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Successful Emergency Percutaneous Coronary Intervention of Challenging Unprotected Left Main Coronary Artery Disease Patient: How to Prepare and Optimize Suprayoga, Imam Mi'raj; Rohman, Mohammad Saifur; Martini, Heny; Satrijo, Budi
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.11

Abstract

Background: Myocardial infarction (MI) due to unprotected left main coronary artery disease (ULMCAD) is a relatively uncommon presentation. It represents as the anatomical subset of coronary artery disease (CAD) with the highest risk of atherosclerotic obstructive CAD. In the setting of acute MI, the treatment options are limited in this particular condition. Major advances in the field of PCI have made PCI as a viable option for patients with ULMCAD who are equally suited for CABG or PCI.Objective: This study aimed to describe the contemporary evidence PCI for ULMCADCase presentation: A man was admitted to our hospital with crescendo angina accompanied with dyspnea. Electrocardiogram (ECG) showed biphasic t wave on V2-V5 leads. He continued to experience symptoms of ischemia and had increased serial cardiac enzymes. Intra-aortic balloon pump (IABP) support was implemented before performing the PCI. After eight days of hospitalization, he was discharged with stable hemodynamics. Conclusion: PCI has risks and advantages when performed on patients with complex CAD, including ULMCAD. The prognosis for this high-risk patient group can be improved with thorough preparation and effective treatment strategies.
Impact of clinical features on in-hospital outcomes in premature coronary artery disease patients post percutaneous coronary intervention Noverike, Nikhen; Rohman, Mohammad Saifur; Rahimah, Anna Fuji; Rizal, Ardian; Prasetya, Indra
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.11

Abstract

Background: Premature coronary artery disease (PCAD) is a significant health concern globally, characterized by the onset of coronary atherosclerosis at an early age. The development of PCAD is influenced by a variety of risk factors and leading to substantial morbidity and mortality. Despite advancements in interventions, the clinical and angiographic characteristics influencing in-hospital outcomes for these patients remain underexplored.Objective: This study aims to investigate the relationship between clinical features and in-hospital outcomes in patients with premature CAD post-percutaneous coronary intervention (PCI) at Dr. Saiful Anwar Hospital.Method: A retrospective cohort study was conducted on 1279 patients who underwent PCI for premature CAD from January 2022 to December 2023. Clinical data, including risk factors and angiographic findings, were collected from medical records. Statistical analyses were conducted using SPSS 22, employing univariate, bivariate, and multivariate logistic regression analyses to determine correlations.Result: The study included 1279 patients, with 438 in the premature CAD group and 841 in the non-premature CAD group. Significant differences were observed in age, sex distribution, BMI, lipid profiles, smoking status, and family history between the groups. Premature CAD patients were younger (mean age 50 vs. 64.8, p<0.001) and had higher rates of smoking and dyslipidemia. Angiographic analysis showed significant differences in LAD and LCx involvement and occlusion rates. In-hospital outcomes indicated higher incidences of shock, cardiac complications, and in-hospital mortality in the non-premature CAD group.Conclusion: Clinical and angiographic characteristics significantly influence in-hospital outcomes for premature CAD patients. Younger age, smoking, and dyslipidemia were prevalent risk factors. Enhanced management strategies focusing on these factors could improve patient outcomes.Keywords: Premature coronary artery disease, percutaneous coronary intervention, clinical characteristics, angiographic findings, in-hospital outcomes. 
Increase Cardiovascular Event in Patient with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Millisani, Hayla Iqda; Prasetya, Indra; Rohman, Mohammad Saifur; Satrijo, Budi
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.5

Abstract

Diabetes mellitus (DM) associated with increase major risk factors of cardiovascular disease, such as peripheral arteriopathy, ischemic heart disease, or cerebrovascular accident. The Framingham study showed that patient with DM considerably increase coronary artery disease (CAD), particularly in old patient and women. Prevalence of DM is rising and cardiovascular mortality associated with DM is the main problem in the world. Additionally, there is a higher death rate among DM patients following a myocardial infarction with complications, such as stent thrombosis, instent restenosis, and no reflow phenomenon can worse overall long term prognosis with CAD. This review c onsiders the mechanism for diabetes mellitus in CAD patient, expecially patient with DM can increase risk of major complication in patient CAD undergoing percutaneous coronary intervention (PCI).
Atrial Fibrillation Development Risk Associated with Metabolic Syndrome Alfata, Fandy Hazzy; Rizal, Ardian; Rohman, Mohammad Saifur; Rahimah, Anna Fuji
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.2

Abstract

Even in the absence of antecedent myocardial infarction or congestive heart failure, atrial fibrillation (AF) is the most frequent arrhythmia seen in daily practice. There are several important predisposing factors for the initiationof AF, including growing older, being a man, being female, having high blood pressure, and having cardiac and noncardiac illnesses. Metabolic syndrome (MS) contributes to the progression of AF through its impact on the atrial substrate. MS involves metabolic risk factors that increase the likelihood of atherosclerotic cardiovascular disease and type 2 diabetes. Insulin resistance plays a significant role in MS pathophysiology, leading to glucose and lipid metabolism dysregulation, increased inflammation, and neurohormonal activation. These processes contribute to the development of hypertension, a major risk factor for AF. Atrial remodeling, including electrical and structural changes, is a common substrate for AF, and MS components further contribute to this remodeling.Hypertension, a key feature of MS, is associated with structural, contractile, and electrical remodeling in the atria, increasing the risk of AF. The renin-angiotensin-aldosterone system, implicated in hypertension regulation, alsoinfluences the pathophysiology of AF through fibrosis, ion channel alterations, oxidative stress, and inflammation. Understanding the intricate interplay between MS and AF can provide insights into therapeutic strategies for managing these conditions and reducing cardiovascular risks.
Effect Of Combination Decafeinated Green Tea and Green Coffee In Reducing Cholesterol Levels In Patients With Metabolic Syndrome Alfata, Fandy Hazzy; Rohman, Mohammad Saifur; Astiawati, Tri; Tjahjono, Cholid Tri; Martini, Heny
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.4

Abstract

Background: Green tea and green coffee are natural ingredients that improve cholesterol levels. Combining the two in experimental animal studies provides more significant benefits when compared to single administration in reducing cholesterol levels.Objective: This study aimed to determine the effect of decaffeinated green tea and green coffee as adjuvant treatments in reducing blood cholesterol levels.Methods: This randomized controlled trial included 90 metabolic syndrome patients determined according to the IDF criteria for Asian people aged 50–70. All subjects received atorvastatin 20 mg and were divided into three groups. Participants in Group 1 received decaffeinated green tea and green coffee 2.5 grams twice daily, Group 2 received 5 grams daily, and Group 3 received a placebo. The total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride levels were measured at the beginning and the end of the study.Results: At 90 days, after administration of the extract of decaffeinated green tea and green coffee, we found that the concentration of total cholesterol in Group 1 and Group 2 was significantly reduced compared to the placebo (-50 ± 6.1 vs. -62.8 ± 5.9 vs. -22.5 ± 5.8 mg/dL; p= <0.05). But there was no significant difference in reduction of total cholesterol levels between the first and second groups. The other parameters also decreased, but not significantly compared to the placebo group.Conclusion: Administration of a combination of decaffeinated green tea extract and green coffee as an adjunctive therapy can reduce the average total  cholesterol, LDL, HDL, and triglyceride levels more than placebo, but only total cholesterol has a significant difference compared to other cholesterol  components.
Early Management of Shock Condition in STEMI Patient Nugraha, Yudha Tria; Anjarwani, Setyasih; Satrijo, Budi; Rohman, Mohammad Saifur
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.9

Abstract

Background: Acute myocardial infarction is one of the emerging cardiovascular events worldwide. Infarcts of the inferior wall were present between one-third and half of the patients with RV involvement. The worse outcome was strongly associated with cardiogenic shock, and 7% of cases were caused by RV failure.Objective: This study aimed to describe the diagnosis and management of cardiogenic shock in STEMICase presentation: A male in his 40s was brought to our hospital 12 hours after the onset of persistent epigastric pain. He had a history of hypertension and a family history of diabetes Mellitus. Diagnostic procedures included blood tests, ECG, X-rays, coronary angiogram, and echocardiography. He underwent PCI to implant DES in his proximal RCA, which had 100% occlusion. The patient was admitted to the intensive cardiovascular care unit for 30 hours and died due to various complications.Conclusion: Current case was very complicated and seriously life-threatening. After acute myocardial infarction, Important problems kept coming up one after the other, and they all affected each other. Patients with cardiogenic shock must be found quickly and treated quickly and aggressively.
A 56 Year Old Male with Acute Stent Thrombosis During Percutaneous Coronary Intervention, How to Resolve This Problem? Millisani, Hayla Iqda; Rohman, Mohammad Saifur; Prasetya, Indra; Widito, Sasmojo
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.8

Abstract

Background: Acute stent thrombosis is the complete occlusion of a coronary artery of the previously implanted stent. This unusual complication occurs in percutaneous coronary intervention (PCI), development of myocardial ischemia, and poor prognosis for the patient. After PCI, acute stent thrombosiscan occur within 0-24 hours and cause the symptoms like acute coronary syndrome. Incidents of stent thrombosis are about 0.6% to 3.4% for Drug Eluting Stent (DES) implantation, depending on the lesion and patient factors. The etiology of acute stent thrombosis is multifactorial, and early detectioncan reduce the mortality rate.Case Illustration: A 56 yo male visited Rumah Sakit Saiful Anwar Malang with stable angina pectoris (Class III symptoms with medical therapy) planned for elective cardiac catheterization with routine medical treatment. During PCI, he complained the chest pain, and from cine angiography evaluation showed no flow at the diagonal branch because of the acute thrombosis. Then got thrombosuction and got a white thrombus. After the PCI procedure, he got fibrinolytic with streptokinase 1.5 million units for 60 minutes. He was transferred to CVCU for observation and discharged after five days.Conclusion: Acute stent thrombosis is a severe complication during and after PCI because it is related to high mortality. The mechanisms by which ST arises are complex and multifactorial and must be early detection.
Benefits of Low Dosage of Colchicine Administration on Decreasing Rehospitalization and Mortality within 30 Days in Post-Acute Coronary Syndrome Patients with ST-Segment Elevation Undergoing Percutaneous Coronary Intervention Satrijo, Budi; Ashari, Yordan Wicaksono; Rohman, Mohammad Saifur; Anjarwani, Setyasih; Tjahjono, Cholid Tri
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.6

Abstract

Background: The role of inflammation in myocardial infarction and post-infarction MI remodeling has become a concern for the development of treatment in the last decade. Colchicine can prevent increased inflammation during acute injury.Objective: This study focused on the role of colchicine as an on-top medical treatment, hoping it can reduce mortality and short-term rehospitalization in patients with STEMI.Methods: 347 AMI patients (18-80 year old adults) who visited RSUD dr. Saiful Anwar Malang, between February 2022 and January 2023, participated in this prospective, randomized, double-blinded, placebo-controlledexperiment. Patients were split into two groups and given either a placebo or  colchicine 0.5 mg daily for a month. Standard medical therapy was administered concurrently to both groups as an approachable guideline. The study endpoints were mortality and rehospitalization rates.Result: After one month of follow-up, there was a reduction in rehospitalization due to cardiovascular causes (2 [1.3%] vs. 4 [2.7%], HR 3.42 [1.36-8.56], p<0.05), which was significant in the treatment group compared to the control group. Also, there was a reduction in all-cause mortality, but not statistically significant (2 [1,3% v 3 [2,0%], HR 3,38 [0,53-7,48], p>0,05). In the treated group, there was also a lower non-cardiovascular rehospitalization rate compared to placebo, but not significant (4 [2.6%] vs. 7 [4.7], HR 0.42 [0.15-1.02], p<0.05).Conclusion: The administration of low-dose colchicine for one month has shown benefits in reducing rehospitalization in patients with STEMI who receive PCI therapy.
When to consider takotsubo cardiomyopathy in menopausal elderly woman presenting chest pain Aziz, Indra Jabbar; Rohman, Mohammad Saifur
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.21

Abstract

Background:  An elderly menopausal woman presenting with chest pain in the emergency department may have coronary artery disease (CAD), Takotsubo cardiomyopathy, or other conditions. It is crucial to conduct a thorough diagnostic evaluation in menopausal elderly woman. Case illustration: A 77-year-old postmenopausal woman presenting with first-onset chest pain after having familial issues and severe psychological stress was admitted to the emergency department. She had no identifiable risk factors for CAD, and her physical examination revealed no significant abnormalities. The electrocardiogram (ECG) indicated non-specific ST-segment elevation in leads V3-V6. Serial ECGs showed an evolution of ST-segment elevation that did not align with the typical pattern observed in STEMI. Despite the elevation in cardiac enzymes in the previous hospital, unfortunately, serial cardiac enzymes were inconsistently normal in our hospital. Therefore, these findings implied that the patient's condition might not be ACS, and we cannot rule out the possibility of Takotsubo syndrome. The patient underwent coronary angiography (DCA) and The DCA results revealed normal coronary with suspicion of apical ballooning of the left ventricle as observed from cine angiography. Subsequent echocardiography demonstrated apical akinesis with basal hyperkinesis, the large area of dysfunctional myocardium extending beyond the territory of a single coronary artery and characteristic apical ballooning resembling an octopus trap, consistent with the diagnosis of Takotsubo syndrome. The patient was managed conservatively with supportive care. Her symptoms improved, and she was discharged after five days. Conclusion: This case highlights the importance of considering takotsubo cardiomyopathy in menopausal elderly woman with no risk factor of CAD presenting with chest pain after having psychological stress.
The role of GALNT and EGFR in vascular calcification: Study on pathophysiology and its implications in vascular therapy Bahar, Mokhamad Aswin; Rohman, Mohammad Saifur
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.4

Abstract

Vascular calcification is a complex biomineralization process that occurs in arteries, primarily driven by the activity of vascular smooth muscle cells (VSMCs). This process involves the deposition of hydroxyapatite minerals in the arterial walls, particularly within the intima and media layers. Vascular calcification significantly increases the risk of cardiovascular diseases, including myocardial infarction, stroke, and heart failure. Understanding the role of GalNAc-transferase (GALNT) and the epidermal growth factor receptor (EGFR) in vascular calcification has advanced significantly. GALNT is involved in the regulation of glycosylation and affects various biochemical pathways, including insulin signaling and lipid metabolism. Variations in GALNT expression can influence the risk of vascular calcification, highlighting the crucial role of glycosylation in the pathogenesis of vascular calcification. On the other hand, EGFR contributes to vascular calcification by modulating the activity of tissue-nonspecific alkaline phosphatase (TNAP) and the formation of calcifying extracellular vesicles, as well as through the proliferation and migration of VSMCs. A deeper understanding of the roles of GALNT and EGFR provides new insights into the pathophysiological mechanisms of vascular calcification and opens up opportunities for the development of more effective therapies. This review aims to enhance scientific knowledge and provide a foundation for further research and the development of more targeted and personalized therapies in the prevention and treatment of vascular calcification.
Co-Authors Achmad Rudijanto Adhika Prastya Wikananda Adi, Andi Wahjono Aditha Satria Maulana Ahsan Ahsan Ainan, Shafa Akbar, Naufal Zulfikar Alfata, Fandy Hazzy Anditri Weningtyas 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 Chomsy, Indah Nur Citra Tarannita Dadang Hendrawan Dea Arie Kurniawan Dedy Irawan Dhani, Fauzan Kurniawan Dian Nugrahenny 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 Efris Kartika Sari, Efris Kartika Endah Kusuma Rastini Evit Ruspiono Fahmi Rusnanta Fahmy Rusnanta Fahmy Rusnanta Fajar, Jonny Karunia Fandy Hazzy Alfatta Faris Wahyu Nugroho Filano, Marco Firdaus, Achmad Jauhar Firdaus, Dylan Hanny Fitranti Suciati Laitupa Ghazyarda Aqilah Setya H Hendarto Harumsari, Stefani Haryati, Lina Hendrawati Hendrawati Heny Martini Hidayat Sujuti Hikmawan Wahyu Sulistomo Hose, Victor Alvianoes Guterez Husnul Khotimah Ika Setyo Rini Ikhwan Handirosiyanto Imelda Krisnasari Imelda Krisnasari Indra Prasetya Indra Prasetya Indra Prasetya Inggita Kusumastuty Irma Kamelia Pratiwi Kahadi, Cik Karolina, Wella Krishna Ari Nugraha Kuhn, Corinna Maria Kurnianingsih, Novi KURNIAWAN, ARY Laitupa, Fitranti Suciati Laukkanen, Noora Julia Lenny Kartika Lestari, Puspa Liemena Harold Adrian Lowry Yunita Lukitasari, Mifetika 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 Nugroho, Ira Vori 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 Purbaningroom, Dian Laila Putri Annisa Kamila Putri Annisa Kamila Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rahma, Oktivani Adelathifa Rahmi, Koyuki Atifa Ratih Kusuma Wardani Ratna Pancasari Ratna Pancasari Renny Suwarniaty Rislan Faiz Muhammad Riswati, Harnanik Puji Riza, Mochamad Faishal Rizal , Ardian Rizal, Ardian Rochmawati, Icmi Dian Rohman, Ibrahim Abdur Sakti, Pradhika Perdana 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 Wiwit Nurwidyaningtyas, Wiwit Yoga Waranugraha Yoga Waranugraha Yoga Waranugraha Yogibuana, Valerinna Yoseph Budi Utomo Yusuf Arifin Zhao, Zihan