to collect information from patient. After admission, peripheral venous blood was drawn once and measuring concentration of serum level of MMP-9 and Troponin-I before definitive thrombolysis. Data are expressed as means ± standard deviation (SD). Correlation between serum level of MMP-9 and serum level of Troponin-I were assessed using Spearman’s rank correlations test. A value of p<0.05 was considered statistically significant.Result. There were 139 patients with ACS and comprising 63 patients with STEMI, 27 patients with NSTEMI, and 49 patients with UAP. Means±SD of Troponin-I from all of samples was 9.49±10.47 ng/dL. Mean±SD of MMP-9 from all of samples was 1296.06±729.97 ng/dL. There were significant correlations between MMP-9 and Troponin-I in patients with ACS (r=0.34, p=0.000).Conclusion. There were significant correlations between MMP-9 and Troponin-I in ACS patients in ICCU RSUP Dr. Sardjito Yogyakarta. Keywords: ACS, MMP-9, Troponin-I]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Budi Yuli Setianto]]>;
<![CDATA[Julia Sari]]>;
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Putrika Prastuti Ra Gharini]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Faculty of Medicine Universitas Gadjah Mada ]]>
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DOI: 10.22146/acta interna.5728
<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.]]>
<![CDATA[On-admission serum soluble CD40 ligand level predicts subsequent myocardial damage in acute myocardial infarction ]]>
<![CDATA[Budi Yuli Setianto Anggoro Budi Hartopo Putrika Prastuti Ratna Gharini]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 04 (2008) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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<![CDATA[Background: Platelet activation plays an important role in plaque rupture and thrombus formation. Activated platelets release soluble CD40 ligand (sCD40LI. It has coagulation and inflammation properties. Enhanced sCD40L activity has been found in acute myocardial infarction, especially in ST-elevation myocardial infarction. The impact of this enhancement on the degree of myocardial damage remains uncertain, although evidence suggests association between sCD40L level and high burden coronary thrombus.Objective: The aim of this study was to find out whether serum sCD40L level on-admission is predictive of subsequent myocardial damage following acute myocardial infarction.Methods: This study was a cross-sectional study. We consecutively enrolled patients with acute myocardial infarction admitted to ICCU Dr. Sardjito Hospital with onset < 24 hours. Blood collection for analysis of sCD40L was withdrawn on-admission before revascularization and heparinization. Serial measurement of creatine kinase (CK-MBllevel in first 24 hours of admission was conducted, the highest level was considered a peak level that reflected myocardial damage. Troponin I was measured in single sample during 72 hours of admission. The association between serum sCD40L and peak CK-MB level was analyzed with Pearson correlation test. Statistical significancy was determined by p value < 0.05.Result: We enrolled 54 consecutive subjects, among them 37 subjects was STEM!. There was a significantly positive correlation between on-admission sCD40L and peak CK-MB level (r = 0.320 ; p value = 0.0201. Nonetheless, sCD40L did not correlate with troponin I level. In STEM I, this correlation was stronger (r = 0.424; p value = 0.0101 and even more stronger in patients with STEMI who underwent revascularization therapy (r = 0.515 ; p value = 0.0291.Conclusion: On-admission serum sCD40L level is predictive of subsequent myocardial damage following acute myocardial infarctionKey words: soluble CD40 ligand - platelet activation - acute myocardial infarction - peak CK-MB myocardial damage]]>
<![CDATA[Non-ST elevation of acute myocardial infarction caused by probable acute stent thrombosis after drug eluting stent implantation: a case report ]]>
<![CDATA[Budi Yuli Setianto Bagus Andi Pramono]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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<![CDATA[Nowadays, one of the modalities in performing reperfusion in coronary artery disease ispercutaneous coronary intervention. Before drug eluting stent era, the problem that occurs themost among interventional cardiologists is restenosis. After drug eluting stent era, restenosiscan be reduced significantly. Unfortunately, it further develops another problem, that is calledstent thrombosis. Mechanism of stent thrombosis is related to vascular response, thrombosis,coagulation, and clinical factors. Based on our experience, non-ST elevation acute myocardialinfarction is caused by probable acute stent thrombosis after drug eluting stent implantation.Therefore, the prevention and therapeutic approaches should be put first in our priority becauseit can provide a serious complication.]]>
