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Intraprocedural Stent Thrombosis During Percutaneous Coronary Intervention: How to Predict Bayu Aji; Mohammad Saifur Rohman; Budi Satrijo; Arief Wibisono
Heart Science Journal Vol 3, No 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.02.7

Abstract

Background: Intraprocedural stent thrombosis (IPST) during percutaneous coronary intervention (PCI) is an uncommon event that results in a poor outcome including STEMI and sudden cardiac death. Concerns about an increased risk of stent thrombosis with drug-eluting stents (DES) continue, even though the incidence, timing, and predictors of stent thrombosis with DES have not been identified.Objective: This study aimed to describe the diagnosis and management of Intraprocedural Stent Thrombosis.Case presentation: We will discuss a 49 year-old male brought to our hospital because of chest pain while doing moderate activity. One month prior to admission, he had history of acute coronary syndrome and 1 DES on right coronary artery was placed. Ticagrelor and aspirin were routinely consumed as dual antiplatelet therapy. The patient was diagnosed with intraprocedural stent thrombosis during PCI with the evidence of intra-catheter thrombosis and ST segment elevations seen in the ECG monitor. We treat the patient with Ticagrelor 180 mg loading dose and intracoronary unfractionated heparin (UFH) during procedure continued with continuous infusion until 24 hours. No event of subsequent acute coronary syndrome was observed.Conclusion: Intraprocedural Stent Thrombosis was a strong predictor of mortality in STEMI patients. This case showed that the present widespread use of DES instead of BMS for coronary implantation although decreased the future risk of repeat revascularization, increased the risk of thrombosis. Prior risk stratification, potent early antiplatelet treatment and anticoagulant of choice with UFH might be used to reduce the risk of thrombosis in STEMI patients undergoing stent implantation.
A Risk Factor which Can Induced Premature CAD in Women with Positive Family History : A Case Report Arif Wicaksono; Mohammad Saifur Rohman; Evit Ruspiono; Cholid Tri Tjahjono
Heart Science Journal Vol 3, No 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.02.8

Abstract

Background: Premature Coronary Artery Disease (CAD) was defined as the incidence of CAD in males younger than 45 years of age and in women younger than 55 years of age. Many factors can cause a woman under the age of 55 to develop a CAD. One of the major roles is the patient's family history associated with the occurrence of CAD which is then associated with one or more other CAD-related risk factors such as hypertension, history of Cerebrovascular Accident (CVA), obesity or dyslipidemia.Objective: This case report was made to elaborate on the importance of family history of PCAD on CAD diagnosis.Case Presentation: A 47-year-old woman who has not yet experienced menopause comes with complaints of Dyspneu on Effort (DOE). She had multiple history of CVA. She is the 2nd child of 3 siblings. Her father has died due to liver problem. Her mother had a CVA at the age of 62 with history of hypertension. Her uncle from different grandmothers, also had a history of sudden death. She was diagnosed with a coronary artery disease and percutaneous coronary intervention was performed.Conclusion: The mortality rate of women with CAD is higher than that of men, confirming that CAD in women who appear at the age of less than 55 years should receive more attention, and the task of health workers here is to strengthen history taking related to family history in women with traditional risk factors who have the possibility of developing CAD in the future.  
Poor Adherence to Secondary Prophylaxis is Associated with More Severe Rheumatic Valve in Pediatric Patients: A Cross-Sectional Study Taufieq Ridlo Makhmud; Mohammad Saifur Rohman; Renny Suwarniaty; Djanggan Sargowo; Faris Wahyu Nugroho; Annisa Hasanah; Bambang Kusbandono; Citra Tarannita; Ratih Kusuma Wardani; Sasmojo Widito; Heny Martini
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.409 KB) | DOI: 10.21776/ub.hsj.2020.001.01.4

Abstract

Background : Rheumatic heart disease (RHD) contributed to a large number of proportion amoung cardiovascular problems in developing county, especially Indonesia. Secondary prophylaxis method using intramuscular injection of Benzathin Penicillin-G (BPG) has been known as the most effective strategy in the prevention of RHD. However, whether this prevention method also resulting in prevention of disease severity in Indonesian patients remained to be examined.Objectives : This study aimed to assess the difference of rheumatic valve severity in Indonesian pediatric patients between adequate and poor adherence to secondary prophylaxis by using intramuscular BPG injection.Methods : This cross-sectional study was conducted at Pediatric Cardiology Department of Saiful Anwar General Hospital from November 2018 to June 2019. Patients with documented history of RHD were included. Frequency of intramuscular BPG injection during the last one year was recorded. Adherence was measured using the proportion of days covered (PDC) and adequate adherence was defined as PDC ≥0.90. The severity of RHD was assessed based on the severity of the mitral and / or aortic valve using echocardiography. Bivariate analysis and multivariate logistic regression analysis was used to identify characteristics associated with rheumatic valve severity.Results : A significant difference of rheumatic mitral and/or aortic valve severity was observed between adequate adherence compared to poor adherence group (p = 0.016). Rheumatic mitral and/or aortic valve were found to be more severe in patients who has one or more episode of ARF recurrence (p = 0.003). Multivariate logistic regression analysis demonstrated that adherence to secondary prophylaxis within the last 1 year has the strongest influence on the severity of rheumatic mitral and/or aortic valve (p = 0.049; OR 7.20).Conclusion : The adherence to secondary prophylaxis has the strongest related the rheumatic valve severity compared to other factors.
Diuretic Resistance in Advanced Heart Failure Anita Surya Santoso; Mohammad Saifur Rohman; Indra Prasetya; Budi Satrijo
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.02

Abstract

Advanced heart failure (HF) is used to characterized patients in HF with severe symptoms, recurrent decompensation and severe cardiac dysfunction. The prevalencekof HFkis approximatelyg1-2% of thecadult population inhdeveloped countries and it will be rising more than 10%pamongapeoplec>70ayears of age, whereas estimated theoprevalence ofcpatients with advanced HF is about 1% until 10%cof thekoverallkHFopopulation. Most ofkthe HF hospitalizationssare due to signs and symptoms of fluidcoverload.Recurrent congestionccould worsen patientssoutcomes.Loopdiureticssare recommended for thectreatmentcofkcongestionqinprHF patient. cHowever,cdiureticvresistanceeispavcommon problem issueiinpacuteqdecompensationtofcadvancedochronicrheartwfailureq(ACHF) patients and established prognostic factor. Some early reports estimated the prevalence of diuretic resistance about 20%-30% in HF population. In this review, we will be discuss how to diagnose the advancedvheartufailurepand the underlying mechanism of diuretic resistancebin HF patients. We also describe pharmacologicalvand non-pharmacologicalstrategies to overcome this issue.
New York Heart Association Functional Class correlated with Depression: Study in Saiful Anwar Hospital Yusuf Arifin; Mohammad Saifur Rohman; Cholid Tri Tjahjono; Djanggan Sargowo; Anna Fuji Rahimah
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.5

Abstract

Background: Heart Failure prevalence was raising as one of the most Objective: to find the correlation of New York Heart Association Functional Class in heart failure patient with DepressionMethod: This cross-sectional study recruited 342 patients diagnosed with HF with previously for more than 3 months, at dr. Saiful Anwar General Hospital during December 2016 to March 2021. Each patient was interviewed for their demography data, and their clinical data, and assessed for their depression with Montgomery-Asberg Depression Rating Scale for Indonesian version. We used Spearman coefficients (rs) to evaluate the correlations between variables.Results: Baseline characteristic among depression and non-depression group demonstrated no significant difference (p>0.05), but for marital status. Populations was predominantly male, with ACE-i/ARB and Beta-blockers treatment. Non predominant treatment was MRAs, Diuretics, Digoxin. Baseline age was 22 years old until 87 years old. Baseline LVEF was 50.4±12.9%. (p >0.05). There were significant correlations between NYHA Class and marital status (p < 0.05), while the other baseline was not significantly different. We performed log regression for the confounding. The result was NYHA Class significantly correlated with and effects the depression.Conclusion: In heart failure patients, NYHA Class was significantly correlated with depression.Keyword: NYHA Class; Heart Failure, Montgomery-Asberg Depression Rating Sclae (MADRS), Depression
Trapping Technique for Successful Retrieval of a Ruptured Balloon Catheter Entrapped in Coronary Artery : A Case Report Putri Annisa Kamila; Budi Satrijo; Mohammad Saifur Rohman; Heny Martini; Indra Prasetya
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.487 KB) | DOI: 10.21776/ub.hsj.2020.001.02.8

Abstract

Introduction: Device entrapment during PCI is an uncommon complication with incidence of less than 1%. Percutaneous retrieval should be favored as the treatment of choice for this condition.Case Illustration: A 61-year-old patient came for an elective percutaneous coronary intervention (PCI) procedure. She suffered from chest pain while doing moderate activities for 1 month. Angiography showed a diffuse lesion with maximum stenosis 90% in the proximal LAD, stenosis 75% in the proximal of Left Circumflex Artery (LCx), and diffuse lesions in the proximal and mid of the Right Coronary Artery (RCA). We decided to perform PCI in the LAD. A transfemoral coronary intervention was performed using a Judkins Left 3.5 (7F) guiding catheter to engage the LAD. A Guidewire ( Run-through NS Floppy) was advanced to the distal LAD. Balloon angioplasty was performed with a 2.75 x 15 mm Fluydo balloon in the proximal LAD at 16 bars, but the balloon was entrapped and while withdrawing the balloon, it accidentally ruptured in the LAD artery with the remaining segment inside the guiding catheter. A second Run-through NS Floppy Guidewire was inserted across the ruptured balloon and a 2.5 x 20 mm Fluydo Balloon was passed on the second wire and was inflated at 16 atm pressure, inside the guiding catheter, trapping the ruptured balloon. The ruptured balloon was successfully removed, by withdrawing the whole system, including the guiding catheter and the wire. Finally, we re-engaged the LAD with the same guiding catheter, passed the wire, and post dilated the stent on the LAD to achieve a good result.Conclusion: Percutaneous retrieval using trapping technique could represent a safe and effective technique for ruptured and entrapment of a balloon-catheter in a coronary artery.
The Role of Congestion Index as Predictor Short-term Clinical Outcome in Patients AHF Veny Kurniawati; Anna Fuji Rahimah; Cholid Tri Tjahjono; Mohammad Saifur Rohman; Yoga Waranugraha
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (353.492 KB) | DOI: 10.21776/ub.hsj.2020.001.02.3

Abstract

IntroductionCongestion is the major problem in Acute Heart Failure (AHF) patients. Despite improving clinical congestion, we should assess and treat the hemodynamic congestion to decrease the progression of the disease and improve outcome of AHF patients. This study assess the ability of congestion index, a simple echocardiography parameter using ePCWP + eRAP to predict short-term clinical outcomes of AHF patients compare with NT-proBNP.Methods This prospective cohort study was conducted at Saiful Anwar General Hospital Malang from January 2108 to July 2019. AHF patients treated according to the 2016 ESC guidelines for AHF. Hemodynamic congestion was defined if congestion index (ePCWP+eRAP) at hospital discharge ≥ 30 mmHg.NT-proBNP level, ePCWP and eRAP were measured at 0-12 hours hospital admisssion and at hospital discharge. Clinical follow-up over a period of 30 days, AHF rehospitalization and mortality due to cardiovascular was registered. ResultsThis was a prospective study of 62 patients hospitalized with AHF. All patients were NYHA functional class IV. AHF mortality and rehospitalization rates in this study were 12.9% and 20.9%, respectively. Patient with congestion index ≥30 mmHg showed a higher 30 day rehospitalization [10 [66.7%] vs 3 [6.4%]; P =0.000; CI 95% OR 7.53(3.11-18.2)] and cardiovascular mortality [7 [46.7%] vs 1 [2.1%] P=0,000; CI 95% OR 5.90(2.95-11.78)]. NT-proBNP level at hospital discharge (cut off 5853 pg/mL; sensitivity 92%; specificity 91%; AUC 0.945; P = 0.000) was better than congestion index (cut off 30 mmHg; sensitivity 92.9%; specificity 91.7%; AUC 0.914; P = 0.000) in predicting AHF rehospitalization. For predicting mortality, NT-proBNP level at hospital discharge (cut off 8733 pg/mL; sensitivity 87.5%; specificity 88.9%; AUC 0.940; P = 0.000) were better than congestion index (cut off 31 mmHg; sensitivity 87.5%; specificity 81.5%; AUC 0.890; P = 0.000). ConclusionCongestion index could predict AHF rehospitalization and mortality within 30 days in patients with AHF.   
Mortality Prevention in Pregnancy With Pulmonary Arterial Hypertension Olivia Handayani; Mohammad Saifur Rohman; Ardian Rizal; Setyasih Anjarwani
Heart Science Journal Vol 1, No 4 (2020): Acute Coronary Syndrome in Daily Practice : Diagnosis, Complication, and Managem
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.04.07

Abstract

Background : Pulmonary hypertension (PH) is a global disease that affects all age groups and progresses in later years. Pregnancy with PH has a poor prognosis, and it is because of delayed diagnosis or even undiagnosed. PH gives high-risk to the mother and fetus; therefore, arranging a multidisciplinary team for pregnancy and delivery management is required.Objective : This case report was structured to emphasize mortality prevention in pregnancy with PH.Case : A 23-year-old female was admitted to the hospital with a chief complaint of dyspnea at rest. She was 34-week pregnant pregnancy and previously had a history of abortion with similar symptoms. After conducting some examinations, the patient was diagnosed with pulmonary hypertension. We planned for lung maturation for the fetus, scheduled termination, delivery method, and post-delivery care. The fetus was dead intra-uterine on day 5 of care, and the mother passed away 24 hours later.Conclusion : In summary, pregnancy was not advised in women with pulmonary hypertension. The collaboration and management by a multidisciplinary team are essential to improve outcomes if the pregnancy was still wanted.
Premature Coronary Artery Disease in Young Male Patient with Strong Family History Dea Arie Kurniawan; Mohammad Saifur Rohman; Anna Fuji Rahimah; Budi Satrijo
Heart Science Journal Vol 3, No 1 (2022): Assesment and Outcome of Coronary Artery Disease in the Reperfusion Era
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.01.8

Abstract

BACKGROUND: Coronary artery disease (CAD) occurring in less than 45 years of age is termed as premature CAD (PCAD). Recent studies showed a prevalence of 4-10 % of PCAD. PCAD is associated with unfavorable outcomes for the patients and had a greater impact on the quality of life. Family History is the best method to explained complex interaction between shared risk factor.CASE ILLUSTRATION: A 37-years old male admitted to Saiful Anwar Hospital for further evaluation of anginal pain. The patient complains of recurrent chest pain since 5 months ago but still relieved by rest. The electrocardiogram showed Wellens Type B which is specific for critical stenosis of the left anterior descending artery (LAD). Then the patient undergoing DCA Ad Hoc. The implantation of a 46 mm DES at proximal until distal LAD was performed. The patient discharged after a day observation.DISCUSSION: The challenging point, in this case, was it happen at a young age with strong family history. There was positive family history of PCAD in 1st degree relative on her brother and mother, despite several risk factors were identified in this case consist of smoking, and dyslipidemia, which make CAD risk higher. Despite adequate control of risk factors, family screening is important to reveal subclinical atherosclerosis.CONCLUSION: Approach to a patient with PCAD comprises of management of traditional risk factors and careful investigation of Family History. Individual with positive family history of PCAD should be treated more cautiously
The Effect of Add-on Garcinia mangostana L. Extract on Endothelial Dysfunction in Type 2 Diabetes Mellitus Subjects with High Risk Framingham Score: A Cohort Study Olivia Handayani; Djanggan Sargowo; Mohammad Saifur Rohman; Budi Satrijo; Cholid Tri Tjahjono; Dadang Hendrawan
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.406 KB) | DOI: 10.21776/ub.hsj.2020.001.01.5

Abstract

Background : Garcinia mangostana L. has been extensively used for years as antioxidant and anti-inflammation. However, its role in the context of endothelial disease was lacking.Objectives : To assess the effect of add-on G. mangostana L. extracts on endothelial dysfunction in type 2 diabetes subjects with high-risk Framingham score, compared to placebo.Methods : This was a prospective cohort study conducted in type 2 diabetes subjects with high-risk Framingham score. Subjects were randomized into two groups. The first group received 2,520 mg/day of G. mangostana L. extract. The second group was given a placebo for 90 days. The outcome measure of our study was the levels of endothelial progenitor cell (EPC), circulating endothelial cell (CEC), nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), Superoxide dismutase (SOD) and fasting blood glucose. Multiple linear regression was used to determine the correlation and effect estimate.Results: A total of 49 patients were included in our study. Of those, elevated levels of EPC and SOD were observed in treatment group compared to placebo. On the other hand, the level of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c was found significantly lower than placebo.Conclusion: Garcinia mangostana L. extract is associated with an increased levels of EPC and SOD, and it is also correlated with a decreased levels of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c.
Co-Authors Adhika Prastya Wikananda Adi, Andi Wahjono Aditha Satria Maulana Alfata, Fandy Hazzy Anita Surya Santoso Anjarwani, Setyasih Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Annisa Hasanah Ardhani Galih Prakoso Ardhino, Ardhino Ardian Rizal Ardian Rizal Ardian Rizal Arief Wibisono Arif Wicaksono Arina Madjidi Ashari, Yordan Wicaksono Astiawati, Tri Aulanni'am Aulanni'am Ayu Asri Devi Ayu Asri Devi Adityawati Aziz, Indra Jabbar Bagus H Kuncahyo Bahar, Mokhamad Aswin Bambang Kusbandono Bambang Rahardjo Bayu Aji Bayu Lestari Budi Satrijo Budi Satrijo Budi Satrijo Caesario, Fahreza Cholid Tri Tjahjono Cholid Tri Tjahjono Cholid Tri Tjahjono Candra Citra Tarannita Dadang Hendrawan Dea Arie Kurniawan Dedy Irawan Dhani, Fauzan Kurniawan Dian Nugrahenny Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Dwi Adi Nugroho Dwi Adi Nugroho Dwi Sarbini Dwigustiningrum, Nur Kaputrin Endah Kusuma Rastini Evit Ruspiono Fahmi Rusnanta Fahmy Rusnanta Fahmy Rusnanta Fajar, Jonny Karunia Fandy Hazzy Alfatta Faris Wahyu Nugroho Firdaus, Achmad Jauhar Fitranti Suciati Laitupa Ghazyarda Aqilah Setya H Hendarto Harumsari, Stefani Haryati, Lina Hendrawati Hendrawati Heny Martini Hidayat Sujuti Hikmawan Wahyu Sulistomo Husnul Khotimah Ika Setyo Rini Ikhwan Handirosiyanto Imelda Krisnasari Imelda Krisnasari Indra Prasetya Indra Prasetya Indra Prasetya Inggita Kusumastuty Irma Kamelia Pratiwi Kahadi, Cik Krishna Ari Nugraha Kurnianingsih, Novi Laitupa, Fitranti Suciati Lenny Kartika Lestari, Puspa Liemena Harold Adrian Lowry Yunita Martini, Heny Maulidiyatun Nuril Faizah Mifetika Lukitasari Mifetika Lukitasari Mifetika Lukitasari Mifetika Lukitasari Millisani, Hayla Iqda Mohammad Aris Widodo Muchammad Dzikrul Haq Karimullah Muhamad Bayu Aji Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Fadlan Nashi Widodo Nashi Widodo Noverike, Nikhen Novi Kurnianingsih Novi Kurnianingsih Novi Kurnianingsih Nugraha, Krishna Ari Nugraha, Yudha Tria Nugrahanti Prasetyorini Nur Ida Panca Nugraheini Nur Ida Panca Nugrahini Nur Permatasari Oktafin Srywati Pamuna Olivia Handayani Olivia Handayani Pamuna, Oktafin Srywati Pande Made Dwijayasa Pawik Supriadi Pawik Supriadi Putri Annisa Kamila Putri Annisa Kamila Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rahmi, Koyuki Atifa Ratih Kusuma Wardani Ratna Pancasari Ratna Pancasari Renny Suwarniaty Rislan Faiz Muhammad Rizal , Ardian Rizal, Ardian Rochmawati, Icmi Dian Salvatore Di Somma Sasmojo Widito Satrijo, Budi Seprian Widasmara Setiawan, Dion Setyasih Anjarwani Setyasih Anjarwani Setyowati, Danti Utami Suprayoga, Imam Mi'raj Suryanto Taufieq Ridlo Makhmud Taufiq Nur Budaya Teguh Aryanugraha Teguh Wahyu Sardjono Titi A W Tonny Adriyanto Veny Kurniawati Veny Kurniawati Wella Karolina Widito, Sasmojo Widodo Nashi Widodo Widodo Wikananda, Adhika Prastya Wira Kimahesa Anggoro Wira Kimahesa Anggoro Yoga Waranugraha Yoga Waranugraha Yoga Waranugraha Yogibuana, Valerinna Yoseph Budi Utomo Yusuf Arifin