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Taslim Taslim
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Journal : Narra J

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Epidemiology and management of acute coronary syndrome in remote and resource-limited settings: Insights from a rural Indonesian hospital Afandy, Jonathan E.; Taslim, Taslim; Sari, Yuliyana; Fajarwati, Dinda D.; Tanjung, Benny Y.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2978

Abstract

Acute coronary syndrome (ACS) remains a major global health and economic burden. In Indonesia, North Kalimantan reports the highest prevalence of heart disease (2.2%), exceeding the national average of 1.5%. Nunukan, the province’s northernmost and predominantly archipelagic region, is served by a single general hospital, reflecting the healthcare challenges faced by many rural Indonesian areas. This study aimed to provide epidemiological insights into ACS cases in this region to inform improved management strategies in similar resource-limited settings. A retrospective cross-sectional study was conducted among ACS patients admitted to Nunukan Regency General Hospital, Nunukan, Indonesia, between January 1 and August 31, 2023. Data on demographics, risk factors, clinical presentation, vital signs, diagnostic findings, treatments, and outcomes were collected from paper-based medical records. Of the 241 patients admitted, 4.56% were diagnosed with ST-elevation myocardial infarction (STEMI), 35.68% with very high-risk non-ST-elevation ACS (VHR NSTE-ACS), and 59.75% with non-very high-risk NSTE-ACS (NVHR NSTE-ACS). The mean age was 55.4±12.26 years, with a predominance of males (51.5%) and obesity (35.7%). The median number of risk factors was 2 (IQR: 1–2.5), with hypertension being the most prevalent (72.6%). Late presentation was common, and only 36.4% of STEMI patients received fibrinolytic therapy. The overall in-hospital mortality rate was 3.3%, and the median length of stay was 6 days (IQR: 5–7). ACS patients in Nunukan exhibited distinct clinical and demographic profiles, characterized by younger age, obesity, multiple risk factors, and delayed presentation. These findings highlight the urgent need to strengthen cardiovascular care capacity and early intervention strategies in remote and resource-limited regions of Indonesia.
Epidemiology and management of acute coronary syndrome in remote and resource-limited settings: Insights from a rural Indonesian hospital Afandy, Jonathan E.; Taslim, Taslim; Sari, Yuliyana; Fajarwati, Dinda D.; Tanjung, Benny Y.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2978

Abstract

Acute coronary syndrome (ACS) remains a major global health and economic burden. In Indonesia, North Kalimantan reports the highest prevalence of heart disease (2.2%), exceeding the national average of 1.5%. Nunukan, the province’s northernmost and predominantly archipelagic region, is served by a single general hospital, reflecting the healthcare challenges faced by many rural Indonesian areas. This study aimed to provide epidemiological insights into ACS cases in this region to inform improved management strategies in similar resource-limited settings. A retrospective cross-sectional study was conducted among ACS patients admitted to Nunukan Regency General Hospital, Nunukan, Indonesia, between January 1 and August 31, 2023. Data on demographics, risk factors, clinical presentation, vital signs, diagnostic findings, treatments, and outcomes were collected from paper-based medical records. Of the 241 patients admitted, 4.56% were diagnosed with ST-elevation myocardial infarction (STEMI), 35.68% with very high-risk non-ST-elevation ACS (VHR NSTE-ACS), and 59.75% with non-very high-risk NSTE-ACS (NVHR NSTE-ACS). The mean age was 55.4±12.26 years, with a predominance of males (51.5%) and obesity (35.7%). The median number of risk factors was 2 (IQR: 1–2.5), with hypertension being the most prevalent (72.6%). Late presentation was common, and only 36.4% of STEMI patients received fibrinolytic therapy. The overall in-hospital mortality rate was 3.3%, and the median length of stay was 6 days (IQR: 5–7). ACS patients in Nunukan exhibited distinct clinical and demographic profiles, characterized by younger age, obesity, multiple risk factors, and delayed presentation. These findings highlight the urgent need to strengthen cardiovascular care capacity and early intervention strategies in remote and resource-limited regions of Indonesia.
Co-Authors Abdul Sabaruddin Abdurrahman, Muhammad Faiz Afandy, Jonathan E. Ahmad Mustamir Waris Andi Athika Magfirah Anugrah, A. Muh Naufal Asfar, A.M.Irfan Taufan Azzahra, Dwi Nabila Bambang Trisakti Dafwen Toresa Dafwen Toresa Darman Darman Deny Jollyta Des Suryani Des Suryani Edriyansyah Eka Sabna Fachruddin, Khaira Amalia Fajarwati, Dinda D. Fajrin, Ahmad Nur Fajrizal Fajrizal, Fajrizal Farida Hanum Fitriani Fitriani Hajrah, Siti Hasrianti, Ririn Heriyanti Heriyanti, Heriyanti Ibrahim Ibrahim Ikhsan, Rd. Muhammad Ilham, Muh. Indra Surya, Indra Irvan Irvan Juniansyah, Muhammad Fadhillah Kahadijah, Kahadijah Marbun, Daniel S Maulana, Imran Meisya Anggraini Mirino, Anthoneta Moh. Fatkuroji MUHAMMAD ALI Muhammad Yusuf Muhdar, Fahriadi Muhdar, Fahriady Muliana, Muliana Nadia Vega Nashriana, Nashriana Ningsih, Kursiah Warti Nur, Syarif Nurhaedah Nurhaedah Nursakina, Nursakina Pannyiwi, Rahmat Permatasari, Mustika Putri, Amelia Septiani Putri, Marsya Putri, Vania Okky Rahmat, Rezqiqah Aulia Ratnawati Ratnawati Rizky, Muhammad Rafly Rometdo Muzawi, Rometdo Sabna, Eka Sari, Yuliyana Satriani Satriani Satrina, Eka Sidabutar, Rivaldi Sinaga, Mersi Suriani Sitepu, Lusti Angelica Sitti Aisyah Sulistiawati Sulistiawati Susi Handayani Susi Handayani Syafutra, Wahyu Pramudya Syahril Syahril Syahtriatna Djusar Syarifnur, Syarifnur Tahang, Heriyanti Tahang, Heriyanti Tanjung, Benny Y. Taroman Pasyah Taufiq, Reny Medikawati Tawakkal, Nurfaidah Toresa, Dafwen tri wahyuni Wahab, Isnaeni Walhidayat, Walhidayat Yuhelmi Yuhelmi Yuliana Yuliana Yundari, Yundari Zulihi, Zulihi Zulkarnain Zulkarnain