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All Journal Jurnal Kedokteran Brawijaya The Indonesian Biomedical Journal Heart Science Journal
Yoga Waranugraha
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Heart Science Journal

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Improving Quality of Life with Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients with SYNTAX Score of More than 22 Wella Karolina; Mohammad Saifur Rohman; Pawik Supriadi; Djanggan Sargowo; Wira Kimahesa Anggoro; Yoga Waranugraha
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.2021.002.02.4

Abstract

Background: The benefit of PCI to improve quality of life (QoL) in chronic coronary syndrome (CCS) is still unclear Objectives: This study aimed to assess the benefit of percutaneous coronary intervention (PCI) in improving QoL among CCS patients receiving OMT.Methods: We conducted a retrospective cohort study. CCS patients who underwent coronary angiography (CAG) and/or PCI were grouped into OMT plus PCI and OMT groups. The SYNTAX score was used to assess the complexity and severity of coronary artery lesions. The outcome measured was QoL assessed using Seattle Angina Questionnaire (SAQ) and rehospitalization.Results: A total of 57 patients in the OMT plus PCI group and 49 patients in the OMT group were included. The percentage of patients with good QoL was higher in the OMT plus PCI group than OMT only group (64.5% vs. 35.5%; p = 0.007). The OMT plus PCI group revealed a better activities of daily living (85.11 ± 12.46 vs. 12.46 ± 21.87; p = 0.014) and angina stability (84.32 ± 23.63 vs. 71.81 ± 27.89; p = 0.014) than OMT group. Among patients with SYNTAX scores of more than 22, achievement of good QoL was greater in the OMT plus PCI group than the OMT group (80.8% vs. 45.5%; p = 0.025).Conclusion: PCI improved the QoL in CCS patients treated with OMT. Second, OMT plus PCI improves physical limitation and angina stability. For patients with a SYNTAX score of more than 22, OMT plus PCI was correlated with good QoL achievement
Accessory Pathway Ablation Located Just Below The Bundle of His: A Challenging Case Puspa Lestari; Ardian Rizal; Yoga Waranugraha
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (880.808 KB) | DOI: 10.21776/ub.hsj.2020.001.01.6

Abstract

We presented a case of Wolff-Parkinson-White (WPW) Syndrome. A 69-year-old man was admitted for evaluation of frequent episodes of palpitation. The diagnosis of WPW syndrome was established based on the 12-lead surface electrocardiogram (ECG) and electrophysiology (EP) study. We conducted the radiofrequency ablation (RFA) to the accessory pathway (AP). The challenging point of this case was the accessory pathway located just below to the bundle of His, which is related to the risk of complete atrioventricular (AV) block. In summary, we conclude that anatomical consideration, EP study, and the ablation strategy were important to improve the safety and success rate of RFA procedure.  
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

Abstract

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.
Do Myocardial Blush Grade Following Chronic Total Occlusion Recanalization Improve Clinical Outcome of Chronic Coronary Syndromes Patients? Ikhwan Handirosiyanto; Mohammad Saifur Rohman; Dadang Hendrawan; Djanggan Sargowo; Yoga Waranugraha; Fahmi Rusnanta; Ardhani Galih Prakoso
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.2020.001.03.6

Abstract

Background : Myocardial blush grade (MBG) is an angiographic parameter to describe the adequacy of myocardial reperfusion. The correlation between myocardial blush and the clinical outcome following chronic total occlusion (CTO) recanalization is still unclear. Our study aimed to investigate the impact of myocardial blush after CTO recanalization on the clinical outcome of CCS patients.Design : A retrospective cohort study was conducted. Patients who underwent CTO recanalization were divided into two groups based on the myocardial blush. Patients were classified as having good myocardial blush (MBG category 2 to 3 or QUBE 0 to 10.2) and poor myocardial blush (MBG category 0 to 1 or QUBE 10.2 to 36.4). The outcome measured was the improvement of angina measured using the Seattle Angina Questionnaire (SAQ) and the reduction of antianginal drug regimens.Results : The follow-up period was ranging from 2 to 24 months following the CTO recanalization procedure. The SAQ for physical limitation (83.86 ± 16.11 vs. 77.92 ± 3.44; p = 0.247), angina frequency (85.27 ± 17.44 vs. 74.76 ± 22.05; p = 0.105), and quality of life (73.24 ± 3.41 vs. 72.82 ± 3.56; p = 0.932) between the two groups was not significantly different. Good myocardial blush was not correlated with the reduction of antianginal drug regimens (10 (52.6) vs. 8 (40); p = 0.639).Conclusion : Myocardial blush post-CTO recanalization was not associated with the improvement of angina symptoms and the reduction of antianginal drug regimens among patients with CCS.
Is There A Role of Glycated Hemoglobin for Predicting Major Ad- verse Cardiac Event in ST-Elevation Myocardial Infarction? Muhammad Abusari; Cholid Tri Tjahjono; Dadang Hendrawan; Yoga Waranugraha; Ayu Asri Devi Adityawati; Ratna Pancasari
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.2020.001.03.4

Abstract

Background : Coronary Artery Disease (CAD) especially ST-Elevation Myocardial Infarction (STEMI) is the leading cause of mortality worldwide. Hyperglycemia and diabetes mellitus are both prevalent among patients with STEMI admitted to the hospital. Glycated hemoglobin (HbA1c) is a marker of glucose control.Objectives : We aimed to investigate the role of HbA1c as the predictor of major adverse cardiovascular events in STEMI patients.Methods : This was a retrospective cohort study. STEMI patients visiting Saiful Anwar General Hospital were registered. Patients were divided into three groups based on the HbA1c level <6.5%; 6.5-8.4% and ≥8.5%; respectively. The primary endpoint was in-hospital Major Adverse Cardiovascular Events (MACE), including cardiac death, recurrent myocardial infarction (MI), recurrent revascularization, acute pulmonary edema, cardiogenic shock, malignant arrhythmia, and stroke.Results: A total of 118 STEMI patients were included in this study, with distribution of 61 patients with HbA1c <6.5%, 25 patients with HbA1c 6.5-8.4%, and 31 patients with HbA1c ≥8.5%; respectively. The HbA1C level was associated with the history of diabetes mellitus (3.2% vs 36% vs 71%; p =0.000) and random blood glucose level at hospital admission (140.71 ± 39.67 mg/dL vs 172.96 ± 53.43 mg/dL vs 366.61 ± 169.67 mg/dL; p = 0.000). The MACE among three groups was not significantly different (17.7% vs 20% vs 35.5%; p=0,149). Conclusion: Our study reveals that the HbA1c level at hospital admission is associated with the history of diabetes mellitus and random blood glucose at hospital admission. However, HbA1c could not predict MACE in STEMI patients
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (27.846 KB) | DOI: 10.21776/ub.hsj.2020.001.01.3

Abstract

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.
Impacts of Residual SNYTAX Score on The Clinical Outcomes following Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients Wira Kimahesa Anggoro; Mohammad Saifur Rohman; Heny Martini; Pawik Supriadi; Cholid Tri Tjahjono; Yoga Waranugraha
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.4

Abstract

Background: The residual SYNTAX score (RSS) can be used to measure the residual stenosis severity and complexity. The prognostic role of RSS in CCS patients is still unknown. We purposed to investigate the impact of RSS on the clinical outcomes following PCI in CCS patients. Methods: A prospective cohort study was performed. Based on the residual SYNTAX score, patients were divided into three groups: RSS 0, RSS 0 to 9.5, and RSS >9.5. The primary outcome was patient-oriented composite endpoint (POCE), including repeat revascularization, myocardial infarction, and all-cause mortality. Results: After 1-year follow-up period, patients in RSS >9.5 group revealed the greater POCE (4.3% vs. 6.4% vs. 23.9%; p = 0.016) than others. The repeat revascularization rate also was greater in the RSS >9.5 group (0.0% vs. 6.4% vs. 19.6%; p = 0.012). However, the hospitalization due to angina rates in all groups was not significantly different (4.3% vs. 4.2% vs. 4.3%; p = 1.000). The multivariate analysis revealed that RSS >9.5 was the strong predictor for repeat revascularization during 1 year follow-up (Odds ratio [OR] = 9.605; 95% confidence interval [CI] = 1.207 - 76.458; p = 0.033). Conclusion: The greater RSS was associated with the higher 1-year POCE and repeat revascularization rate in CCS patients. The high RSS was also the strong predictor for 1-year repeat revascularization for CCS patients. 
Overcoming High Cardiovascular Disease Burden in Indonesia: The Importance of Massive Cardiovascular Disease Risk Factor Screening, Aggressive Guideline-Directed Treatment, and Community-Based Programs Yoga Waranugraha
Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.1

Abstract

Indonesia is a developing country with a large number of populations. Cardiovascular disease (CVD) is a serious public health concern in Indonesia because of its high burden. Moreover, the high-risk CVD patients were under treatment. Optimal CVD prevention can be the solution to this issue. In this paper, we are talking mainly about the role of massive CVD risk factor screening, precise risk stratification, aggressive guideline-directed treatment, and community-based programs in reducing the CVD burden.
Impact of Strict and Lenient Heart Rate Control on Six-Minute Walk Test and Quality of Life in Atrial-Fibrillation Patients with Rheumatic Mitral Stenosis : Randomized Control Trial Dwigustiningrum, Nur Kaputrin; Rizal, Ardian; Putri, Valerinna Yogibuana Swastika; Rahimah, Anna Fuji; Rohman, Mohammad Saifur; Wikananda, Adhika Prastya; Waranugraha, Yoga; Astiawati, Tri; Laitupa, Fitranti Suciati
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.8

Abstract

Background: Recent studies showed no outcome difference between strict and lenient rate control in the general Atrial Fibrillation (AF) population. However, for AF and Rheumatic Mitral Stenosis (RMS) patients, evidences were lacking.Objective: To assess the impact of strict and lenient heart rate control on the Six-Minute Walk Test (SMWT) and Health Related Quality of Life (HRQoL) in patients with AF and RMS.Material and Methods: A prospective multicenter trial across tertiary hospitals in East Java assessed strict and lenient heart rate control's impact on the SMWT and HRQoL in AF and RMS patients. Sixty-one participants were randomized into strict and lenient groups over six months from March to August 2023. Medications were adjusted to achieve target heart rates, and HRQoL was assessed using SF-36 and SMWT at baseline and three months post-target heart rate attainment.Result: In our study, 29 patients were under strict heart rate control, and 32 were under lenient control. We found a decrease in HRQoL across all subscales, with significant differences observed in general health perception and physical function among those under strict control (p=0.002 and 0.03, respectively). However, no significant disparity was found in the SMWT distance difference between lenient and strict groups (p=0.529), nor in METs (p=0.326).Conclusion: In the study, lenient heart rate control demonstrates significant effects on the general health perception and physical function subscales compared to strict heart rate control. 
The Complexity in Managing Acute Heart Failure Patients in Intensive Cardiac Care Unit Waranugraha, Yoga
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.1

Abstract

Acute heart failure (AHF) is characterized by sudden or gradual onset of heart failure. AHF patients face the possibility of mortality, not only due to cardiovascular causes but also due to the complications arising from organ dysfunction caused by inadequate perfusion or the presence of organ congestion. It is frequent for patients with AHF to require treatment in the intensive cardiac care unit (ICCU). In this article, we are discussing and summarizing the current AHF treatment strategy in ICCU.
Co-Authors Anna Fuji Rahimah Ardhani Galih Prakoso Ardian Rizal Astiawati, Tri Ayu Asri Devi Adityawati Baskoro, Shalahuddin Suryo Bogi Pratomo BP Putra Suryana Budi Satrijo Bunga Bella Pratiwi Cholid Tri Tjahjono Cik Kahadi Dadang Hendrawan Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwigustiningrum, Nur Kaputrin Fahmi Rusnanta Hendrawati Hendrawati Heny Martini Icmi Dian Rochmawati Ikhwan Handirosiyanto Laitupa, Fitranti Suciati Mohammad Rizki Fadlan Mohammad Saifur Rohman Muhammad Abusari Muhammad Rizki Fadlan Pawik Supriadi Pawik Supriadi Puspa Lestari Putri Annisa Kamila Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Ratna Pancasari Rizal, Ardian Saerang, Gebryel Dennis Saputri, Vemmy Lian Sasmojo Widito Setyasih Anjarwani Susanti Lara Dewi Wella Karolina Wikananda, Adhika Prastya Wira Kimahesa Anggoro Wira Kimahesa Anggoro Wiwit Nurwidyaningtyas Yoseph Budi Utomo Yuke Fawziah Kemala