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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Heart Science Journal Solo Journal of Anesthesi, Pain and Critical Care Journal of Mechanical Design and Testing (JMDT) Berita Kedokteran Masyarakat Indonesian Journal of Biomedicine and Clinical Sciences

Budi Yuli Setianto

Departemen Kardiologi Dan Kedokteran Vaskular, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Jalan Farmako Sekip Utara,Yogyakarta 55281 Telp. +62 274 560300

Author-ID : 2970799

Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Neuroscience Nursing Public Health

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Articles

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Distal embolization durante percutaneous coronary intervention: a case report Budi Yuli Setianto Betty Dwi Lestari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 01 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.994 KB)

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

Clinical Characteristics of Adult Uncorrected Secundum Atrial Septal Defect, A Pilot Study Lucia Krisdinarti; Anggoro Budi Hartopo; Dyah Wulan Anggrahini; Ahmad Hamim Sadewa; Abdus Samik Wahab; Budi Yuli Setianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 2 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTAtrial septal defect (ASD) is the most frequent congenital heart disease in adulthood. Pulmonary hypertension (PH) complicating ASD compels patients seeking medical assistance because of its disabling symptom. Most adult ASD develop PH which render significant morbidity and mortality. The aim of the study is to characterize the clinical profiles of adult patients with ASD. The study design was cross sectional. The subjects were enrolled consecutively from outpatient clinics and inpatient wards. The demography, medical and imaging data were collected and recorded in case report form. Descriptive statistics was applied to characterize the subjects. Seventy-six subjects were enrolled. The majority were women (77.6 %) in the productive and child-bearing ages (63.2%). The most common symptoms were dyspneu on effort, fatigue, and palpitation. Most subjects had functional capacity of WHO class functional II (70.2 %). The mean oxygen saturation was 96.4 %. Based on the echocardiography examination, 77.6% of subjects had suffered from PH. The mean longest diameter of defects were 2.7 cm. The direction of blood flow was mostly left to right (77.6 %). Left and right ventricle function were within normal limit. Right heart catheterization showed mean left atrial pressure 11.5 mmHg, which confirmed the precapillary or arterial PH. Mean pulmonary artery pressure was 42.0 mmHg. The pulmonary artery resistance index mostly less than 4 Wood Unit/ m2 (63.7 %), indicating the feasibility to close the defect. Whereas 24.6 % of subjects were contraindicated for closing. Pulmonary artery hypertension (PAH) was diagnosed in 77.6 % subjects, meanwhile 13.2 % had borderline PAH. In conclusion, most adult ASD patients had developed PAH, mostly young women in productive ages, mainly visited hospital due to symptom of PH, the direction of flow predominantly left to right side and mostly had reduced functional capacity.

Resistin associated with higher cardiovascular events in intermediate grace score of acute coronary syndrome Rizki Amalia Gumilang; Nahar Taufiq; Budi Yuli Setianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Previous studies revealed that inflammatory biomarkers have a role in the clinical outcomes of acute coronary syndromes (ACS) and also in prediction of cardiovascular events using GRACE score. Resistin, a recently identified inflammatory biomarker, also has a role in clinical outcomes of ACS but its role related to GRACE score risk stratification is unknown. Three risk stratifications of ACS based on GRACE scores were used i.e. low, intermediate, and high. Some studies reported that inflammatory biomarkers have a role in cardiovascular events of patients with low risk GRACE scores, but their role in the patients with intermediate risk still needs to be elucidated. This study aimed to investigate the role of resistin in cardiovascular events of ACS patients with intermediate risk GRACE score. This was an observational study using a cross-sectional design involving sixty-three patients with ACS who fulfilled the inclusion and exclusion criteria. Blood samples were drawn 24 h after onset. Resistin level was analyzed and classified according to its median values. The cardiovascular event was defined as mortality, ischemic events, acute heart failure or arrhythmia during hospitalization. The result showed that cardiovascular events were significantly higher in patients with resistin levels higher than median i.e. 23.8% compared to those with resistin levels similar or lower than median i.e. 11.1% (OR 3.348, 95%CI: 1.125-10.007 p=0.027). It can be concluded high resistin level is associated with an increase of cardiovascular events of ACS with intermediate risk GRACE score.

Association between the level of high-sensitivity troponin I (Hs-Trop I) and major adverse cardiovascular events in patients with acute myocardial infarction of segment elevation (STEMI) with primary percutaneous coronary intervention (PCI) Daniel Daniel; Firandi Saputra; Hendry Purnasidha Bagaswoto; Budi Yuli Setianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 1 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005401202203

ST-segment elevation myocardial infarction (STEMI) is a condition which increases the risk of developing major adverse cardiovascular events (MACEs). For patients with STEMI, an efficient method of risk stratification is necessary in order to evaluate the clinical outcome. Troponin has been commonly used in the diagnosis of both STEMI and NSTEMI. The use of high sensitivity assays of troponin has been extensively studied in order to measure the size of myocardial damage caused by STEMI. This study aimed to investigate the association between the level of high sensitivity troponin I (Hs-Trop I) and the incidence of MACEs in patients with primary percutaneous coronary intervention (PCI) in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. It was a cross-sectional observational analytic study involving a total of 195 patients. Data were obtained from both the SCIENCE (Sardjito Cardiovascular Intensive Care) registry and the medical record of Dr. Sardjito General Hospital. Pearson’s Chi square test to evaluate the association between variables was applied. To determine the effect of confounding variables, a multivariate analysis was used. A significant difference in the baseline characteristics between the supramedian and inframedian Hs-Trop I groups (cutoff value of 2063.8 ng/mL) in age, onset, total ischemic time, wire crossing time and the smoking history of both groups was observed. Bivariate analysis showed a significant associations between Hs-Trop I and MACEs (p = 0.033), acute heart failure (p = 0.009) as well as mortality (p = 0.024). Meanwhile, no significant association between Hs-Trop I and cardiogenic shock (p = 0.977) and malignant arrythmia (p = 0.551) was reported. Furthermore, multivariate analysis showed Hs-Trop I, age and wire crossing time were significantly associated with the incidence of MACEs (p = 0.045). In conclusion, there is a significant association between the Hs-Trop I levels and the MACEs events in STEMI patients with primary PCI in Dr. Sardjito General Hospital, Yogyakarta, Indonesia.

Desain Wire Winding Machine Sebagai Alat Bantu Pembuatan Kabel Pemandu Stent Koroner Muslim Mahardika; Miftakhudin Miftakhudin; Budi Yuli Setianto
Journal of Mechanical Design and Testing Vol 1, No 1 (2019): Articles
Publisher : Departemen Teknik Mesin dan Industri, Universitas Gadjah Mada

Guide wires (kabel pemandu) merupakan perangkat pendukung utama untuk melakukan operasi pada lumen (pipa pembuluh darah), pemasangan stent koroner atau ring organ jantung, serta pada operasi urology. Perangkat ini berfungsi sebagai pemandu dan pembawa agar dapat mencapai pembuluh darah (atherosclerosis) yang mengalami penyempitan atau penyumbatan karena penimbunan plak. Sejak guide wire diperkenalkan pada tahun 1980an, pemasangan coronary stent (stent koroner) pada pasien bisa dilakukan tanpa pembedahan. Dokter spesialis cenderung lebih suka melakukan operasi dengan pemasangan stent koroner dibandingkan dengan operasi pembedahan. Kebutuhan stent koroner yang begitu besar di Indonesia dan semua perangkat tersebut merupakan produksi luar negeri (impor), memunculkan dorongan untuk mengkaji stent terlebih guide wire dan membuat suatu mesin wire winding machine yang dapat memproduksi guide wire di dalam negeri sendiri, sehingga dapat menggantikan ketergantungan perangkat pemasangan stent dari luar negeri. Pada penelitian ini desain dilakukan dengan menggunakan software CAD dan analisis dilakukan dengan menggunakan software analisis tegangan. Hasil simulasi analisis tegangan pada mesin didapatkan bahwa tegangan maksimum pada model wire winding machine adalah sebesar 20,9 MPa, safety factor minimum pada model mesin, yaitu sebesar 11,93, dan nilai displacement yang terjadi pada wire winding machine adalah sebesar 0,435 mm.

Correlation of Serum Levels of Matrix Metalloproteinase-9 to Acute Heart Failure Event as a Complication af Acute Coronary Syndrome Sasongko Hadi Purnomo; Budi Yuli Setianto; Lucia Krisdinarti
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17791

Background: Acute heart failure (AHF) after acute coronary syndrome (ACS) is the biggest complication with a poor prognosis in a long term. The infl uence of MMP-9 as proteolytic enzyme that degrades extracellular matrix in remodeling left ventricle was recognized. However, according to researcher’s knowledge, evaluation of the MMP-9 as a predictor of AHF after ACS was never reported. Objective: To fi nd out the serum level of MMP-9 in ACS with AHF higher than that without it, as well as to fi nd out the level of MMP-9 with risk of AHF after ACS. Method: The study used a cross-sectional study. Samples were collected by using a consecutive sampling technique among patients with ACS treated in ICCU of Public Hospital Dr Sardjito Yogyakarta, since June 2008 to August 2010. Questionnaires were used to collect sample raw data. The level of MMP-9was examined a time at admission in ICCU before trombolysis was done. The heart failure had Killip II- IV scores. Factors infl uencing the incidence was analyzed by using multivariate analysis technique. A signifi cance level was at p< 0.05. The relative risk of acute heart failure at a certain level of MMP-9 (from cut-off value) was obtained after it was adjusted. Result: Among 122 subjects, 75 was without AHF and 47 with AHF. Median of the level of MMP-9 in the whole sample of ACS was 1248.55 ng/mL with a minimum of 170.50 ng/mL and maximum of 3058.40 ng/mL. Moreover, the level of MMP-9 in ACS with AHF (1700.81±740.43 ng/mL) was signifi cantly higher than ACS without AHF (1189.55±654.60 ng/mL) with p value = 0.000. Independent risk factor after the multivariate analysis was done indicates the level of MMP-9 above 1444 ng/mL (RR= 4.2) and the location of anterior infarction (RR= 2.9). Conclusion: In patients with ACS treated in ICCU of RSUP Dr Sardjito, the level of MMP-9 with AHF was higher than that without it. If the level of MMP-9 above 1444 ng/mL, the possibility of AHF was 4.2 times.Keywords: acute coronary syndrome, MMP-9, acute heart failure after acute coronary syndrome

ST Elevation Myocardial Infarction in Young Women Caused by a Coronary Embolism Generated from Mitral Valve Disease: a Case Report Budi Yuli Setianto; Nahar Taufiq; Muhamad Taufik Ismail
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17793

Coronary emboli causing ST elevation myocardial infarction (STEMI) is a rare condition. Intracardiac thrombus generated by valvular disease is the most common source of intracoronary embolism and mitral stenosis is frequently affected by intraatrial thrombus. Therapeutic strategy of coronary embolism is challenging because there were still no recommendation regarding coronary embolism published to day. We reported A 25 years old woman was admitted to the emergency department because of STEMI with complication of acute pulmonary edema and cardiogenic shock, and recurrent cardiac arrest. Angiographically showed total occlusion of left main artery with thrombotic lesions. Unfortunately after unfractionated heparin (UFH) was given and performed catheter cannulation, thrombus run to distal part of left coconary artery. Procedure is stopped and then patient transferred to cardiac care unit, but death shortly after arrival. Transthroracic echocardiography revealed mild to mild-modertae mitral stenosis with severe regurgitation due to mitral valve prolaps, aortic regurgitation, and left atrial and ventricular dilatation with no thrombus or spontaneous echo contrast, and failed to fi nd thrombus with in atrium. The presence af atrial dilatation and aortic regurgitation increased risk of thrombosis, meanwhile mitral regurgitation were reported as protective factor of atrial thrombosis. The pathophysiology of arterial thrombus or whitethrombus involving platelet activation leads to double antiplatelets and GbIIb/IIIa inhibitior to be more cruciale in coronary embolism. Double antiplatelet dan UFH administration did not improve survival in these patients. So that further research was needed to make a consensus of therapy. Careful assessment of intracardiac thrombus and risk of thromboembolism were important to prevent systemic embolization.Keywords: STEMI, coronary embolism, mitral valve disease.

NSTEMI Presenting with Acute Pulmonary Edema with Culprit Lession Total Occluced Left Circumflex: a case report Budi Yuli Setianto; Nahar Taufiq; Heri Hernawan
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17794

Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the ECG to dichotomize patients into having ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI)/ Unstable Angina (UA) in order to rapidly triagepatients to receive reperfusion therapy. Left circumfl ex artery occlusion is often categorized as NSTEMI because of the absence of signifi cant ST elevation on the 12 standard ECG leads. ST elevation is the condition ‘sine qua non’ for diagnosing acute total coronary occlusion causing transmural infarction. However, ST elevation when there is circumfl ex artery occlusion is seen onthe 12 standard ECG leads in fewer than 50% of patients. We reported a 77 years old women who diagnosed with NSTEMI. Twelve lead ECG showed ST depressed in V2-V5. On angiography we found a totaly ocluded of left circumfl ex as culprit lession.Keywords: NSTEMI; culprit lession; total occlusion; left circumflex artery

29-Years Old Woman Presenting with ST Elevation Myocardial Infarction Dyah Wulan Anggrahini; Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17795

Myocardial infarction in young female is rare condition, but carries significant morbidity and mortality. The recognition management for MI in young female is challenging due to its unspecific clinical presentation and lack of guidance in the current guidelines. We reported a 29-years old woman presenting with infarction type chest pain, showing ST- elevation in the inferior leads with total AVblock as complication. The risk factors in this patient were smoking, family history, cardiomyopathy, and preeclampsia history. The cause for myocardial infarction in this patient was atherosclerotic plaque rupture, but we did not manage to performed coronary intervention due to her low ventricular function and unavailability data for myocardial viability at the time of hospitalization.

Electrical and Mechanical Activity of The Heart Erdiansyah Zulyadaini; Hariadi Hariawan; Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 1, No 2 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17812

The regularity and rhythm of contraction of the heart muscles (myocardium) depends on how electrical impulses spreads through the conduction system organized. The process is initiated by electrical stimulation which thencauses depolarization. Depolarization is a series of ion transfer through channels that are specifi c to myocardial cell membrane (sarcolemma). These canals spread across the sarcolemma, which include:the Na+ channels, Ca2+ channels, channelK+, Na+-Ca2+exchanger, Na+-K+-ATPase pump and Ca2+active pump. The infl ux of Na+ ions into cell will start depolarization and then spread through conduction system to the rest of the myocardium.

Co-Authors . Supomo Abdus Samik Wahab Ahmad Hamim Sadewa Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Cindy Elfira Boom Cornelia Ancilla Cynthia Yosephine Silitonga Damarkusuma, Arditya Daniel Daniel Dyah Wulan Anggrahini Erdiansyah Zulyadaini Erika Maharani Ferdinandus Bayu Satria Firandi Saputra Firandi Saputra, Firandi Gharini, Putrika Prastuti Ratna Gumilang, Rizki Amalia Hani Khairina Hariadi Hariawan Hendry Purnasidha Bagaswoto Heri Hernawan Heri Hernawan, Heri Indah Sukmasari Ira Puspitawati Irsad Andi Arso, Irsad Andi Jauhari, Haris Julia Sari Juni Kurniawaty Muhdar Abubakar Djayanti Sari Lucia Kris Dinarti Lucia Krisdinarti Lucia Krisdinarti Maria Debby Maharatno Martalena Br Purba, Martalena Br Miftakhudin Miftakhudin Muhamad Taufik Ismail Muslim Mahardika Nahar Taufik Nahar Taufiq Nahar Taufiq Nahar Taufiq Nahar Taufiq Nahar Taufiq, Nahar Pamrayogi Hutomo Pradhana, Aditya Prasetia, Arif Eka Putrika Prastuti Ra Gharini Putrika Prastuti Ra Gharini Rahadiyanti, Ayu Rano Imawan Rochmat, Muflihatul Baroroh Ruchanihadi Ruchanihadi Sasongko Hadi Purnomo Satria Mahendra Sukmadja, Daniel Vina Yanti Susanti Yuli Astuti Yunita Widyastuti

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