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Sodiqur Rifqi
Bagian/SMF Kardiologi dan Kedokteran Vaskuler RSUP Dr.Kariadi Semarang
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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THE EFFECT OF REMOTE ISCHEMIC PRECONDITIONING IN DIABETIC PATIENTS AFTER ELECTIVE PERCUTANEUS CORONARY INTERVENTION ANGGRIYANI, NOVI; PARAMITA, DONNA; RIFQI, SODIQUR
JNH (Journal of Nutrition and Health) Vol 3, No 2 (2015): JOURNAL OF NUTRITION AND HEALTH
Publisher : Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (200.475 KB) | DOI: 10.14710/jnh.3.2.2015.%p

Abstract

Background Experimental and clinical investigations suggest that reperfusion is considered ?a double-edged sword?, as reperfusion would restore oxygen and nutrients supply to the ischemic myocardium to improve its functional recovery, but in the other hand reperfusion could augment myocardial ischemic damage, known as myocardial ischemia-reperfusion (I/R) injury. The brief and repeated cycles of I/R given at a distant organ before a sustained ischemia and reperfusion, known as remote ischemic preconditioning (RIPC), would protect the heart from lethal I/R injury. Objective The effect of ischemic preconditioning in a diabetic heart is a contradictory whether it could improve or worsen the damage degree of myocardial  I/R injury, as reported by some previous studies. These inconsistent reports need further studies. Methods Twenty-four diabetic patients with stable CAD undergoing elective percutaneus coronary intervention were randomly assigned to 2 groups: 14 patients submitted to RIPC and 10 patients were control group. We induced RIPC by inflating a blood pressure cuff placed on the upper limb to 20 mmHg above systolic arterial pressure for 5 min and deflating the cuff for 5 min; 4 cycles were performed. All patients had CK-MB level measured at baseline and 18-24 hours after the elective PCI. Myocardial injury was considered when post-PCI CK-MB level rose up to 1-3 fold of the upper normal limit. Results A higher proportion in control group (40%) experienced myocardial injury, compared with the group receiving RIPC (0%) (p = 0.02). The mean of baseline CK-MB was equal in both control and RIPC groups (19.07 ± 2.84 and 17.5 ± 2.32, respectively; p = 0.165). While the mean of post-PCI CK-MB level in two groups differed significantly (34.2 ± 10.43 and 24.42 ± 4.03, respectively; p = 0.017). Conclusions RIPC lower the incidence of myocardial injury in diabetic patients after elective percutaneus coronary intervention. These data suggest that diabetic patients still gain protection of RIPC.
Prediction Score of Antegrade Chronic Total Occlusion Percutaneous Coronary Intervention Success in Dr. Kariadi Central General Hospital Semarang Pudjiastuti, Anggit; Rifqi, Sodiqur; Sofia, Sefri Noventi
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.583 KB) | DOI: 10.36408/mhjcm.v7i2.514

Abstract

Background: Lesion characteristics of chronic total occlusion (CTO) are predictors of percutaneous coronary intervention (PCI) success. A prediction score consist of these predictors can help CTO-PCI operators. Various prediction score had been established but none had been established in Indonesian population. Methods: This observational cohort study was performed in patients underwent native vessel CTO-PCI in Dr.Kariadi Hospital during 2018. Target vessels, ostial lesion, blunt stump, calcification, long lesion, bending, side branch, bridging collateral, and retrograde collateral were angiographic variables proposed to be predictors of CTO-PCI success. All of the variables were quantitatively assessed by two observers. Bivariate and multivariate analysis used to identify independent predictors of CTO-PCI success and to establish a scoring model. Results: A total 200 patients underwent CTO-PCI procedures were included to this study. All of the procedures used antegrade approach. The prediction score established as follows: bending (1 point), calcification (2 point), blunt stump (3 point), long lesion (1 point), and poor retrograde collateral filling (2 point). Total score ranged from 0 to 9 with decreased probability of success from 92.3% to 0.5%. Score value ? 3 categorized as difficult lesion with higher risk to failure compared to score value <3 (OR 15.4; p<0.001). The score model had good calibration and discrimination in predict CTO-PCI success (AUC 0.88; p<0.001). Conclusion: Bending, calcification, blunt stump, long lesion, and poor retrograde collateral were predictors of CTO-PCI success. The score consist of these variables could predict antegrade CTO-PCI success. Keywords: chronic total occlusion; percutaneous coronary intervention; success; prediction score.
Aspirasi Trombus Selektif Memperbaiki Aliran Koroner dan Mengurangi Tingkat Badai Trombus pada Pasien Sindroma Koroner Akut Dengan Elevasi Segmen ST yang dilakukan Intervensi Koroner Perkutan Primer Bramantyo, Liborius; Bahrudin, Udin; Ardhianto, Pipin; Uddin, Ilham; Rifqi, Sodiqur
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.685 KB) | DOI: 10.36408/mhjcm.v8i3.583

Abstract

Latar belakang: Embolisasi distal koroner berkontribusi terhadap tingginya kejadian kardiovaskular mayor (KKVM) pasca intervensi koroner perkutan primer (IKPP). Aspirasi trombus (AT) manual berpotensi mengurangi embolisasi distal dan memperbaiki perfusi mikrovaskular pada pasien sindroma koroner akut dengan elevasi segmen ST (SKA-EST), terutama pasien dengan badai trombus tinggi. Tujuan: Mengetahui pengaruh aspirasi trombus selektif terhadap skor TIMI trombus dan luaran klinis pasca IKPP. Metode: Penelitian retrospektif pada pasien SKA-EST dengan onset ?12 jam dan skor trombus TIMI awal ?3 yang menjalani IKPP dengan aspirasi trombus selektif di RSUP Dr. Kariadi periode Januari 2018 sampai Desember 2019. Luaran klinis yang diobservasi adalah KKVM selama rawat inap yang terdiri dari mortalitas, syok kardiogenik, edema paru akut, aritmia, revaskularisasi ulang, dan stroke. Hasil: Sejumlah 100 pasien memenuhi kriteria, terdiri dari 50 pasien kelompok AT dan 50 pasien kelompok non-AT. Rerata skor trombus TIMI awal kelompok AT dan non-AT, masing-masing 4,76 dan 3,8 (p<0,001). Kelompok AT mengalami penurunan skor trombus TIMI lebih baik dibanding non-AT (4,72 vs. 3,8, p<0,001). Terdapat 8 (16%) pasien kelompok AT dan 11 (22%) pasien non-AT yang mengalami KKVM pasca IKPP (RR 1,08, IK 95% 0,89-1.30, p=0,44). Kesimpulan: Aspirasi trombus selektif mungkin mengurangi tingkat badai thrombus. Aspirasi trombus mungkin menurunkan kejadian kardiovaskular mayor selama rawat inap pasca IKPP pada pasien dengan skor trombus TIMI di atas 4 setara dengan yang memiliki skor trombus TIMI kurang dari 4 tanpa aspirasi trombus.
Co-Authors Bramantyo, Liborius DONNA PARAMITA, DONNA Ilham Uddin NOVI ANGGRIYANI, NOVI Pipin Ardhianto, Pipin Pudjiastuti, Anggit Sefri Noventi Sofia Udin Bahrudin, Udin