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

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The Relationship of Heart Rate Recovery Post Exercise Stress Test To Syntax Values In Patients With Stable Coronary Artery Disease Iskandar, Iskandar; Anjarwani, Setyasih; Tjahjono, Cholid Tri; Satrijo, Budi; Swastika Putri, Valerinna Yogibuana
Heart Science Journal Vol. 3 No. 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improv
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.4

Abstract

Background:The prognostic usefulness of abnormal heart rate recovery (HRR) as a predictor of death has been discovered. Abnormal HRR results from inadequate vagal activation after exercise. The association between HRR and angiography in CAD (coronary artery disease) has been studied, however the conclusions are still being contested due to a lack of data. The purpose of this study is to see if HRR after an EST (exercise stress test) may predict the severity of syntax values in individuals with stable CAD at Saiful Anwar Hospital Malang (RSSA). Methods:This study is an analytic observational study with a retrospective cross sectional design. It was held in Saful anwar, Malang Hospital during January 2017–December 2019, including 366 patients. All patients underwent exercise stress test for CAD screening and coroner angiography. Those were divided into two groups, which included syntax score  < 23 (n=148) and syntax score ≥ 23 (n= 218). Result: Chi-square analysis was used to analyze the relationship correlation between HRR1, HRR2 and Syntax Score, and was used to compared between HRR1 (heart rate recovery first minutes), HRR2 (heart rate recovery second minute) and Syntax Score group. The confounding factor was adjusted with multivariate logistic regression analysis and AUC curve. There was a significant negatif correlation between abnormal HRR1 and HRR2 after exercise and Syntax score, with strong correlation (HRR1 ; OR = -2.11, p = 0.00 AUC :90,8%, HRR2 ; OR = -1,6, p = 0,48, AUC : 70,4%).  Conclusion: Abnormal first and second minutes of HRR after exercise stress test in stable CAD patient have a higher incidence of high Syntax Score (>1) than stable CAD patient with normal HRR. Keywords: Coronary artery disease (CAD), Heart rate recovery (HRR), Syntax. 
Correlation Between Smoking and Il-1 Level and Arterial Stiffness as Measured By Cavi in the Young Adult Population Without other Cardiovascular Risk Factors. Galih Prakosa, Ardani; Tjahjono, Cholid Tri; Kurnianingsih, Novi; Sargowo, Djanggan; Anjarwani, Setyasih
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.2023.004.03.5

Abstract

Background: Recent studies have shown that arterial stiffness is a strong predictor of cardiovascular events and all-cause mortality, with CAVI (Cardio-Ankle Vascular Index) as a non-invasive arterial stiffness testing method indaily practice.Objective: This study was conducted to examine the relationship between smoking -as a risk factor for arterial stiffness- and CAVI values, as well as levels of IL-1β (Interleukin 1β) as a cytokine that plays a role in the pathophysiology of arterial stiffness.Methods: Eighty-four participants, including smokers and non-smokers without other cardiovascular risk factors, were included in the study. Demographic data, medical history, and smoking behavior were taken using a questionnaire, then IL-1β and CAVI levels were examinedResults: The mean level of IL-1β in smoking subjects was significantly higher (15.09 ± 0.48) than in non-smoking subjects (5.53 ± 0.79; p=0.001). CAVI values in smoking subjects were also significantly higher (8.0 ± 0.06) than in non-smoking subjects (6.9 ± 0.02; p=0.001). Further analysis showed a strong positive correlation between smoking and IL-1β levels (r=+0.776; p=0.001) and CAVI values (r=+0.759; p=0.001).Conclusion: This study shows that smoking significantly correlates with IL-1β levels and CAVI values. The greater number of cigarettes used per day and the longer duration of smoking, there was a positive correlation between IL-1β levels and arterial stiffness as measured by CAVI.
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.
The Effect of Exercise Training as Adjuvant Treatment on Functional Capacity in Congenital Heart Disease with Negative Vaso Reactivity Test Pulmonary Hypertension Patient at Saiful Anwar Hospital Malang Pratiwi, Irma Kamelia; Martini, Heny; Tjahjono, Cholid Tri; Anjarwani, Setyasih; Handari, Saskia Dyah
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.2023.004.03.3

Abstract

BackgroundPulmonary hypertension associated with congenital heart disease (CHD) is an important subgroup that accounts for approximately 11% of all patients with PAH. Physical limitations are one of the main symptoms of hemodynamic changes in patients with PH. Objective This study aimed to evaluate the effect of physical exercise therapy for 12 weeks as an additional therapy with PDE-5 inhibitors on the functional capacity of patients with Congenital Heart Disease accompanied by Pulmonary Artery Hypertension (CHD – PH). MethodThis research was an analytic experimental study with a prospective cohort research method. This study used data sources obtained from medical records to adjust subjects based on inclusion and exclusion criteria, initial cardiac training test examination data was carried out at IPJT in patients selected as subjects. The patient's clinical outcomes were followed in the next 12 weeks. ResultThis research was conducted on 16 samples divided into two groups, namely the control and study groups. The evaluation after 12 weeks found that there was an increase in mileage as measured through the 6MWT submaximal test and a better duration of physical activity in the study group tested through the Endurance Shuttle Walk Test (ESWT). This is consistent with the effect of physical exercise, which suppresses systemic inflammation and causes vasodilation, thereby increasing oxygen delivery to the tissues. This causes more optimal aerobic metabolism and reduces lactate production. So that the patient did not quickly feel tired during activities. However, there was no significant increase in the Incremental Shuttle Walk Test. This could be due to the relatively short training duration of 12 weeks. Conclusion A positive correlation exists between physical exercise and increased functional capacity of patients with CHD who were evaluated using 6MWT and ESWT.
Interleukin-6 (IL-6) as a Marker of Endothelial Dysfunction Confirmed Using Flow Mediated Dilatation in Active Smoker Wicaksono, Arif; Kurnianingsih, Novi; Tjahjono, Cholid Tri; Widito, Sasmojo; Swastikaputri, Valerina Yogibuana; Wihastuti, Titin Andri
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.4

Abstract

Background: The pro-inflammatory cytokine interleukin-6 (IL-6) is thought to be the catalyst for endothelial dysfunction caused by smoking. Flow-mediated dilatation (FMD) is a non-invasive method to identify the development of blood vessel endothelial dysfunction at an early stage. However, several studies have not sufficiently explained how smoking and IL-6 interact.Objective: This study focuses on the role of Interleukin-6 (IL-6) in the process of endothelial dysfunction confirmed using non-invasive modalities such as Flow Mediated Dilatation (FMD) in smokers related to the risk of cardiovascular disease in the future with the hope of providing insight in education to smokers to quit smoking.Material and Methods: In this study, we gathered 116 male participants, of which 56 were nonsmokers, and 60 were smokers, and we used IL-6 and FMD testing. SPSS for Windows version 23 will be used to analyze the data.Result: According to the analysis of laboratory tests, the average IL-6 level in light smokers was 67.7±3.2 and in moderate smokers it was 95.1±11.0; with a p-value of 0.009, indicating a significant difference among the groups. The average FMD in the smoking group was 5.4±0.4% (p-value 0.000), whereas the average FMD in the non-smoker samples was 10.9±0.9%. We also looked at the average FMD among light and moderate smokers based on Brinkman Index, which was 5.5±0.4% and 5.0±0.4%, with a p-value of 0.780, indicating no significant difference between the groupsConclusion: Compared to non-smokers, this study demonstrates a correlation between IL-6 and smoking activity. However, there was no statistically significant difference between the prevalence of endothelial dysfunction and the degree of smoking dependence in this investigation.
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.
Correlation Study of Cotinine and Monocyte Chemoattractant Protein-1 (MCP-1) with Carotid Intima-Media Thickness (cIMT) in Male Active Tobacco Smoke Satwikajati, Sawitri; Kurnianingsih, Novi; Tjahjono, Cholid Tri; Wihastuti, Titin Andri; Sargowo, Djanggan; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.6

Abstract

Background : Tobacco smoke exposure induces intima-media thickness by reducing nitric oxide and increasing adhesive molecule activity, with circulating cotinine serving as a marker; we hypothesize a correlation between monocyte chemoattractant protein-1 (MCP-1) and carotid intima-media thickness (cIMT) in active male smokers. Method : We conducted an observational cross-sectional analytic study involving 125 male participants, with 62 being active tobacco smokers and 63 non-smokers. Data were presented as mean ± SD, and the correlation between variables was analyzed using Pearson correlation. Result : Cotinine and MCP-1 levels were significantly higher in the smoker population (p 0.000) compared to non-smokers. The incidence of positive cIMT findings was higher in the smoker group (5%) than in the non-smoker group (2%). In the active smoker population, cotinine (r 0.21; p 0.11) showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 showed a negative correlation (r -0.19, p 0.14) with positive cIMT findings. Smoking duration (r 0.162; p 0.223) and the amount of tobacco smoke (r 0.003; p 0.982) demonstrated a positive correlation with cotinine. MCP-1 exhibited a non-significant positive correlation with smoking duration (r 0.122; p 0.345) and a non-significant negative correlation with the amount of tobacco smoke (r -0.002; p 0.989). Conclusion : Among active tobacco smokers, cotinine showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 exhibited a non-significant negative correlation with positive cIMT findings. 
Hypothermia theraphy in patients post cardiac arrest Yudha, Tria; Prasetya, Indra; Tjahjono, Cholid Tri; Anjarwani, Setyasih
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.2025.006.01.5

Abstract

Cardiovascular disease is the leading cause of death in several developing countries, and many of these deaths occur before reaching the hospital due to cardiac arrest. Most patients who return to spontaneous circulation (ROSC) and are brought to the hospital experience severe neurological damage during cardiac arrest, and this damage is the cause of in-hospital mortality. Improvements in survival and neurologic improvement of patients with CA have focused on two main therapy areas. The first area is improved education and skills of medical and paramedical personnel to improve perfusion post CA. The second area is a greater emphasis on post-resuscitation care which includes optimizing oxygenation and ventilation, avoiding hypotension, treating causes of CA such as acute coronary ischemia, and initiating hypothermia therapy if necessary, as in the 2020 guidelines and recommendations from the American Heart Association (AHA), International Liaison Committee of Resuscitation, and European Resuscitation Council covering the entire spectrum of post-resuscitation care.  The AHA guidelines 2020 recommend optimizing hypothermia therapy for 24 hours with a target temperature between 320C - 360C in ROSC patients to improve clinical outcomes of neurological status after cardiac arrest. This is contrast to the study of Martinell et al in their research which concluded that there was no significant difference in survival rates within 30 days after cardiac arrest in patients who received either hypothermia therapy or those who did not. Hypothermia therapy, which is currently part of the post-resuscitation care recommendations, has varied variables and remains controversial in its implementation. Based on this, this referent will discuss the effects of hypothermia therapy on post-cardiac arrest patients, the stages, and the practical aspects of implementing hypothermia therapy.
Correlation Between Platelet Index, Neutrophil-Lymphocyte Ratio, and Mean Platelet-Volume Lymphocyte Ration with Lesion in Chronic Coronary Syndrome Based on SYNTAX Score Fathurohim, Zainal; Tjahjono, Cholid Tri; Arthamin, Maimun Zulhaidah; Kurnianingsih, Novi
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.5

Abstract

AbstractBackground: Platelet aggregation and inflammation have been associated with atherosclerosis, and inflammatory parameters such as mean platelet volume (MPV), platelet distribution width (PDW), neutrophil-lymphocyte ratio (NLR), and mean platelet-lymphocyte volume ratio (MPLVR) are often used. However, the relationship between these inflammatory parameters and the SYNTAX Score in CAD remains uncertain.Objective : The purpose of this study was to investigate the relationship between angiographic SYNTAX score, NLR, and platelet parameters (MPV, PLR, MPLVR).Material and Methods : We conducted a study involving patients undergoing elective coronary angiography from January 2023 to June 2023 at Dr. Saiful Anwar General Hospital, who were 18 years of age or older and had CAD. All participants willingly agreed to be part of the study. We collected complete routine blood counts and performed blood biochemistry assessments 24 hours before the coronary angiography procedure. Pearson's correlation was used to examine the relationship between the variables.Result: A total of 366 individuals meeting the study's inclusion criteria were included. MPV, PLR, MPLVR, NLR, and PDW showed weak to negligible correlations with the SYNTAX Score, displaying correlation coefficients of 0.260, 0.190, 0.320, 0.470, and 0.290, respectively, all with p-values <0.001.Conclusion: This study in individuals with coronary artery disease revealed a limited to negligible correlation between the SYNTAX Score and inflammatory parameters including MPV, PLR, MPLVR, NLR, and PDW. 
The Role of Antioxidants and Anti-Inflammatory Agents in Cardiometabolic Disease Aryanugraha, Teguh; Sargowo, Djanggan; Rahimah, Anna Fuji; Tjahjono, Cholid Tri
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.3

Abstract

Cardiovascular diseases remain a major cause of morbidity and mortality worldwide. Cardiovascular diseases associated with metabolic disorders are collectively referred to as Cardiometabolic Diseases (CMDs). Oxidative stress and inflammation are key contributors to the development and progression of CMDs. Antioxidants and anti-inflammatory agents have garnered significant attention as potential therapeutic strategies for preventing and managing cardiovascular disorders. To better understand the complex interactions between oxidative stress, inflammation, and cardiovascular health, this review paper will focus on the mechanisms of action and potential advantages of antioxidants and anti-inflammatory drugs in reducing the risk factors associated with CVDs and enhancing cardiovascular health in general.
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