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All Journal Indonesian Journal of Cardiology Heart Science Journal
Siska Suridanda Danny
Cardiology Consultant, Intensive Care And Cardiovascular Emergency Division / Faculty Of Medicine University Indonesia / National Cardiovascular Center Harapan Kita
Health Professions Immunology & microbiology Medicine & Pharmacology

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Hemodynamic impairment of double culprit ST elevation myocardial infarction, double the trouble: a case report Mikhael Asaf; Jonathan Edbert Afandy; Siska Suridanda Danny
Jurnal Kardiologi Indonesia Vol 47 No 2 (2026): April - June, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2235

Abstract

In “Hemodynamic impairment of double culprit ST elevation myocardial infarction, double the trouble: a case report” (Indonesian Journal of Cardiology, 46(2), 80-88. https://doi.org/10.30701/ijc.1791), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1791. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1791
Hemodynamic impairment of double culprit ST-elevation myocardial infarction, double the trouble: a case report Mikhael Asaf; Jonathan Edbert Afandy; Siska Suridanda Danny
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1791

Abstract

Background: Multiple culprit artery involvement is rare (2.5%) among ST-segment elevation myocardial infarction (STEMI) patients undergoing primary coronary intervention (PCI). It can occur due to multiple factors and reflects a widespread pathophysiologic process. Most patients present with unstable hemodynamics and cardiogenic shock (CS), which results in a high mortality rate. Currently, there are no guidelines or consensuses on the management of multiple culprit arteries in STEMI patients. Case Illustration: A 51-year-old man with chest pain in the past 16 hours was referred to the National Cardiovascular Center Harapan Kita. ECG at presentation revealed sinus rhythm with ST elevation in the inferior, posterior, and right leads. He was diagnosed with late-onset infero-posterior STEMI + right ventricle infarction, Killip IV, and thrombolysis in myocardial infarction 6/14, then was prepared for early PCI due to ongoing chest pain and CS. The patient underwent complete revascularization with drug-eluting stents and thrombus aspiration due to the high thrombus burden of the lesion in the right coronary artery and first obtuse marginal artery. After early PCI, his hemodynamic condition improved, and epigastric pain was his only complaint. However, on the following day, the patient experienced acute pulmonary edema and rhythm conversion to total AV block. He was managed conservatively with heparinization, inotropes, vasopressors, diuretics, and noninvasive ventilation. After 14 days of hospitalization, the patient was discharged without any complaints. Conclusion: Double culprit STEMI is rare and associated with catastrophic hemodynamic impairment, including CS, at presentation. Individualized treatment with early and aggressive revascularization yields relatively good results.
Expert Opinion on the Use of Inclisiran in Post-Acute Coronary Syndrome Patients in Indonesia Dafsah Arifa Juzar; Sunanto Ng; Isman Firdaus; Akhtar Fajar Muzakkir; Bambang Widyantoro; Faisal Habib; Hendry Purnasidha Bagaswoto; Siska Suridanda Danny; Erwinanto Erwinanto; Anwar Santoso
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1991

Abstract

Elevated low-density lipoprotein cholesterol (LDL-C) levels are an independent risk factor for the progression of atherosclerotic cardiovascular disease (ASCVD). Achieving substantial LDL-C reduction is recognized as a primary therapeutic goal, particularly for those at the highest risk of future cardiovascular events. Statin-based lipid-lowering therapy remains the cornerstone of secondary prevention in acute coronary syndrome (ACS). However, many high-risk individuals require combination therapy with non-statin agents to achieve guideline-recommended LDL-C targets. A novel, long-acting small interfering RNA (siRNA)-based proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, inclisiran, has emerged as a therapy that provides rapid and sustained LDL-C reduction. Despite these therapeutic advancements, various hurdles continue to hinder optimal lipid management in Indonesia. To address these challenges, an expert meeting involving cardiologists from multiple cities across Indonesia was convened, and the resulting consensus opinion of experts aimed to provide insights into the current hurdles in managing post-ACS and the potential use of inclisiran following high intensity statin or highest tolerated dose statins, with or without ezetimibe, in post-ACS patients in Indonesia.
Co-Authors Aditya Rachman, Aditya Akhtar Fajar Muzakkir Akhtar Fajar Muzakkir Amiliana M. Soesanto Amir Aziz Alkatiri Andi Alfian Zainuddin Anjarwani, Setyasih Anwar Santoso Anwar Santoso Ariani, Rina Astiawati, Tri Bambang Widyantoro Dafsah Arifa Juzar Daniel PL Tobing Danny, Hendry Purnasidha Dewi Utari Djafar, Dewi Utari Dian Zamroni Dwi Yuda Herdanto Dwiputra, Bambang Dwiputra1, Bambang Erwinanto Erwinanto Faisal Habib Faisal Habib Faris Basalamah Habib, Faisal Hendry Purnasidha Bagaswoto Hendry Purnasidha Bagaswoto Hilman Zulkifli Amin Ilhami, Yose Ramda Indra Prasetya Irmalita Irmalita Isman Firdaus Ispar, Akhtar Fajar Muzakkir Ali Jonathan Edbert Afandy Jonathan Edbert Afandy Liastuti, Lies Dina Manoefris Kasim Mazwar, Irmaliyas Miftah Pramudyo Mikhael Asaf Mikhael Asaf Muhammad Munawar Muzakkir, Akhtar Fajar Poppy S Roebiono Pratama, Vireza Putra, Iwan Cahyo Santosa Renan Sukmawan Rezeki, Arindya Robot, Marselly Maria Rossimarina, Vienna Sunanto Ng Sungkar, Safir Tanto, Ines Vidal Taofan, Taofan Wirawan, Hendy Yoga Yuniadi Zulkarnain, Edrian