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Budi Satrijo

Department Of Cardiology And Vascular Medicine Medical Faculty Of Universitas Brawijaya Dr. Saiful Anwar General Hospital Malang, Indonesia

Author-ID : 3606198

Health Professions Immunology & microbiology Medicine & Pharmacology Nursing

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Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: Late is Better Than Not Done at All Hendrawati Hendrawati; Mohammad Saifur Rohman; Cholid Tri Tjahjono; Sasmojo Widito; Budi Satrijo; Yoga Waranugraha; Muhammad Rizki Fadlan
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.2020.001.03.5

Background : For ST-segment elevation myocardial infarction (STEMI) patients, reperfusion through primary percutaneous coronary intervention (PCI) must be done to return the coronary arteries' blood flow. However, a large proportion of patients received late PCI. This study aimed to assess the impact of late PCI on the clinical outcomes of STEMI patients.Methods : A retrospective cohort study was conducted in Saiful Anwar General Hospital from January 2017 to April 2018. A total of 192 STEMI patients were divided into three groups: (1) on-time PCI; (2) late PCI; and (3) no PCI. The outcome measured included six months and 12 months of cardiovascular mortality and hospital readmission because of worsening heart failure and recurrent myocardial infarction (MI).Results: At six-month follow-up period, we found that hospital readmission was higher in the no PCI group (9.2% vs. 12.1% vs. 34.8%; p = 0.009). The recurrent MI (0% vs. 0% vs. 7.2%; p = 0.010) and worsening heart failure (6.2% vs. 8.6% vs. 33.3%; p < 0.001) was also higher in the no PCI group. On 12 months follow up period, the mortality (4.6% vs. 13.8% vs. 21.7%; p = 0.015) and hospital readmission (15.4% vs. 20.7% vs. 42%; p = 0.001) rate was higher in no PCI group. Hospital readmission because of worsening heart failure was also higher in no PCI group (9.2% vs. 17.2% vs. 37.7%; p = 0.015).Conclusion: Not performing revascularization was correlated with higher mortality and hospital readmission rate in STEMI patients. Late PCI was associated with better outcomes than not conducting revascularization.

Reperfusion Arrhythmia in Acute Myocardial Infarction: Clinical Implication and Management Harris Kristanto; Budi Satrijo; Sasmojo Widito; Ardian Rizal
Heart Science Journal Vol 3, No 1 (2022): Assesment and Outcome of Coronary Artery Disease in the Reperfusion Era
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.01.2

Reperfusion is a critical component of myocardium survival in acute myocardial infarction to minimize infarct size and improve clinical prognosis. Reperfusion, on the other hand, may result in increased and accelerated myocardial injury, a condition known as reperfusion injury. Following reperfusion, several arrhythmias are observed, and it is called reperfusion arrhythmia. Reperfusion arrhythmia is one manifestation of reperfusion injury. Numerous modest studies have evaluated what reperfusion arrhythmias are defined. It is described as an arrhythmia that occurs immediately or within the first minutes after coronary blood flow is restored. Traditionally, Accelerated Idioventricular Rhythm (AIVR) has been seen as a reperfusion arrhythmia. However, reperfusion may reveal any arrhythmia (or none at all); conversely, AIVR may occur in the absence of reperfusion. Calcium excess within the cells is thought to be a significant factor in the development of reperfusion arrhythmias. This may affect the significant delay following depolarization and the regional heterogeneity of regional blood flow restoration inside the ischemic zone, resulting in reperfusion arrhythmia. In some studies, it was mentioned that these arrhythmias may be due to ongoing myocardial cell damage and ischemia. Arrhythmias associated with reperfusion require special attention since hemodynamics can deteriorate quickly. In this review, clinical significance and management of reperfusion arrhythmia, as well as its link with reperfusion injury will be discussed.

Left Atrial Emptying Fraction as Precictor Parameter of Major Adverse Cardiovascular Events (MACE) and Decrease of Functional Capacity in Patients With STEMI Treated by Primary Percutaneous Coronary Intervention Harris Kristanto; Budi Satrijo; Anna Fuji Rahimah
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.2022.003.02.4

Background: HF is common following ST-elevated myocardial infarction (STEMI) and aasociated with morbidity and mortality. Echocardiography is routine examination and commonly utilized for risk stratification. In current guideline. Enlarged LA volume, doppler parameter, and tissue doppler imaging were used for diastolic dysfunction. However, they have several limitation. LAEF may be superior to LAVI, doppler parameter, or TDI as markers of cardiac function in acute phase after AMI. This study conducted to assess the LAEF in predicting death, rehospitalization of heart failure (HF), and decrease functional capacity after STEMI.Methods and Results: Between January 2018 and January 2021, 391 patients with STEMI who got primary percutaneous coronary intervention were included. After STEMI, patients had echocardiography within 48 hours. All of the patients were subjected to standardized 2-dimensional echocardiography procedures. The LAEF was determined by dividing the maximal LA volume by the minimal LA volume. The primary endpoint of this study was a Major Adverse Cardiovascular Events that consisting of all-cause death and rehospitalization because decompensation of heart failure within 12 months. The secondary end point was decline of functional capacity within 12 months. During the 12-month follow-up period, 162 individuals developed MACE. Only LAEF remained an independent predictor of MACE after adjusting for clinical, biochemical, and echocardiographic factors. (P = 0.000, Odds Ratio 15,46 (CI 95%: 9,264 – 26,409)). For secondary end point, there was a significant difference in the number of patients experiencing decreased functional capacity between the groups with LAEF ≥37.5% and LAEF <37.5% (based on cut off value) in the 6-month range (p=0.000 ) and was consistent within 12 months (p=0.000).Conclusion: LAEF can be a predictor of MACE and decline functional capacity of STEMI patients who have undergone primary PCI within 12 months.

In-hospital Mortality Reduction among Heart Failure Patients Treated with Optimal Dose of Angiotensin-Converting Enzyme Inhibitors Yoseph Budi Utomo; Mohammad Saifur Rohman; Yoga Waranugraha; Djanggan Sargowo; Sasmojo Widito; Budi Satrijo; Setyasih Anjarwani
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Background : Angiotensin-converting enzyme inhibitors (ACEI) should be titrated to the optimal dose for adequate inhibition of the Renin-Angiotensin-Aldosterone system (RAAS). The up-titration of ACEI to the optimal doses during in-hospital treatment is challenging.Objectives : This study aimed to investigate whether the use of optimal dose of ACEI during in-hospital treatment could give more benefit to the outcome of heart failure (HF) patients.Methods : We involved 171 HF patients in this prospective cohort study. 29 and 142 HF patients were treated with optimal dose and suboptimal dose of ACEI during in-hospital treatment, respectively. The primary endpoint was in-hospital and 30 days post-discharge mortality. The secondary endpoint was 30 days post-discharge rehospitalization due to worsening of HF.Results: Only 17% of HF patients treated with optimal dose of ACEI during in-hospital treatment. In-hospital mortality in optimal dose of ACEI group was lower than in suboptimal dose of ACEI group (0% vs. 19.7%; p = 0.009). The 30 days post-discharge mortality (0% vs 2.7%; p = 0.375) and rehospitalization (6.9% vs 16.7%; p = 0.184) between both groups were not significantly different.Conclusion: The use of optimal dose of ACEI during in-hospital treatment reduced in-hospital mortality in HF patients.

Intraprocedural Stent Thrombosis During Percutaneous Coronary Intervention: How to Predict Bayu Aji; Mohammad Saifur Rohman; Budi Satrijo; Arief Wibisono
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.2022.003.02.7

Background: Intraprocedural stent thrombosis (IPST) during percutaneous coronary intervention (PCI) is an uncommon event that results in a poor outcome including STEMI and sudden cardiac death. Concerns about an increased risk of stent thrombosis with drug-eluting stents (DES) continue, even though the incidence, timing, and predictors of stent thrombosis with DES have not been identified.Objective: This study aimed to describe the diagnosis and management of Intraprocedural Stent Thrombosis.Case presentation: We will discuss a 49 year-old male brought to our hospital because of chest pain while doing moderate activity. One month prior to admission, he had history of acute coronary syndrome and 1 DES on right coronary artery was placed. Ticagrelor and aspirin were routinely consumed as dual antiplatelet therapy. The patient was diagnosed with intraprocedural stent thrombosis during PCI with the evidence of intra-catheter thrombosis and ST segment elevations seen in the ECG monitor. We treat the patient with Ticagrelor 180 mg loading dose and intracoronary unfractionated heparin (UFH) during procedure continued with continuous infusion until 24 hours. No event of subsequent acute coronary syndrome was observed.Conclusion: Intraprocedural Stent Thrombosis was a strong predictor of mortality in STEMI patients. This case showed that the present widespread use of DES instead of BMS for coronary implantation although decreased the future risk of repeat revascularization, increased the risk of thrombosis. Prior risk stratification, potent early antiplatelet treatment and anticoagulant of choice with UFH might be used to reduce the risk of thrombosis in STEMI patients undergoing stent implantation.

Common Femoral Artery Aneurysm: A Challenging Diagnostic and Treatment of a Rare Case Ayu Asri Devi Adityawati; Novi Kurnianingsih; Budi Satrijo; Indra Prasetya
Heart Science Journal Vol 2, No 2 (2021): Dealing with Vascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.02.7

BACKGROUND: Aneurysm of peripheral artery is a rare vascular pathology, especially aneurysm in common femoral artery. Here, we presented a case report of right common femoral artery aneurysm caused by infectionCASE REPORT: a 76-year-old man referred to our hospital with pulsatile groin mass at his right thigh. He had no prior history of surgery or traumas, but he has been treated in private hospital due to septic condition, hypertension, and diabetes mellitus type II. Based on findings from physical examination and radiology examination, a diagnosis of common femoral artery aneurysm was made. The patient was referred to Cardiovascular and Thoracic Surgeon Department and scheduled for routine surgery, but on third day of admission patient became hemodynamically unstable and on re-examination it was found that the aneurysm had been ruptured. Emergency surgery was conducted on that day. During surgery patient was hemodynamically stable with PRC transfusion.DISCUSSION: Aneurysms can occur in almost any artery in the body. Femoral artery aneurysm was rare. Diagnostic procedure with various modalities were needed to establish a precise diagnosis for patient which come with swelling in his/her lower extremity. Doppler ultrasound was conducted in order to find a saccular mass with neck and a yin and yang phenomenon, which can narrow down the differential diagnosis to pseudoaneurysm or aneurysm. Subsequent CT angiography clearly confirmed the involvement of 3 layer arterial wall as a sign of an aneurysm. Femoral artery aneurysms (FAA) may be caused by weakening of the arterial wall due to atherosclerosis or mycotic aneurysm. Surgical repair of aneurysm is an option when symptomatic and that should also be considered when there is ongoing hemodynamic instability or limb ischemia.CONCLUSION: The common femoral artery aneurysm aren’t common. It is very rarely to be isolated aneurysm and usually don’t tend to be rupture. Whenever a femoral artery aneurysm is found, search and follow-up for other aneurysms should take place. Annual follow-up is recommended. Straightforward surgical management brings good results in this group of patient. Keywords: Femoral artery aneurysm, Common femoral artery aneurysm, Isolated aneurysm, Mycotic aneurysm

Diuretic Resistance in Advanced Heart Failure Anita Surya Santoso; Mohammad Saifur Rohman; Indra Prasetya; Budi Satrijo
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.2021.002.01.02

Advanced heart failure (HF) is used to characterized patients in HF with severe symptoms, recurrent decompensation and severe cardiac dysfunction. The prevalencekof HFkis approximatelyg1-2% of thecadult population inhdeveloped countries and it will be rising more than 10%pamongapeoplec>70ayears of age, whereas estimated theoprevalence ofcpatients with advanced HF is about 1% until 10%cof thekoverallkHFopopulation. Most ofkthe HF hospitalizationssare due to signs and symptoms of fluidcoverload.Recurrent congestionccould worsen patientssoutcomes.Loopdiureticssare recommended for thectreatmentcofkcongestionqinprHF patient. cHowever,cdiureticvresistanceeispavcommon problem issueiinpacuteqdecompensationtofcadvancedochronicrheartwfailureq(ACHF) patients and established prognostic factor. Some early reports estimated the prevalence of diuretic resistance about 20%-30% in HF population. In this review, we will be discuss how to diagnose the advancedvheartufailurepand the underlying mechanism of diuretic resistancebin HF patients. We also describe pharmacologicalvand non-pharmacologicalstrategies to overcome this issue.

Trapping Technique for Successful Retrieval of a Ruptured Balloon Catheter Entrapped in Coronary Artery : A Case Report Putri Annisa Kamila; Budi Satrijo; Mohammad Saifur Rohman; Heny Martini; Indra Prasetya
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Introduction: Device entrapment during PCI is an uncommon complication with incidence of less than 1%. Percutaneous retrieval should be favored as the treatment of choice for this condition.Case Illustration: A 61-year-old patient came for an elective percutaneous coronary intervention (PCI) procedure. She suffered from chest pain while doing moderate activities for 1 month. Angiography showed a diffuse lesion with maximum stenosis 90% in the proximal LAD, stenosis 75% in the proximal of Left Circumflex Artery (LCx), and diffuse lesions in the proximal and mid of the Right Coronary Artery (RCA). We decided to perform PCI in the LAD. A transfemoral coronary intervention was performed using a Judkins Left 3.5 (7F) guiding catheter to engage the LAD. A Guidewire ( Run-through NS Floppy) was advanced to the distal LAD. Balloon angioplasty was performed with a 2.75 x 15 mm Fluydo balloon in the proximal LAD at 16 bars, but the balloon was entrapped and while withdrawing the balloon, it accidentally ruptured in the LAD artery with the remaining segment inside the guiding catheter. A second Run-through NS Floppy Guidewire was inserted across the ruptured balloon and a 2.5 x 20 mm Fluydo Balloon was passed on the second wire and was inflated at 16 atm pressure, inside the guiding catheter, trapping the ruptured balloon. The ruptured balloon was successfully removed, by withdrawing the whole system, including the guiding catheter and the wire. Finally, we re-engaged the LAD with the same guiding catheter, passed the wire, and post dilated the stent on the LAD to achieve a good result.Conclusion: Percutaneous retrieval using trapping technique could represent a safe and effective technique for ruptured and entrapment of a balloon-catheter in a coronary artery.

The Role of Colchicine in Acute Coronary Syndrome Liemena Harold Adrian; Budi Satrijo; Djanggan Sargowo; Indra Prasetya
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.2020.001.04.02

Background: Despite the advances of current optimal treatment of atherosclerotic disease, the incidence of events after acute coronary syndrome (ACS) remains high. Colchicine, with its well-established pleiotropic anti-inflam- matory effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation. NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitated by cholesterol crystals that are present in all atherosclerosis stages. ???????????????????????????????????????? ???????????????????????????????????????? ???????? ???????????????????????????????????????????????????????????????? ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? cytokines are the crucial inflammatory pathway mediators that promote the formation of plaque and instability in the inflammatory cascade.Objective: This review will elaborate on the function of immune cells in atherosclerosis, explain the mechanisms of NLRP3 inflammasome activation in the context of AAI, and address the possible role of colchicine specifically targeting NLRP3 inflammasome and its concomitant downstream mediators in ACS, and provide an overview of current or ongoing studies produced in this area.Discussion : NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitat- ed by cholesterol crystals that are present in all atherosclerosis stages. Subsequent activation of pro-inflammatory ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? ???????????????????????????????????? ???????????? ???????????? ???????????????????????????? ???????????????????????????????????????????????? pathway mediators that promote the formation of plaque and instability in the inflammatory cascade. A potential advantage of a medication acting through an inflammatory milieu found in atherosclerotic lesions has recently become the need for novel therapeutic options. Colchicine, with its well-established pleiotropic anti-inflammato- ry effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation.Conclusion: Colchicine is a safe and reliable medication for ACS patients, alongside reveal various benefit in reducing inflammation through inhibition of NLRP3 Inflammasome`

Premature Coronary Artery Disease in Young Male Patient with Strong Family History Dea Arie Kurniawan; Mohammad Saifur Rohman; Anna Fuji Rahimah; Budi Satrijo
Heart Science Journal Vol 3, No 1 (2022): Assesment and Outcome of Coronary Artery Disease in the Reperfusion Era
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.01.8

BACKGROUND: Coronary artery disease (CAD) occurring in less than 45 years of age is termed as premature CAD (PCAD). Recent studies showed a prevalence of 4-10 % of PCAD. PCAD is associated with unfavorable outcomes for the patients and had a greater impact on the quality of life. Family History is the best method to explained complex interaction between shared risk factor.CASE ILLUSTRATION: A 37-years old male admitted to Saiful Anwar Hospital for further evaluation of anginal pain. The patient complains of recurrent chest pain since 5 months ago but still relieved by rest. The electrocardiogram showed Wellens Type B which is specific for critical stenosis of the left anterior descending artery (LAD). Then the patient undergoing DCA Ad Hoc. The implantation of a 46 mm DES at proximal until distal LAD was performed. The patient discharged after a day observation.DISCUSSION: The challenging point, in this case, was it happen at a young age with strong family history. There was positive family history of PCAD in 1st degree relative on her brother and mother, despite several risk factors were identified in this case consist of smoking, and dyslipidemia, which make CAD risk higher. Despite adequate control of risk factors, family screening is important to reveal subclinical atherosclerosis.CONCLUSION: Approach to a patient with PCAD comprises of management of traditional risk factors and careful investigation of Family History. Individual with positive family history of PCAD should be treated more cautiously

Co-Authors Aditya Reza Pratama Andona Murni Maharani Anita Surya Santoso Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardian Rizal Arief Wibisono Ayu Asri Devi Adityawati Bayu Aji Cholid Tri Tjahjono Dadang Hendrawan Dea Arie Kurniawan Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Harris Kristanto Hendrawati Hendrawati Heny Martini Indra Prasetya Indra Prasetya Liemena Harold Adrian Mifetika Lukitasari Mohammad Saifur Rohman Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Rizki Fadlan Novi Kurnianingsih Olivia Handayani Putri Annisa Kamila Sasmojo Widito Setyasih Anjarwani Shalahuddin Suryo Baskoro Yoga Waranugraha Yoseph Budi Utomo

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