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Suko Adiarto
Department Of Cardiology & Vascular Medicine, Faculty Of Medicine, Universitas Indonesia.
Health Professions Medicine & Pharmacology

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Rokok, Perokok pasif, Kematian Kardiovaskular dan Jaminan Kesehatan Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 33, No. 3 Juli - September 2012
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v33i3.41

Abstract

Peran rokok dalam menyebabkan kematian prematur akibat berbagai sebab/penyakit telah lama di-dokumentasi kan. Namun demikian, angka konsumsi rokok secara agregat masih terus meningkat.  Peto dan Lopez memproyeksikan, dengan pola konsumsi rokok saat ini, angka kematian akibat rokok di seluruh dunia pada tahun 2000-2050 akan mencapai 520 juta. Data dari berbagai penelitian epidemiologi menunjukkan sebagian besar kematian ini disebabkan oleh penyakit kardiovaskular dan secara demografis proporsi kematian dini akibat penyakit kardiovaskular ini  terjadi di Negara-negara berkembang di kawasan Afrika dan Asia Tenggara. Akibat yang sangat logis, mengingat data pada penelitian yang lain memperlihatkan bahwa lebih dari 80% prevalensi perokok di dunia berada di Negara dengan pendapatan perkapita rendah. Penelitian lain menunjukkan, di kawasan Eropa Timur, Asia Tengah dan Asia tenggara, sekitar 50% dari  seluruh penduduk berusia dewasa adalah perokok.
Biomarker pada Infark Miokard Akut: Diperlukan yang lebih Dini Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 32, No. 4 Oktober - Desember 2011
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v32i4.81

Abstract

Paling tidak dalam 4 dekade terakhir, Infark Miokard Akut (IMA) masih menempati urutan pertama dalam daftar penyakit penyebab kematian di seluruh dunia. Secara historis, terdapat kemajuan yang sangat pesat dalam penatalaksanaan penyakit ini, baik dalam segi diagnostik, terapi medikamentosa, maupun tindakan revaskularisasi. Khususnya di bidang diagnostik, penggunaan 3 kriteria WHO yang meliputi nyeri dada tipikal, perubahan EKG dan meningkatnya biomarker (enzim) yang spesifik sangat membantu meningkatkan akurasi diagnostik IMA secara signifikan. Bandingkan, pada tahun 1940­1950 hanya sekitar 15 persen penderita yang dirawat di ICCU dengan dugaan ternyata benar­benar mengalami IMA.Kemajuan di bidang diagnostik juga diikuti oleh kemajuan yang sangat pesat dalam penata laksanaan IMA, dimana fokus utama tatalaksana IMA telah bergeser dari limitasi luasnya infark dengan cara menurunkan kebutuhan oksigen miokard menjadi terapi reperfusi, baik dengan cara farmakologi (fibrinolitik) maupun secara mekanik (Primary PCI)
Sel Punca Pada Penyakit Kardiovaskular: Kembali ke Bench Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 31, No. 2 Mei - Agustus 2010
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v31i2.137

Abstract

Ungkapan from bench to bedside sesungguhnya merupakan dambaan setiap peneliti yang bergerak dalam ilmu-ilmu dasar kardiovaskular, dimana penemuan yang mereka hasilkan dari laboratorium pada tingkat kultur sel sampai uji efektitivitasnya pada hewan coba dengan model penyakit kardiovaskular dapat men-emukan aplikasi klinik yang bermanfaat. Tidak semua temuan yang secara teoritis menjanjikan pada tingkat laboratorium maupun hewan coba dapat menunjukan efektivitas yang diharapkan pada uji klinik. Bahkan, ketika suatu modalitas yang secara meyakinkan menunjukkan potensi terapetik yang baik pada pe-nelitian laboratorium atau hewan coba, namun gagal pada tingkat uji klinik seringkali diuji kembali pada penelitian laboratorium untuk mencari pemecahan dari kegagalan pada uji klinik tersebut.
Of All Antioxidants, Would One Finally Be Used Clinically For Atherosclerotic Disease? Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 34, No. 1 Januari - Maret 2013
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v34i1.303

Abstract

Oxidation of LDL by oxygen free radicals results in unregulated uptake of modified LDL by macrophages in arterial wall. This is considered a key initiating factor for development and progression of atherosclerotic process. It is then logical to hypothesize that anti-oxidants, which can directly scavenge free radicals, can be useful in preventing atherosclerotic process. Initial support for this hypothesis accumulated rapidly from numerous in-vitro studies.
Stratifikasi Risiko, Cost-Analysis dan Jaminan Kesehatan Nasional di Bidang Kardiovaskular Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i4.491

Abstract

Mulai berlakunya sistem kesehatan nasional di Indonesia menandai era baru di bidang pembiayaan kesehatan nasional, dimana pembiayaan kesehatan yang sebelumnya didominasi oleh pembayaran tunai secara pribadi kini secara perlahan tapi pasti telah bergeser pada sistem asuransi, dimana keikutsertaan seluruh warga negara merupakan salah kunci sukses terselenggaranya sistem pembiayaan ini dengan baik. Berkaca pada pendapat para ahli di bidang pembiayaan kesehatan dan pengalaman negara-negara maju, tidak disangsikan lagi, ketika telah berjalan dengan sempurna sistem ini merupakan sistem pembiayaan terbaik. Tentu saja pada tahap awal pelaksanaan sistem jaminan ini masih terdapat beberapa kekurangan mendasar yang perlu mendapat perhatian serius untuk dapat segera diperbaiki.Seperti mengkonfirmasi data statistik yang telah ada tentang mortalitas dan morbiditas, BPJS kesehatan baru-baru ini me release data penyakit dengan pembiayaan kesehatan tertinggi dimana penyakit jantung dan pembuluh darah, keganasan (kanker) dan penyakit ginjal kronik merupakan 3 penyakit yang memuncaki tabel pengeluaran keuangan BPJS kesehatan.1 Penyakit jantung dan pembuluh darah berada di urutan pertama dengan jumlah pengeluaran
Catheter Directed Thrombolysis pada Trombosis Vena Dalam Iliofemoral Fadhil P. Apriansyah; Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i4.496

Abstract

Background Iliofemoral deep vein thrombosis (IFDVT) is associated with more severe outflow obstruction which results in more severe DVT symptoms and late clinical sequelae. Despite anticoagulation therapy, IFDVT patients is still at risk to develop postthrombotic syndrome (PTS). Recent studies found that additional catheter-directed thrombolytic therapy may offer advantages in reducing PTS and maintaining venous patency. Several ongoing multi-center randomized controlled trials are expected to evaluate safety and efficacy of CDT in IFDVT patients, and define who will benefit most.Case Illustration A 59-year-old male was presented with numbness, pain, and movement limitation in the left leg that were preceded by left leg swelling. Peripheral edema was found in both patient’s leg but more prominent on the left side. Dupplex sonography revealed extensive soft thrombus from left iliac vein to left tibialis vein. Initial anticoagulation therapy took no effect to the thrombus. Catheter-directed thrombolysis was performed and provided satisfactory symptoms resolution as well as thrombus dissolution.Summary A case of iliofemoral DVT has been reported. The present therapeutic strategy of anticoagulation therapy has not been proven to prevent PTS. CDT is an effective way in achieving clot lysis in acute thrombosis, and this may help to prevent PTS and subsequent ulceration. The potential benefits of therapy must be weighed carefully against the risk of bleeding. There are several ongoing RCTs that are awaited to help provide evidence on functional outcome after CDT and define who will benefit most.
Peran Ekokardiografi sebagai Modalitas Diagnostik Pendukung pada Diseksi Aorta Stanford A Terlokalisir Haris Munirwan; Amiliana Mardiani Soesanto; Rina Ariani; Taofan Taofan; Suko Adiarto; Ismoyo Sunu; Bagus Herlambang; Dicky Aligheri; Retno Dwi Astuti
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i4.497

Abstract

Ascending Stanford type A aortic dissection carries a high morbidity and mortality. Proper identification of the proximal origin of the dissection and determination of concomitant aortic valve involvement significantly facilitate surgical repair which may improve survival.2Rapid imaging is necessary for the timely diagnosis of a potentially life-threatening condition. Transthoracic Echocardiography is highly accurate for the detection of acute aortic syndromes especially identify ascending aortic pathology such as type A aortic dissection.3 We report the unusual case of 52-years old male who present atypical presentation of aortic dissection with unclear view of dissection by CT Angiography aorta, and diagnosed as Localized Stanford A Aortic dissection with supported data by echocardiography modality.
The Protective Effect of Vitamin E for Reducing Intra-Hospital Mortality in Acute Limb Ischemia Patients Suci Indriani; Suko Adiarto; Hananto Andriantoro; Ismoyo Sunu; Taofan Siddiq; Iwan Dakota
Jurnal Kardiologi Indonesia Vol 42 No 1 (2021): Indonesian Journal of Cardiology: January - March 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1114

Abstract

Background Management of acute limb ischemia (ALI) is still a huge challenge. Current advances of endovascular therapeutic approach in management of ALI have decreased the overall amputation rate, nevertheless, mortality rate remains high which may be caused by metabolic consequences of reperfusion injury. Aim To understand the role of vitamin E to intra-hospital and 30-day mortality among acute limb ischemia patients. Methods This retrospective cohort study included all patients with ALI between 2015 to 2018. Vitamin E 2x400 mg orally for seven days was given based on physician preference after ALI diagnosis was confirmed. Data were collected from Vascular Registries of National Cardiovascular Center Harapan Kita (NCCHK), Jakarta, Indonesia. Univariate analysis and logistic regression models were used to explore factors that contribute to intra-hospital and 30-day mortality. Results A total of 160 patients with ALI involving 192 limbs were admitted to our hospital. Mostly were male (63.1%) and mean age were 56±13 years old. Majority of the patients had unilateral lesion (80%), and were diagnosed with Rutherford stage IIA (36.3%), followed by stage IIB (33.8%), stage I (20%), and stage III (10%) respectively. Intra-hospital and 30-day mortality were 28.1% and 36.9%, respectively. Low treatment of vitamin E increased intra-hospital mortality (HR 5,6 95%CI 1.7-18.3), however, it did not affect 30-day mortality. Other factors including IABP insertion, arrhythmia, bleeding requiring transfusion and acute renal failure were associated with higher intra-hospital and 30-day mortality. In addition, menopause (HR 3.2; CI 1.16-8.85) was also a predictor of 30-day mortality. Conclusion Vitamin E administration reduced intra-hospital mortality but not on 30-day mortality in acute limb ischemia patients. Keywords: Acute Limb Ischemia, vitamin E, mortality, reperfusion injury
Factors Influencing Mortality of Thoracic Aortic Surgery in The Third World Country Diansari, Rienna; Aligheri, Dicky; Herlambang, Bagus; Wicaksono, Sony Hilal; Mendel, Brian; Yaniarti, Dian; Alkatiri, Amir Aziz; Andriantoro, Hananto; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1494

Abstract

Background: A prominent increase of overall global death rate of aortic disease is seen on developing country, with South-east Asia having the highest increase of 41%. Lack of identification and prompt management of the diseases in conjunction with lack of facilities in third world countries that could perform aortic surgery made the procedure more complex when the patients admitted to tertiary hospitals Methods: The data was obtained through medical record of patients underwent thoracic aortic surgery from 2018 to 2021 in National Cardiovascular Center Harapan Kita (NCCHK). One-year and 3-year survival analysis was obtained through phone calls and digital messages. Statistical analysis was done to investigate the impact of surgical complexity as the main predictor and other variables on primary (in-hospital mortality) and secondary (mid-term survival) outcome. Results: A total of 208 patients were included in the analysis; 157 (75,5%) underwent complex surgery, and 51 (24,5%) underwent non-complex surgery. In-hospital mortality was similar across 2 groups (23,6% vs 13,7%; p = 0,1240). On multivariable analysis, malperfusion syndrome (OR 3,560; p = 0,002), CPB duration > 180 minutes (OR 4,331; p = 0,001), and surgical priority (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) were identified as independent predictor of in-hospital mortality. Cox regression identified diabetes (HR 4,539; p = 0,025) and emergency procedure (HR 9,561; p = 0,015) as independent predictors for 1-year mortality, and diabetes (HR 3,609; p = 0,004), aortic dissection (HR 2,795; p = 0,029), and maximum aortic diameter (HR 1,034; p = 0,003) for 3-year mortality. Surgical complexity was not associated with early and mid-term mortality. Conclusions: In patients undergoing thoracic aortic surgery, surgical complexity was not associated with early and mid-term survival. Early and mid-term survival was largely determined by patient comorbidities and intra-surgery factors.This article has a related Erratum.
Percutaneus Transluminal Angioplasty Using Carbon Dioxide Contrast in Chronic Limb Threatening Ischemia patient with Renal Failure Sabara, Saga Malela Aria; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1696

Abstract

Background: At the present times, it is estimated that more than 202 million patients suffer from peripheral arterial disease (PAD) worldwide. Chronic limb-threatening ischemia (CLTI) represents the end stage of PAD often need lower extremity amputation, and the aftermath can be worse. For the patient with CLTI and chronic renal disease (CKD) who need endovascular therapy, iodinated contrast may enhance the risk of contrast-induced nephropathy (CIN). CIN is an acute renal injury and may lead to irreversible loss of renal function. In high-risk patients who were allergic to iodinated contrast material and for those with renal insufficiency Hawkins in the 1970s pioneered the intra-arterial application of carbon dioxide (CO2) gas angiography to reduce the volume use of iodinated contrast. Case Illustration: Single case was presented in this report. An 80-years old man referred to National Cardiovascular Center Harapan Kita with the chief complaint of independent rest pain and non healing wound in his left forefinger, in accordance with the criteria CLTI. The duplex ultrasound examination shows total occlusion at left anterior tibialis artery. The patient then undergone percutaneous transluminal angioplasty (PTA) procedure using Carbon Dioxide (CO2) contrast agent and using Plain Old Balloon Angioplasty (POBA) technique for revascularization. The flow to the distal of left anterior tibialis artery returned using only 30 ml of Iodinated contrast. The follow up of this patient shows there is no increase of serum creatinine level and eGFR Summary: Endovascular therapy in patient with CLTI with high risk of operation could be performed in patient with CKD using the carbon dioxide contrast agent in order to minimize the usage of iodinated contrast avoiding further loss of renal function. In this case report, the procedure has performed successfully without increase in serum creatinine and decrease of GFR. Keywords: CLTI, Carbondioxide Contrast, Endovascular Therapy
Co-Authors Aligheri, Dicky Amiliana Mardiani Soesanto Amir Aziz Alkatiri Amir Aziz Alkatiri Bagus Herlambang Bagus Herlambang Bagus Herlambang Brian Mendel Dian Yaniarti Diansari, Rienna Dicky Aligheri Dicky Aligheri Fadhil P. Apriansyah Hananto Andriantoro Hananto Andriantoro Ismoyo Sunu Ismoyo Sunu Iwan Dakota Mendel, Brian Munirwan Haris Retno Dwi Astuti Rienna Diansari Rina Ariani Sabara, Saga Malela Aria Sony Hilal Wicaksono Suci Indriani Taofan Siddiq Taofan Taofan Yaniarti, Dian