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All Journal Jurnal Kedokteran Brawijaya Medical Journal of Indonesia JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Journal of Issues in Midwifery Heart Science Journal CRJIM (Clinical and Research Journal in Internal Medicine) Caring : Jurnal Pengabdian Masyarakat Journal of Nursing Science Update Journal of Community Health and Preventive Medicine (JOCHAPM)

Cholid Tri Tjahjono

Brawijaya Cardiovascular Research Center Department Of Cardiology And Vascular Medicine Faculty Of Medicine, Universitas Brawijaya Malang

Author-ID : 3606196

Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Endovascular Stenting for Critical Limb Ischemia Patient with Superficial Femoral Artery Occlusive Disease: A Case Report Mohammad Ryan Ramadhan; Novi Kurnianingsih; Djanggan Sargowo; Cholid Tri Tjahjono
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

BACKGROUND: Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease (PAD), in the absence of intervention, may lead to lower extremity amputation or death. In cases where medical management is not effective or severe cases of PAD, endovascular and surgical interventions are indicated.2 Endovascular interventions become a first-line approach of CLI management and have advanced considerably within the past decade.1,3CASE DESCRIPTION: A 73-year old female with complain of left leg pain, accompanied with necrotic wound since 6 months ago. Duplex ultrasound showed no-flow from proximal to distal left superficial femoral artery (SFA). From CT-Angiography showed total occlusion from proximal left SFA to proximal poplitea artery about 7,2cm with collateral vessels. She was diagnosed with CLI left inferior extremity Fontaine IV Rutherford III. Angiography inferior extrimities was performed with total occlusion from proximal to distal left SFA with collateral vessels run to distal. We deployed a self-expanding stent with size 6mmx100mmx120cm at proximal-mid SFA. The patient showed improvement and was discharged after 5-days observationDISCUSSION: Patients with CLI have high risk of limb-loss without revascularization and high short term risk of cardiovascular events. Endovascular revascularization of femoro-popliteal occlusive offers lower initial risks than open surgery, with grade IIB-recommendation for lesion less than 25cm. Clinical success of endovascular stenting on CLI usually synonymous to limb salvageCONCLUSION:Favorable results can be achieved with endovascular stenting approach in patients with CLI, where close follow-up treatment afterwards can save limb loss.

Right-Sided Heart Failure Presentation in Severe Valvular Aortic Stenosis: How to Deal with Diuretic Use? Fahmy Rusnanta; Cholid Tri Tjahjono; Anna Fuji Rahimah; Heny Martini
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.2021.002.01.07

BACKGROUND: Patients with right-sided heart failure and severe aortic stenosis (AS) have many clinical challenges to overcome fluid retention. Typical diuretic therapeutic approach can be recommended for the guidance of removing fluid overload in severe AS with right ventricular (RV) failure. The aim of this case review is to understand how to assess and manage RHF and severe AS. CASE SUMMARY: A 65-year-old female with worsening bilateral leg swelling and she aware of shortness of breath for 3 months. Physical examination revealed a grade 3/6 ejection systolic murmur at the aortic area radiating to the neck, a grade 2/6 diastolic murmur at the pulmonic area, and a grade 3/6 systolic murmur at the apex radiating to the axilla, increased jugular venous pressure, prominent bilateral leg swelling, and minimal rhonci at the base of the lungs. The chest X-ray showed worsening cardiomegaly in the last 3 months. Echocardiography revealed high gradient severe valvular AS, decreased systolic RV function, and other valvular dysfunctions including moderate mitral regurgitation, moderate pulmonary regurgitation, and mild tricuspid regurgitation. She was introduced high dose furosemide infusion. The average urine output production was 5 L/day and negative fluid balance was 3 L/day. Furosemide dose was adjusted daily according to urine output production and she was discharged after 6 days hospitalization. DISCUSSION: This case report provides an example of RV failure in severe AS patient. Hemodynamic monitoring and typical approach of diuretic therapies should be needed in the management of fluid overload in severe AS. KEYWORDS: right-sided heart failure, severe aortic stenosis, diuretic.

Community-Based Cardiac Rehabilitation To Improves Medication Adherence in Stable Coronary Artery Disease Tonny Adriyanto; Cholid Tri Tjahjono; Mohammad Saifur Rohman; Sasmojo Widito; Ardian Rizal
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Cardiovascular disease contributes to 48% of deaths in the world. A cohort study at the Harapan Kita National Heart Center and 5 Indonesia hospitals in 2006 showed that the death rate due to heart disease in hospitals was around 6-12%. Rehospitalization rate reached 29% and the all-out expense of INA-CBG claimed for inpatient was Rp 42.4 trillion. The major problem causing rehospitalization was poor compliance to medication in coronary artery disease (CAD) patients. Education to improve compliance has been known not only reduced rehospitalization rate but also improve quality of life. In these review the author discussed the efficacy of community based cardiac rehabilitation for rehospitalisation reduction dan quality of life improvement.

Is There A Role of Glycated Hemoglobin for Predicting Major Ad- verse Cardiac Event in ST-Elevation Myocardial Infarction? Muhammad Abusari; Cholid Tri Tjahjono; Dadang Hendrawan; Yoga Waranugraha; Ayu Asri Devi Adityawati; Ratna Pancasari
Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.03.4

Background : Coronary Artery Disease (CAD) especially ST-Elevation Myocardial Infarction (STEMI) is the leading cause of mortality worldwide. Hyperglycemia and diabetes mellitus are both prevalent among patients with STEMI admitted to the hospital. Glycated hemoglobin (HbA1c) is a marker of glucose control.Objectives : We aimed to investigate the role of HbA1c as the predictor of major adverse cardiovascular events in STEMI patients.Methods : This was a retrospective cohort study. STEMI patients visiting Saiful Anwar General Hospital were registered. Patients were divided into three groups based on the HbA1c level <6.5%; 6.5-8.4% and ≥8.5%; respectively. The primary endpoint was in-hospital Major Adverse Cardiovascular Events (MACE), including cardiac death, recurrent myocardial infarction (MI), recurrent revascularization, acute pulmonary edema, cardiogenic shock, malignant arrhythmia, and stroke.Results: A total of 118 STEMI patients were included in this study, with distribution of 61 patients with HbA1c <6.5%, 25 patients with HbA1c 6.5-8.4%, and 31 patients with HbA1c ≥8.5%; respectively. The HbA1C level was associated with the history of diabetes mellitus (3.2% vs 36% vs 71%; p =0.000) and random blood glucose level at hospital admission (140.71 ± 39.67 mg/dL vs 172.96 ± 53.43 mg/dL vs 366.61 ± 169.67 mg/dL; p = 0.000). The MACE among three groups was not significantly different (17.7% vs 20% vs 35.5%; p=0,149). Conclusion: Our study reveals that the HbA1c level at hospital admission is associated with the history of diabetes mellitus and random blood glucose at hospital admission. However, HbA1c could not predict MACE in STEMI patients

When to Return for Usual Activity After ACS The Benefit of Cardiac Rehabilitation Cholid Tri Tjahjono
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.2020.001.04.01

Cardiac rehabilitation (CR) can be managed as global long-term care and comprehensive risk reduction of cardiac patients based on preventive care through a professional multi-disciplinary integrated process approach.11 Multidisciplinary CR elements include: patient evaluations, physical activity counselling, exercise training, diet/nutritional counseling, psychosocial management, lipid management, smoking avoidance, management of weight, and regulation of blood pressure. Exercise training if begun at the post-ACS acute phase, would achieve its greatest beneficial effect on the process of LV remodeling in the dysfunctional LV and cardiopulmonary rehabilitation in patients after acute coronary syndrome. Cardiac rehabilitation (CR) can be managed as global long-term care and comprehensive risk reduction of cardiac patients based on preventive care through a professional multi-disciplinary integrated process approach

Validation of Saiful Anwar Clinical Congestion Score in Comparison with NT-proBNP for Prediction of Short-term Outcome in Acute Heart Failure with Reduced Ejection Fraction Liemena Harold Adrian; Mohammad Saifur Rohman; Muhammad Rizki Fadlan; Cholid Tri Tjahjono; Anna Fuji Rahimah; Novi Kurnianingsih
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.2020.001.04.06

Background : Risk stratification of acute heart failure (AHF) patient during hospital admission utilizing clinical scores emerges as an alternative to standart natriuretic peptide measurement. Development of Saiful Anwar clinical congestion score (SACS) as multivariable predictive model for prediction of short-term outcome in AHF with reduced ejection fraction (AHF-rEF) requires validation in comparison to NT-proBNP.Objective : To validate prognostic value of SACS compare with NT-proBNP in AHF-rEFMethod : This single-center, prospective cohort study was held in dr. Saiful Anwar General Hospital during January 2019 to June 2020. From total 89 AHF-rEF patients who admitted to emergency department, were assigned to SACS prospective questionnaire fulfillment and NT-proBNP measurement during first 12-hours since admission. Patients were divided into two groups based on SACS score and NT-proBNP value during admission. 90-days follow up was performed after index hospitalization with outcome of interest i.e all-cause mortality (ACM) and HF-related rehospitalization (HFR).Results : ACM and HFR rate in this study were 16.8% and 22.5%, respectively. SACS ≥6 demonstrated higher ACM and HFR rate during 90-days follow-up compared to SACS <6 (p=0.000; p=0.000, respectively). Performance of SACS ≥6 on admission showed good discriminative power for predicting 90-days ACM and HFR (AUC 0.841, p=0.000; AUC 0.788, p=0.000, respectively) compared to NT-proBNP ≥5000pg/mL (AUC 0.812, p=0.000; AUC 0.819, p=0.000, respectively). Additive value of NT-proBNP ≥5000pg/mL on top of SACS ≥6 increases discriminative power for predicting 90-days ACM and HFR after index hospitalization (AUC 0.836, p=0.000; AUC 0.90, p=0.000, respectively).Comclusion : SACS has demonstrated prognostic value compared to NT-proBNP for prediction of 90-days ACM and HFR after index hospitalization in AHF-rEF patients.

The Role of Garcinia Mangostana Pericarp Extract as Antioxidant to Inhibit Atherosclerosis Process in High Risk Framingham Score Patient; Original Article Aris Munandar ZI; Djanggan Sargowo; Ardian Rizal; Cholid Tri Tjahjono; Sasmojo Widito; Anna Fuji Rahimah
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.2021.002.01.04

Atherosclerosis is the pivotal role of cardiovascular disease (CVD) involving oxidative stress dan inflammation. Garcinia has anti-oxidant property for years. This study was performed to explore the role of α-Mangostin of Garcia Mangostana Pericarp Extract as an antioxidant in inhibiting atherosclerotic process in patients with high-risk Framingham score. Methods: This prospective cohort design was led in 90 grown-ups with high hazard cardiovascular score which were resolved dependent on Framingham criteria, age 50–70 years of age. The patients were divided into two groups. One group was administered 2520 mg/day Garcinia mangostana Linn extracts (GMLE) in 3 divided doses for 90 days and the other group was administered a placebo. Parameters were Nitric Oxide (NO), Superoxide Dismutase (SOD) and Malondialdehyde (MDA), measured at baseline and after 90 days of treatment. An Independent T-test was performed for normally distributed data and the Mann-Whitney test was performed for abnormally distributed data with a significance level of p≤0.05.Results: Among the 77 subjects, we found that the plasma, MDA, concentration was significantly decreased compared with placebo 0,29±0.5 vs -0.04±0.25, respectively p = 0.011). SOD level significantly decreased in GMLE patients compared with placebo patients (0,17±0.79 vs -0.27±0.67, respectively, p=0.010) and we found that there was slightly increased in nitric oxide (NO), but no significantly compared with placebo 4.34±10.01 and 2.35±7.39, respectively, p = 0.37).Conclusion: Garcinia mangostana pericarp extract has an antioxidant effect that significantly inhibit atherosclerosis process in high-risk Framingham score patients

Impacts of Residual SNYTAX Score on The Clinical Outcomes following Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients Wira Kimahesa Anggoro; Mohammad Saifur Rohman; Heny Martini; Pawik Supriadi; Cholid Tri Tjahjono; Yoga Waranugraha
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.2021.002.03.4

Background: The residual SYNTAX score (RSS) can be used to measure the residual stenosis severity and complexity. The prognostic role of RSS in CCS patients is still unknown. We purposed to investigate the impact of RSS on the clinical outcomes following PCI in CCS patients. Methods: A prospective cohort study was performed. Based on the residual SYNTAX score, patients were divided into three groups: RSS 0, RSS 0 to 9.5, and RSS >9.5. The primary outcome was patient-oriented composite endpoint (POCE), including repeat revascularization, myocardial infarction, and all-cause mortality. Results: After 1-year follow-up period, patients in RSS >9.5 group revealed the greater POCE (4.3% vs. 6.4% vs. 23.9%; p = 0.016) than others. The repeat revascularization rate also was greater in the RSS >9.5 group (0.0% vs. 6.4% vs. 19.6%; p = 0.012). However, the hospitalization due to angina rates in all groups was not significantly different (4.3% vs. 4.2% vs. 4.3%; p = 1.000). The multivariate analysis revealed that RSS >9.5 was the strong predictor for repeat revascularization during 1 year follow-up (Odds ratio [OR] = 9.605; 95% confidence interval [CI] = 1.207 - 76.458; p = 0.033). Conclusion: The greater RSS was associated with the higher 1-year POCE and repeat revascularization rate in CCS patients. The high RSS was also the strong predictor for 1-year repeat revascularization for CCS patients.

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

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.

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

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

Co-Authors Adhika Prastya Wikananda Aditya Reza Pratama Adriyawan Widya Nugraha Afifah, Yuri Afifuddin, Mokhammad Alfata, Fandy Hazzy Amanda, Febrina Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Anjarwani, Setyasih Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardani Galih Ardhani Galih Ardhani Galih Ardhia, Jessica Fio Ardian Rizal Ardian Rizal Arif Wicaksono Arif Wicaksono Arifah, Medisa Roro Putri Nur Aris Munandar ZI Arityanti, Dean Aryanugraha, Teguh Ashari, Yordan Wicaksono Astiawati, Tri Ayu Asri Devi Adityawati Ayu Asri Devi Adityawati Badai Bhatara Tiksnadi Bambang Rahardjo Budi Satrijo Budi Satrijo Dadang Hendrawan David Rubiyaktho Dedy Irawan Desandri, Dwita Rian Diah Ivana Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Dwiputra, Bambang Elvira Sari Dewi Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Erwan, Nabila Erina Evit Ruspiono Evit Ruspiono Fahmy Rusnanta Fandy Hazzi Alfata Fathurohim, Zainal Febrianora, Mega Firdaus, Achmad Jauhar Fitra, Maha Galih Prakosa, Ardani Hasan, Harris Hayati, Yati Sri Hendrawati Hendrawati Heny Martini Heny Martini Hergaf, Indah Widyasari Hidayanti, Puji Astuti Nur Idris Idham Ikeningrum, Dyah Ayu Imelda Krisnasari Indhiarti, Tantri Refa Indra Prasetya Indra Prasetya Indra Prasetya Indriani, Anin Indriyani, Damayanti Irsad Andi Arso, Irsad Andi Iskandar Iskandar Jannah, Riska Raudhatul Kartika, Annisa Wuri Krevani, Citra Kiki Kurnianingsih, Novi Lestari, Defyna Dwi Liemena Harold Adrian Machfud, Savinka Salsabiela Iriana Maimun Zulhaidah Arthamin, Maimun Zulhaidah Makes, Indira Kalyana Martini, Heny Mayangsari, Veny Mifetika Lukitasari Mohammad Ryan Ramadhan Mohammad Saifur Rohman Mohammad Saifur Rohman Monika Sitio Muchammad Dzikrul Haq Karimullah Muhammad Abusari Muhammad Firdaus Muhammad Munawar Muhammad Ridwan Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Rizki Fadlan Ni Putu Frida Baskarani Novi Kurnianingsih Novi Kurniningsih Oktafin Srywati Pamuna Olivia Handayani Pawik Supriadi Pratiwi, Irma Kamelia Puji Astuti Nur Hidayanti Putri, Valerina Yogibuana Swastika Qhabibi, Faqrizal Ria Rahimah, Anna Fuji Ratna Pancasari Raynaldo, Abdul Halim Rita Hamdani Rizal, Ardian RWM Kaligis Saskia Dyah Handari Sasmojo Widito Sasmojo Widito Satrijo, Budi Satwikajati, Sawitri sawitri satwikajati Seprian Widasmara Setyasih Anjarwani Setyowati, Danti Utami Susilowati, Eliana Swastika Putri, Valerinna Yogibuana Swastikaputri, Valerina Yogibuana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Titin Andri Wihastuti Tonny Adriyanto Vori, Ira Widiani, Luh Widito, Sasmojo Wira Kimahesa Anggoro Wulandari, Ayu Pramitha Yasmine Fitrina Siregar Yoga Waranugraha Yogibuana, Valerinna Yudha, Tria Yusuf Arifin Zulhaidah A, Maimun

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