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Arif Mansjoer
Divisi Kardiologi, Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Pengaruh Fungsi Ginjal Sebelum Intervensi Koroner Perkutan Primer Terhadap Perbedaan Kesintasan 30 Hari Pasien Infark Miokard Elevasi Segmen ST Fahmi Razi Darkuthni; Sally Aman Nasution; Aida Lydia; Murdani Abdullah; Dono Antono; Cleopas Martin Rumende; Maruhum Bonar Hasiholan Marbun; Hamzah Shatri; Arif Mansjoer; Ika Prasetya Wijaya; Lusiani Lusiani
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.195.204-11

Abstract

Penyakit jantung koroner merupakan penyebab kematian penyakit kardiovaskular utama di Indonesia. Revaskularisasi fase akut secara mekanis maupun farmakologis merupakan tatalaksana utama pada STEMI. Mortalitas paska revaskularisasi masih tinggi. Salah satu faktor penting yang memengaruhi kesintasan pasien STEMI adalah fungsi ginjal. Gangguan fungsi ginjal yang dicerminkan dengan estimated glomerulus filtration rate (eGFR) < 60 diketahui berhubungan dengan perfusi miokard yang buruk paska IKP primer. Penelitian ini bertujuan untuk memberikan gambaran karakteristik pasien STEMI yang menjalani IKP primer berdasarkan fungsi ginjal sebelum IKP dan menganalisa perbedaaan kesintasan dalam 30 hari pasien STEMI-IKP primer berdasarkan fungsi ginjal sebelum IKP. Metode studi observasional kohort retrospektif dan pengukuran fungsi ginjal dikelompokkan berdasarkan eGFR dengan rumus CKD-EPI menjadi dua yaitu eGFR < 60 dan eGFR ≥ 60. IKP primer dilakukan pada 211 pasien STEMI. Insiden mortalitas eGFR < 60 sebesar 14,7%, sedangkan dengan eGFR ≥ 60 sebesar 4,4%. Perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR (p < 0,05) dengan crude HR (IK95%) 3,433 (1,269-9,284). Tidak terdapat perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR setelah di-adjusted. Mortalitas dalam 30 hari pada kelompok eGFR < 60 lebih tinggi dibandingkan dengan kelompok eGFR ≥ 60. Kata kunci: infark miokard akut, intervensi koroner perkutan, fungsi ginjal, mortalitas.
Predictors of Handgrip Strength Changes in Elderly Patients Madina, Ummi Ulfah; Setiati, Siti; Laksmi, Purwita Wijaya; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. The increasing elderly population throughout the world has been related to the increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes. Previous studies have assessed the association of age, sex, nutritional status, functional status, mental status, and comorbidity, but varied results. No longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia. The aim of this study was to determine the correlation between age, sex, nutritional status, functional status, depressive symptoms, comorbidity, and handgrip strength changes in elderly patients. Methods. A prospective cohort study using secondary data of elderly patients who were routinely visiting Geriatric OutPatients Clinic at Cipto Mangunkusumo Hospital, Jakarta, from the INA-FRAGILE register observed for one year (2013- 2014). The multivariate logistic regression analysis was used to assess the correlation between sex, age, nutritional status (MNA score), functional status (ADL score), depressive symptoms (GDS-SF score), comorbidities (CIRS score), and handgrip strength changes. Results. From 162 subjects which were included in the study, the mean age was 72.9 (SD 5.9) years, predominantly female (57.41%), with good nutrition (83.9%), independent (median 9- 20), not depressed (median 0-11), has average comorbidity index 11.8 (SD 3.7), and 53.1% experienced decreased handgrip strength. Nutritional status (OR = 2.7, p = 0.033) and comorbidity (OR 0.3, p <0.002) correlated with handgrip strength changes
Association of Glucose Variability in the First 72 Hours of ICUCare with ICU Mortality in Critically-III Patients Yasmine, Elizabeth; Mansjoer, Arif; Purnamasari, Dyah; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Hyperglycemia during hospitalization is a risk factor that can be managed in order to reduce mortality. Inspite of hyperglycemia, glucose variability also brings negative outcome to cells. Studies about glucose variability effect to mortality had been studied using many variables of glucose variability. Methods. Retrospective cohort study is done to 280 critical ill patient in ICU and HCU in Cipto Mangunkusumo Hospital who admitted to critical care between January 2012-August 2013. MAG change and glucose standard deviation are divided into 4 quartiles. Relationship between MAG change and glucose standard deviation are analyzed using Chi Square test. To control the confounders (MSOFA score, Charlson comorbidities index, hypoglycemia, and hyperglycemia), logistic regression is done Results. Median of MAG change is 3.3 mg/dL/hour and median of glucose standard deviation is 37.63 mg/dL. Mortality proportion is higher in upper quartile of MAG change and glucose standard deviation compared to lower quartile. OR of upper quartile MAG change to ICU mortality is OR 4.26 (95% CI 1.98-9.15) and OR of upper quartile glucose standard deviation to ICU mortality is OR 2.78 (95% CI 1.35-5.71). These results are adjusted to MSOFA score, hypoglycemia, and hyperglycemia. In logistic regression test, fully adjusted OR are 3.34 (95% CI 1.08-10.31) and 0.90 (95% CI 0.28-2.88) for MAG change and glucose standard deviation, respectively. Conclusions. Mortality proportion of upper quartile of MAG change (>8.1 mg/dL/hour) is higher than lower quartile (59 mg/dL) is higher than lower quartile(<22.7 mg/dL), but the difference is not statistically significant.
Faktor-Faktor yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (HFpEF) Rawat Jalan di RSUPN Dr. Cipto Mangunkusumo Pratama, Derin Anugrah; Nasution, Sally Aman; Muhadi, Muhadi; Mansjoer, Arif; Alwi, Idrus; Purnamasari, Dyah; Lydia, Aida; Tahapary, Dicky Levenus
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is still no data regarding risk factors that affect the quality of life of HFpEF patients. This study aimed to determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) on the quality of life of HFpEF patients. Methods. A cross-sectional study was conducted. Data was collected from adult HFpEF (based on echocardiography in the last 6 months) patients (>18 years old) who visited the Cardiology Clinic at Cipto Mangunkusumo Hospital from January 2022 to December 2023. Quality of life was measured using the MLHF questionnaire. Bivariate analysis was performed to find the relationship between risk factors (age, gender, hypertension, DM, smoking, and obesity) and patients’ quality of life. Multivariate analysis was performed for hypertension, DM, gender, and age variables. Results. Out of 206 subjects, 72.33% of patients were dominant in the physical domain items, and 27.67% of patients were dominant in the emotional domain items. The majority of patients dominant in physical items had overall good quality of life. The majority of patients dominant in emotional items also had good quality of life. No significant relationship was found between the dominant domain item and the quality of life in HFpEF patients. We also found that there was no significant relationship between socio-demographic factors and risk factors for dominant domain items. However, there was a significant relationship between age (p=0.005), gender (p=0.001), and smoking history (p=0.001) with the quality of life in HFpEF patients. Adult patients had a poorer quality of life compared to elderly patients (OR= 0.33 [95% CI 0.17-0.66]). No significant relationship was found between hypertension, diabetes mellitus, dyslipidemia, and obesity with the quality of life in HFpEF patients. Conclusions. There is a statistically significant relationship between age, gender, and smoking history with the quality of life in HFpEF patients. Meanwhile, there is no significant relationship between hypertension, diabetes mellitus, and obesity with the quality of life in HFpEF patients.
Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik Andru, Gestana; Widhani, Alvina; Putranto, Rudi; Mansjoer, Arif; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score >5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value <0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.
Profil Kadar Vitamin D dan Hubungannya dengan Derajat Keparahan Klinis serta Parameter Inflamasi pada Pasien Terkonfirmasi COVID-19 Hasudungan, Wicensius Parulian; Rachman, Andhika; Widhani, Alvina; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. The available data currently is not adequate to show the differences in vitamin D levels across various clinical stages of COVID-19 in Indonesia. Therefore, this study was conducted to determine the profile of vitamin D levels and its relationship with the clinical severity and inflammatory parameters in confirmed COVID-19 patients. Methods. The study was conducted at Cipto Mangunkusumo Hospital and Wisma Atlet COVID-19 Emergency Hospital from January to December 2021. Subjects who were 18 years old and above and had confirmed COVID-19 status through COVID-19 Polymerase Chain Reaction (PCR) from oropharyngeal swab were included. Those who refused to participate in the study were excluded. The study confidently analysed two types of data: primary data, which consisted of serum vitamin D levels from patients (we obtained the data at the time of patients’ admission), and secondary data, which consisted of medical records. Results. It is worth noting that of the 96 subjects, 77.08% had a vitamin D deficiency. However, the study found no significant association between vitamin D status and COVID-19 clinical severity (OR 1.16 (0.61 – 2.23); p = 0.641). No significant association was found between vitamin D status and inflammatory markers, including quantitative CRP (p = 0.691), D-dimer (p = 0.956), and neutrophil-lymphocyte ratio (p = 0.883). Conclusions. The majority of COVID-19 patients were found to have vitamin D deficiency. Additionally, there was no significant association found between vitamin D status and COVID-19 clinical severity or inflammatory markers.
Hubungan Heart Rate Variability dengan Global Longitudinal Strain pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Jakarta Hadi, Dwi Rendra; Rusdi, Lusiani; Tarigan, Tri Juli Edi; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. Diabetes mellitus (DM) remains a major global health issue due to its direct consequences and complications, particularly cardiovascular complications. These complications are influenced by autonomic neuropathy, which can be assessed by Heart Rate Variability (HRV). Autonomic dysfunction is thought to impair heart function, which can potentially be predicted early by observing Global Longitudinal Strain (GLS). The relationship between HRV and GLS has not been extensively studied. Therefore, this study aimed to identify the relationship between HRV and GLS. Methods. A cross-sectional study with a population of adult type 2 DM patients residing in Jakarta in December 2020. HRV parameters included RR interval, Standard Deviation of NN Intervals (SDNN), Root Mean Square of Successive Difference (RMSSD), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Global longitudinal strain was analyzed using echocardiography. Results. Analysis was conducted on 167 samples. The mean value of GLS was -20.30 (SD 1.57). There were no correlation between RR interval (r = -0.07, p = 0.377), SDNN (r = -0.10, p = 0.189), RMSSD (r = -0.12, p = 0.098), LF (r = -0.003, p = 0.968), HF (r = -0.09, p = 0.21), and LF/HF ratio (r = -0.10, p = 0.189) with GLS. No association was found between hypertension, history of smoking, dyslipidemia, duration of diabetes, and HbA1C with GLS. Conclusion. There is no correlation between heart rate variability and global longitudinal strain in type 2 DM patients.
Co-Authors Ahmad Fariz M.Z Zein, Ahmad Fariz M.Z Aida Lydia Aida Lydia, Aida Alvina Widhani, Alvina Andhika Rachman Andru, Gestana Cleopas Martin Rumende Dicky Levenus Tahapary Dono Antono Dyah Purnamasari Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Elizabeth Yasmine Elizabeth Yasmine, Elizabeth Fahmi Razi Darkuthni Hadi, Dwi Rendra Hasudungan, Wicensius Parulian Idrus Alwi Ika Prasetya Wijaya Lusiani Lusiani Lusiani Rusdi, Lusiani Maruhum B.H. Marbun Muhadi Muhadi, Muhadi Murdani Abdullah Pratama, Derin Anugrah Purwita Wijaya Laksmi Rudi Putranto Sally A Nasution, Sally A Sally Aman Nasution Sally Aman Nasution, Sally Aman Saskia Aziza Nursyirwan Saskia Aziza Nursyirwan, Saskia Aziza Siti Setiati Siti Setiati Sukamto Koesnoe Sukamto Koesnoe Tri Juli Edi Tarigan Ummi Ulfah Madina Ummi Ulfah Madina, Ummi Ulfah