Bambang Budi Siswanto
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, University Of Indonesia, And National Cardiovascular Center Harapan Kita, Jakarta

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Role of Highly Sensitive Cardiac Troponin T Assay in Stable Coronary Artery Disease Raymond Pranata; Nico Kusuma; Rachel Vania; Bambang Budi Siswanto
Jurnal Kardiologi Indonesia Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i1.794

Abstract

Cardiac troponins (cTn) are the preferred biomarkers of myocardial necrosis, usually used for diagnosis and risk stratification in acute coronary syndromes. Highly sensitive troponin T (hs-cTnT) may be elevated in stable coronary artery disease (SCAD), in which subclinical plaque erosion or rupture and distal embolization and subclinical ischemic episode. hs-cTnT may be used as a prognostic marker in SCAD and can predict cardiovascular events and patient’s mortality rate. In this article, plaque characteristic that is linked to hs-cTnT, it’s used as prognostic biomarker and comparison to other indicators are the focus of discussion. Abstrak Troponin adalah biomarker yang paling disukai untuk mendeteksi nekrosis miokardium dan untuk mendiagnosis dan stratifikasi risiko pada sindrom koroner akut. Highly sensitive troponin T (hs-cTnT) dapat meningkat pada penyakit jantung koroner stabil dimana terjadi ruptur plak atau erosi dan embolisasi distal sublklinis, dan episode iskemik subklinis. Sehingga biomarker tersebut dapat digunakan sebagai marker prognostik pada penyakit jantung koroner stabil dan dapat memprediksi angka kejadian kardiovaskular dan tingkat mortalitas pasien. Pada artikel ini akan dibahas mengenai karakteristik plak yang dihubungkan dengan peningkatan hs-cTnT, pengunaan sebagai biomarker prognostik dan serta perbandingan dengan indikator lainnya.
Pulmonary Hypertension In Indonesia: Where and How is the Data? What is the Gaps? Bambang Budi Siswanto
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2(S) (2017): Supplement, Abstracts of Jogja INternational CARdiovascular TOpic Series (JIN
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.27968

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Pulmonary Hypertension In Indonesia: Where and How is the Data? What is the Gaps?
The Prevalence of Pulmonary Hypertension in Destroyed Lung Due to Post Pulmonary Tuberculosis and Its Relation to Exercise Capacity Diana Septiyanti; Astari Pranindya Sari; Wahju Aniwidyaningsih; Budhi Antariksa; Bambang Budi Siswanto
Jurnal Respirologi Indonesia Vol 38, No 4 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1986.031 KB) | DOI: 10.36497/jri.v38i4.24

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Background: To improve patient’s quality of life, understanding destroyed lung (DL) is very important, however, it is very limited in information related to it as well as to the existency of pulmonary hypertension (PH) in destroyed lung. In this study, we investigated relationship between DL with PH status and the exercise capacity through 6 minutes walking test (6MWT). Method: Cross-sectional analytic study involving 54 DL subjects. Subjects performed echocardiography to exclude cardiac abnormality and to determine whether they had PH. Subjects were then divided into two groups based on their PH status. They underwent 6MWT and their walking distance and peripheral oxygen saturation were measured. Student t-test was used for analyzing data. Furthermore, we determined correlation between walking distance and mean Pulmonary Artery Pressure (mPAP) value also peripheral oxygen saturation and mPAP. Result: We calculated the mean of walking distance between the two groups. The mean from subjects with PH and without PH were 329.18 and 388.77 meter respectively (p=0.035). We found negative correlation between the mean of walking distance and subject’s mPAP using statistical analysis Pearson correlation test (r= -0,457, p = 0,001) while percentage of 6MWT by its prediction also had a negative correlation (r= -0,468, p=
Pengalaman Awal Tindakan MitraClip di Pusat Jantung Nasional Harapan Kita, Jakarta Prima Almazini; Nani Hersunarti; Rarsari Soerarso; Bambang Budi Siswanto; Doni Firman; Amiliana M Soesanto
Cermin Dunia Kedokteran Vol 43, No 3 (2016): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i3.27

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Latar Belakang: MitraClip merupakan pilihan terapi untuk pasien regurgitasi katup mitral berat yang berisiko tinggi untuk operasi. Tujuan penelitian ini adalah melaporkan tindakan MitraClip di Pusat Jantung Nasional Harapan Kita Jakarta. Metode: Penelitian retrospektif di Pusat Jantung Nasional Harapan Kita, Jakarta. Data diperoleh dari database komputer dan rekam medis dari Februari 2014 sampai Januari 2015, kemudian dianalisis dengan SPSS. Hasil: Enam orang pasien berusia 51 – 75 tahun, menjalani tindakan MitraClip; 5 pasien regurgitasi katup mitral berat dan 1 pasien regurgitasi katup sedang. Satu pasien perempuan dan 5 pasien laki-laki. Dua pasien merupakan regurgitasi mitral degeneratif dan 4 pasien regurgitasi mitral fungsional. Dua pasien dipasangi satu buah MitraClip dan 4 pasien dipasangi dua buah MitraClip. Setelah tindakan, derajat regurgitasi berkurang menjadi ringan pada 2 pasien dan menjadi sedang pada 4 pasien. Dimensi diastolik akhirventrikel kiri berkurang dari 66 ± 6,5 mm saat awal menjadi 59 ± 7,3 mm (p=0,04) saat pulang. Dimensi sistolik akhir ventrikel kiri berkurang dari 50 ± 10,6 mm saat awal menjadi 48 ± 10,0 mm saat pulang (p=0,27). Satu bulan setelah tindakan MitraClip, 2 pasien dengan kelas fungsional I dan 4 pasien dengan kelas fungsional II. Tidak ada pasien yang meninggal dalam perawatan di rumah sakit. Satu pasien perawatan ulang di rumah sakit karena gagal jantung. Simpulan: MitraClip merupakan pilihan terapi yang efektif dan aman untuk pasien regurgitasi mitral degeneratif dan fungsional yang risiko tinggi untuk operasi. Dimensi ventrikel kiri, kelas fungsional NYHA, derajat keparahan regurgitasi katup, dan tingkat perawatan ulang mengalami perbaikan setelah dipasang MitraClip.
Pengaruh Rehabilitasi Jantung Terhadap Tekanan Darah, Kadar Lipid dan Gula Darah: Analisis Statemen Gipta Galih Widodo; Dewi Irawati; Bambang Budi Siswanto; Djunaiti Sahar
Malahayati Nursing Journal Vol 4, No 9 (2022): Volume 4 Nomor 9 2022
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v4i9.7119

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ABSTRACT Cardiac rehabilitation can provide broad benefits and prevent recurrence of heart disease. Cardiac rehabilitation can help patients to return to their ability to carry out normal activities. Indicators that can be used to measure the success of cardiac rehabilitation are blood pressure, lipid profile and blood sugar levels.The purpose of this study was to classify statements and to examine the relationship between the concept of cardiac rehabilitation on blood pressure, lipid levels and blood sugar. Statement analysis stages include selecting statements to be analyzed, simplifying statements, classifying statements, testing concepts in statements for definition and validity, specifying relationships between concepts, testing logic, and determining testability. The relationship between the concept of cardiac rehabilitation with blood pressure, lipid levels and blood sugar was found to be a causal relationship type and with a symmetrical positive direction. The type of relationship between the concepts of blood pressure, lipid levels and blood sugar is conditional and with asymmetric positive direction. Cardiac rehabilitation affects blood pressure, lipid levels and blood sugar. Keywords: Cardiac Rehabilitation, Blood Pressure, Lipid Levels, Blood Sugar, Statement Analysis ABSTRAK Rehabilitasi jantung dapat memberikan manfaat yang luas dan mencegah kejadian berulang penyakit jantung. Rehabilitasi jantung dapat membantu pasien untuk kembali memiliki kemampuan dalam beraktifitas secara normal. Indikator yang dapat digunakan untuk mengukur keberhasilan rehabilitasi jantung adalah tekanan darah, profil lipid dan kadar gula darah. Tujuan penelitian ini adalah untuk mengklasifikasikan statement dan untuk menguji hubungan diantara konsep rehabilitasi jantung terhadap tekanan darah, kadar lipid dan gula darah. Tahapan analisis statement meliputi memilih statemen untuk dianalisis, menyederhanakan statement, mengklasifikasikan statement, menguji konsep dalam statement untuk definisi dan validitas, menspesifikan hubungan diantara konsep, menguji logika, dan menentukan kemampuan uji. Hubungan konsep rehabilitasi jantung dengan tekanan darah, kadar lipid dan gula darah didapatkan tipe hubungan kausal dan dengan arah positif yang simetris. Tipe hubungan antar konsep tekanan darah, kadar lipid dan gula darah adalah kondisional dan dengan arah positif yang asimetris. Rehabilitasi jantung berpengaruh terhadap tekanan darah, kadar lipid dan gula darah. Kata Kunci: Rehabilitas Jantung, Tekanan Darah, Kadar Lipid, Gula Darah, Analisis Statemen
Individual Characteristics, Adherence, and Barriers to Medication Adherence of Hypertensive Patients at the Indonesia - Timor Leste Border Pius Almindu Leki Berek; Bambang Budi Siswanto; Dewi Irawati; Wisnu Jatmiko
Nurse Media Journal of Nursing Vol 12, No 3 (2022): (December 2022)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/nmjn.v12i3.46219

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Background: Until the last decade, the incidence of hypertension has increased sharply. It has been reported that individuals with hypertension show a low level of adherence to their therapy management. Moreover, there has been no previous research evaluating individual characteristics, adherence, and barriers to medication adherence among people with hypertension at the border of Indonesia and Timor Leste.Purpose: This study aimed to identify individual characteristics, adherence, and barriers to medication adherence among hypertensive patients.Methods: A total of 112 hypertensive patients recruited using a quota sampling method at the border of Indonesia and Timor Leste participated in this cross-sectional study. Data were collected using the Hill-Bone Questionnaire to identify adherence and the Adherence Barrier Questionnaire (ABQ) to identify barriers to medication adherence. Individual characteristics were also collected. To confirm the hypertension condition at the time of data collection, measurements of blood pressure were retaken. Descriptive statistics and Chi-square analysis were used for data analysis.  Results: The average of systolic blood pressure was 163.85(18.24) mmHg, and the diastolic blood pressure was 99.30(11.57) mmHg. The Chi-square test showed that education and occupation had a significant relationship with adherence (p<0.05) and barriers to medication adherence (p=0.000). Meanwhile, other characteristics, including age, gender, and marital status, were not significantly related to adherence (p>0.05) and barriers to medication adherence (p>0.05).Conclusion: There is a relationship between education and occupation with adherence and barriers to medication adherence, but there is no relationship when viewed from such individual characteristics as age, gender, and marital status. Further research is needed to identify effective educational methods to increase the knowledge, motivation, and self-efficacy of hypertensive patients to improve blood pressure control.
THEORY DEVELOPMENT: PATIENT’S LIFE CAPACITY THEORY THROUGH SELF- EMPOWERMENT MODEL IN CARDIAC REHABILITATION Widodo, Gipta Galih; Irawati, Dewi; Hamid, Achir Yani S.; Siswanto, Bambang Budi; Purwaningsih, Puji
INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC) Vol 8, No 2 (2023): INJEC
Publisher : Asosiasi Institusi Pendidikan Ners Indonesia (AIPNI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24990/injec.v8i2.549

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Introduction: Cardiac rehabilitation can provide extensive benefits and prevent recurrent heart disease, however participation in cardiac rehabilitation rates is still low. Health promotion strategies witheducation can improve the ability and independence to carry out cardiac rehabilitation at home. The purpose of this study is to describe, explore, predict, and control phenomena to create a theoretical construction of a self-empowerment model in cardiac rehabilitation programs at home.Methods: Theory construction uses procedures that include establishing the central concept, establishing the source of the theory, determining the meaning of the theory, identifying concepts, examining concept definitions, identifying statements, establishing relationships between concepts, analyzing the logical adequacy of the theory, determining the usefulness of the theory, and explaining the level of generalizability and parsimony of the theory.Results: The self-empowerment model can be used to provide nursing care to patients with cardiac rehabilitation, especially cardiac rehabilitation at home. This model can optimize the achievement of patient capacity by increasing patient ability and independence. Patients are responsible, confident, and disciplined to change their behavior toward optimal health.Conclusions: This model is specific to the cardiac rehabilitation environment (home-based cardiac rehabilitation) to increase the participation of patients after cardiovascular interventions in cardiacrehabilitation programs to improve patient capacity which includes physical health, functional capacity,and quality of life.
Non-dominant handgrip strength is associated with higher cardiorespiratory endurance and elevated NT-proBNP concentrations in ambulatory male adult outpatients with stable HFrEF Triangto, Kevin; Radi, Basuni; Siswanto, Bambang B.; Tambunan, Tresia FU.; Heriansyah, Teuku; Harahap, Alida R.; Kekalih, Aria; Katsukawa, Hajime; Santoso, Anwar
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1278

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Understanding the significance of handgrip strength is essential for identifying frailty in heart failure patients. The aim of this study was to identify the association between handgrip strength and cardiorespiratory endurance while highlighting the importance of the musculoskeletal system in cardiac rehabilitation for patients with heart failure. An observational cross-sectional study was conducted at Harapan Kita Hospital, Jakarta, Indonesia, from April 2022 to April 2023, among patients with heart failure with reduced ejection fraction (HFrEF) attributed to cardiomyopathy or coronary artery disease. Patients were classified by a 6-minute walk test (6MWT) distance into <400 meters (low endurance) or ≥400 meters (high endurance). The short physical performance battery (SPPB), handgrip strength, ultrasonographic forearm muscle thickness, left ventricle ejection fraction, tricuspid annular plane systolic excursion, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured. Results indicated significant differences in non-dominant handgrip strength, gait speed, and sit-to-stand SPPB scores between patients achieving a 6MWT distance of ≥400 meters and those below this threshold, with values of 31.11±6.88 kg vs 27.66±6.66 kg (p=0.049), 0.52±0.08 m/s vs 0.61±0.13 m/s (p=0.001), and 10.71±2.47 seconds vs 12.85±4.11 seconds (p=0.014), respectively. Stronger non-dominant handgrip strength (>30 kg) was associated with higher endurance (odds ratio (OR): 3.80; 95%CI: 1.35–10.67; p=0.010) and thicker forearm muscles (>1.9 cm) as measured by ultrasonography (AUC: 0.713; 95%CI: 0.585–0.840, p=0.001). In conclusion, a cut-off of ≤30 kg for non-dominant handgrip strength could effectively stratify the male patients into a lower endurance group (6MWT ≤400 meters), which is associated with elevated NT-proBNP levels and reduced forearm muscle thickness.
Protokol Latihan BEST yang Disesuaikan dalam Rehabilitasi Gagal Jantung Triangto, Kevin; Radi, Basuni; Siswanto, Bambang Budi; Tambunan, Tresia Fransiska Ulianna; Heriansyah, Teuku; Harahap, Alida Rosita; Kekalih, Aria; Ambari, Ade Meidian; Dwiputra, Bambang; Desandri, Dwita Rian; Katsukawa, Hajime; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1738

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Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.
Exploring the Relationship Between Comprehensive Respiratory Assessment and Intra-Extracardiac Biomarkers in Heart Failure Rehabilitation Triangto, Kevin; Radi, Basuni; Siswanto, Bambang B.; Tambunan, Tresia FU.; Heriansyah, Teuku; Harahap, Alida R.; Kekalih, Aria; Katsukawa, Hajime; Santoso, Anwar
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.248

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Introduction: Heart failure with reduced ejection fraction (HFrEF) is well-known as a systemic disease that involves cardiac and extracardiac issues, with respiratory function playing on of the key role in rehabilitation prognosis. Biomarkers such as soluble suppression of tumorigenicity 2 (sST2), myostatin, miRNA-133, and NT-proBNP indicate disease progression. Notably, sST2, which is also produced by the lungs, predicts heart failure outcomes. This study examines the relationship between comprehensive respiratory assessments (e.g., diaphragmatic ultrasonography, spirometry) and intra-extracardiac biomarkers to improve rehabilitation strategies. Methods: Sixty-nine HFrEF patients underwent respiratory evaluations, including diaphragmatic ultrasonography, spirometry, chest expansion measurements, and a six-minute walking test (6MWT). Biomarkers assessed were sST2, myostatin, miRNA-133, and NT-proBNP. Associations between respiratory parameters and biomarkers were analyzed using t-tests and correlation analyses. Results: The median age was 56 years, and 33 (47.82%) of the subjects had diaphragmatic dysfunction, resulting in poorer 6MWT performance (378.03±58.15 m vs 409.75±63.65 m, p=0.017) and other parameters. Superior chest expansion negatively correlated with sST2 (r=−0.387, p=0.001) and positively with miRNA-133 (r=0.442, p<0.001). Similar results were found for inferior chest expansion. No significant correlations were observed for other biomarkers. Conclusion: This study highlights strong associations between chest expansion and sST2/miRNA-133, suggesting that incorporating respiratory assessments and training into HFrEF rehabilitation could enhance outcomes by addressing cardiorespiratory insufficiencies. Given sST2's predictive value for heart failure prognosis, these findings support a multi-component rehabilitation strategy incorporating respiratory training, such as aerobic and inspiratory muscle exercises, to enhance cardiopulmonary outcomes. This integrated approach offers promise for future HFrEF rehabilitation protocols.
Co-Authors Achir Yani S. Hamid Adi, Andi Wahjono Agung Waluyo Ambari, Ade Meidian Amiliana M Soesanto Amiliana M. Soesanto Andi Mahavira Andy Kristyagita Anna Ulfah Rahajoe Anwar Santoso Aria Kekalih Asrory, Virna Dwi Oktariana Astari Pranindya Sari Basuni Radi BRM Ario S. Kuncoro Budhi Antariksa Budhi S. Purwowiyoto Dedi Afandi Desandri, Dwita Rian Dewi H Suprobo Dewi H Suprobo DEWI IRAWATI Dewi Irawati Dewi Irawati Diana Septiyanti Doni Firman Dwiputra, Bambang Emir Yonas Endang Ratnaningsih Erwin Mulia Fatoni, Mukhamad Ganesja M Harimurti Ganesja M Harimurti Gipta Galih Widodo Hadrian Deka Hananto Andriantoro Harahap, Alida R. Harahap, Alida Rosita Hari Utomo Hariadi Hariawan Harmani Kalim Herliana , Rini Huda , Khoirul I Made Putra Swi Antara Idrus Alwi Ikhda Ulya, Ikhda Indarto, Malik Jantra Indriwanto Sakidjan Januar W Martha Jaya, Irvantri Aji Junaiti Sahar Jusup Endang Juzni Alkatiri Katsukawa, Hajime Kusuma, Nico Listyaningsih, Erlin Lukman H. Makmun Muhammad Munawar Nani Hersunarti Nani Hersunarti Nani Hersunarti Nani Hersunarti Nani Hersunarti Nani Hersunarti Nani Hersunarti Nani Hersunarti Nico Kusuma Nico Kusuma Nitia A. Asbarinsyah Nur Haryono Nurhay Abdurachman Nusanti, Synthia Oktarina, Virna Dwi Pius Almindu Leki Berek Poppy S Roebiono Pranata, Raymond Pratama, Erlan Anugrah Prima Almazini Purwowiyoto, Budhi S. Rachel Vania Rachel Vania Radityo Prakoso Raja Adil C Siregar Rarsari S. Soerarso Rarsari Soerarso Rarsari Soerarso Rarsari Soerarso Rarsari Soerarso Rarsari Soerarso Raymond Pranata Retna Dewayani Rif'ati, Lutfah Rizki Rizki Rony Mario Candrasatria, S Taofan Sadikaningtya, Lirasati Sekarsari, Rita Seskoati Prayitnaningsih Siska Sulistiowati Sri Yona Syntia Nusanti Tambunan, Tresia Fransiska Ulianna Tambunan, Tresia FU. Teuku Heriansyah, Teuku Tony Suharsono, Tony Triangto, Kevin Vania, Rachel Vidya Gilang Rejeki Wahju Aniwidyaningsih Wendy M. Saragih Wienta Diarsvitri William Sanjaya Wisnu Jatmiko Yoga Yuniadi Yonas, Emir