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All Journal Medical Journal of Indonesia Narra J Jurnal Penyakit Dalam Indonesia
Lukman H. Makmun
Faculty of Medicine University of Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients Makmun, Lukman H.; Abdurachman, Nurhay; Alwi, Idrus; Afandi, Dedi; Siswanto, Bambang B.; Andriantoro, Hananto; Ratnaningsih, Endang; Utomo, Hari
Medical Journal of Indonesia Vol 11, No 1 (2002): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (548.88 KB) | DOI: 10.13181/mji.v11i1.45

Abstract

Several large placebo-controlled trials have confirmed that angiotensin converting enzyme (ACE) inhibitors significantly reduce mortality aid morbidity in all functional grades of congestive heart failure (CHF), nevertheless only a proportion of patients who may benefit from treatment are priscribed an ACE inhibitor. One of the perceived difficulties is the occurrence of first-dose hypotension in susceptible patients. A double-blind, randomised, single-dose therapy, parallel-group study was conducted with the aim to compare the first-dose responses to low dose ACE inhibitors captopril and perindopril in patients with stable chronic heart failure. Seventy patients (New York Heart Association class I-IV) were included. Blood pressure was recorded every 15 minutes 2 hours before starting treatment. The mean of these readings was taken as the baseline blood pressure. Patients were randomised to receive a single-dose of captopril 6.25 mg or perindopril 2 mg. After taking the drug, blood pressure was monitored every 15 minutes for 2 hours, every 30 minutes during 5 hours then hourly after 2 hours. The maximum mean arterial pressure fall from baseline of perindopril was 0.85 mmHg compared to captopril 4.60 mmHg. The maximum mean systolic fall from baseline of perindopril was 3 31 mmHg compared to captopril 6.76 mmHg while the maximum mean diastolic fall from baseline of perindopril was 1.08 mmHg compared to captopril 2.63 mmHg. The hypotensive effect of the captopril group started soon after dosing and reached its maximum after 1 to 2 hours while perindopril showed slight reduction of systolic after 1 hour and slight reduction of diastolic after 4 hours. Compared to captopril, perindopril seemed to be less likely to cause first-dose hypotension in patients with heart failure. (Med J Indones 2002; 11: 19-23)Keywords: first dose hypotension, perindopril, captopril, chronic heart failure
Peran Tindakan Revaskularisasi terhadap Kesintasan Pasien Non ST Elevation Myocardial Infarction (NSTEMI) Amarendra, Gerie; Makmun, Lukman H.; Antono, Dono; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Pendahuluan. Pengaruh revaskularisasi terhadap kesintasan pasien non ST elevation myocardial infarction (NSTEMI) masih belum jelas. Waktu revaskularisasi yang optimal pada pasien NSTEMI belum ditemukan. Penelitian ini bertujuan mengetahui pengaruh revaskularisasi terhadap kesintasan pasien NSTEMI, juga mengetahui pengaruh waktu revaskularisasi terhadap kesintasan pasien NSTEMI. Metode. Penelitian dengan disain kohort retrospektif diakukan terhadap 300 pasien non ST elevation myocardial infarction yang dirawat di RSUPNCM pada kurun waktu Desember 2006-Maret 2011. Data klinis, laboratorium, elektrokardiografi (EKG), ekokardiografi, dan angiografi koroner dikumpulkan. Pasien yang telah terhitung enam bulan setelah onset kemudian dihubungi melalui telepon untuk melihat status mortalitasnya. Perbedaan kesintasan revaskularisasi ditampilkan dalam kurva Kaplan Meier dan perbedaan kesintasan diantara dua kelompok diuji dengan Log-rank test dengan batas kemaknaan Hasil. Terdapat perbedaan kesintasan yang bermakna pada uji log rank (p Simpulan. Kesintasan enam bulan pasien NSTEMI yang menjalani terapi medikamentosa dan revaskularisasi lebih baik dibandingkan dengan terapi medikamentosa saja. Tidak terdapat perbedaan kesintasan enam bulan pasien NSTEMI berdasarkan waktu revaskularisasi.
A novel diastolic dysfunction score: A proposed diagnostic predictor for left ventricular dysfunction in obese population Kamelia, Telly; Rumende, Cleopas M.; Makmun, Lukman H.; Timan, Ina S.; Djauzi, Samsuridjal; Prihartono, Joedo; Fardizza, Fauziah; Tabri, Nur A.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1564

Abstract

Obesity-related diastolic dysfunction is an emerging contributor to heart failure and cardiovascular mortality. However, effective and accessible diagnostic tools are still limited. Current methods for assessing diastolic dysfunction are often invasive or technologically demanding, making them impractical for routine clinical use and community settings. The aim of this study was to develop a novel, non-invasive scoring system designed to predict diastolic dysfunction in obese adults, addressing this diagnostic gap. This community-based, prospective cross-sectional study was conducted in Jakarta, Indonesia, from March to November 2021, and included 82 participants aged 18 to 60 years, all with a body mass index (BMI) ≥25 kg/m². Patients with acute or critical illnesses, valvular heart diseases, or acute confusional states were excluded. Each participant underwent blood tests, polysomnography, and echocardiography. Of the study population, 80.5% were diagnosed with obstructive sleep apnea (OSA), and 12.2% exhibited diastolic dysfunction, all within the OSA group. The novel scoring system integrates four predictors: oxygen desaturation index (ODI) ≥39 (score 1; prevalence ratio: 4.31 (95% confidence interval (CI): 1.58–11.75)), HbA1C ≥5.95% (score 2; prevalence ratio: 6.32 (95%CI: 2.84–14.06)), pulmonary artery wedge pressure (PAWP) ≥10 mmHg (score 1; prevalence ratio: 5.95 (95%CI: 2.30–15.39)), and global longitudinal strain (GLS) ≥-16.95% (score 1; prevalence ratio: 4.32 (95%CI: 1.87–9.99)). A score of ≥2 predicted diastolic dysfunction with 90% sensitivity, with positive predictive value and negative predictive value of 40.91% and 98.33%, respectively. In conclusion, the diastolic dysfunction score is a simple and practical tool for the early detection of diastolic dysfunction in obese individuals without cardiovascular symptoms.
Co-Authors Arini Setiawati Bambang Budi Siswanto Dedi Afandi Dono Antono Endang Ratnaningsih Esthika Dewiasty, Esthika Fardizza, Fauziah Gerie Amarendra Hananto Andriantoro Hari Utomo Idrus Alwi Ina S. Timan, Ina S. Joedo Prihartono Nafrialdi Nafrialdi Nurhay Abdurachman Rumende, Cleopas M. Samsuridjal Djauzi Tabri, Nur A. Telly Kamelia Theresia G Kurniawan, Theresia G