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All Journal Medical Journal of Indonesia Universa Medicina Indonesian Journal of Cardiology Narra J Cermin Dunia Kedokteran
Bambang Widyantoro
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Indonesia- National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Latihan Fisik bagi Penderita Hipertensi Sarastuti, Arum Widi; Widyantoro, Bambang
Cermin Dunia Kedokteran Vol 45, No 12 (2018): Farmakologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.381 KB) | DOI: 10.55175/cdk.v45i12.555

Abstract

Hipertensi merupakan faktor risiko utama penyakit kardiovaskular yang dapat meningkatkan morbiditas dan mortalitas. Latihan fisik merupakan salah satu bentuk upaya nonfarmakologis pencegahan, pengobatan serta rehabilitasi pasien hipertensi. Dosis latihan fisik hendaknya sesuai kondisi masing-masing penderita hipertensi.Hypertension is a major risk factor for cardiovascular disease which, if not properly treated, can increase morbidity and mortality. Exercise is non-pharmacological method in prevention, treatment and rehabilitation of hypertension. The dose of physical exercise should be appropriate.
An effort to find biomarker for micro-vascular obstruction in patient with myocardial infarction undergoing primary revascularization: is fibrinogen the answer? Bambang Widyantoro
Jurnal Kardiologi Indonesia Vol. 35, No. 3 Juli - September 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i3.425

Abstract

Meski revaskularisasi telah menunjukkan manfaat besar dalam menurunkan morbiditas dan mortalitas pada pasien infark miokard akut dengan elevasi segmen ST (IMA-EST), manfaat dari intervensi koroner perkutan primer (IKPP) yang berhasil mengembalikan aliran koroner epikardial seringkali tidak optimal di tingkat mikro sirkulasi karena adanya obstruksi mikrovaskular.Obstruksi mikrovaskular (OMV) berperan penting dalam menentukan prognosis pasien paska tindakan,1, 2 dan telah dilaporkan bahwa keberadaan obstruksi mikro-vaskular berkorelasi dengan penurunan survival pasien paska IMA-EST, melalui pengaruhnya pada proses remodeling ventrikel.3, 4
PERFORMA SIMPLIFIED ACUTE PHYSIOLOGY SCORE 3 SEBAGAI PREDIKTOR MORTALITAS PADA UNIT RAWAT INTENSIF KARDIOVASKULAR Akhtar Fajar Muzakkir; Dafsah Arifa Juzar; Andi Alfian Zainuddin; Dwi Yuda Herdanto; Bambang Widyantoro; Dian Zamroni; Siska Suridanda Danny; Isman Firdaus; Daniel PL Tobing; Irmalita Irmalita
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.702

Abstract

Background: Severity of illness scoring systems has gained increasing popularity in Intensive Care Units (ICUs) since 1980s. Physicians used them for predicting mortality and assessing illness severity in clinical trials. The Simplified Acute Physiology Score 3 (SAPS 3) is the only score that can predict hospital mortality within an hour of admission to ICU. Although this scoring systems has been widely used in ICUs, they have not been commonly applied in Intensive Cardiovascular Care Units (ICVCUs) since the population is quite different especially in disease subset. Therefore, the objective of this study was to evaluate the parameters in the SAPS 3 scoring system performance for predicting mortality in ICVCU population.Methods: This was an observational study with cross-sectional approach using secondary data from RAICOM (Registry of Acute and Intensive Cardiovascular Care on Outcome) taken from September 2013 – September 2014 in the ICVCU National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia. The secondary data were collected, analysed, and matched with SAPS 3 variables. All missing and invalid data were excluded. All data was processed and the SAPS 3 score was calculated in each patient. Multivariate analysis with logistic regression was conducted to evaluate the significance of the parameters in predicting mortality. Discrimination was assessed by area under the receiver operator characteristic curve (AUROC). Calibration was assessed by Hosmer-Lemeshow goodness-of-fit test through calculating the ratio of observed?to?expected numbers of deaths.Results: A total of 233 patients were included in this study and the observed hospital mortality was 16.7% (39/233). The patients enrolled were divided into survivors and nonsurvivors. Bivariate analyses of SAPS 3 variables showed intra-hospital location before ICVCU admission, use of vasoactive agents, reasons for ICVCU admission, infection, Glasgow Coma Score (GCS), creatinine level, and platelet count were significantly different between nonsurvivors than survivors (P<0.05). The SAPS 3 score was significantly higher in nonsurvivors than survivors. The AUC (95% confidence intervals [CIs]) for SAPS 3 score was 0.752 (0.669–0.835). The Hosmer?Lemeshow goodness?of?fit test for SAPS 3 demonstrated a Chi?square test score of 1.729, P = 0.943. Multivariate logistic regression was conducted for all variables that were probably correlated to prognosis. Eventually, intermediate ward as intra-hospital location before ICVCU admission was selected as an independent risk factors for predicting mortality (OR 4.165; 95% CI 1.462-11.864; P=0.008), whereas surprisingly the presence of community-acquired pneumonia (CAP) before ICVCU admission was a protective factor from hospital mortality (OR 0.224; 95% CI 0.068-0.730; P=0.013).Conclusion: Parameters in the SAPS 3 score system exhibited satisfactory performance in discrimination. In predicting hospital mortality, these parameters also showed good calibration for estimating hospital mortality. Intermediate ward as intra-hospital location before ICVCU admission appeared to be independently associated with mortality whereas patients with CAP comorbid as a protective factor against mortality. Despite the good result of this study, there are still plenty room of improvement for developing similar score in the future specifically for ICVCU population.
Perlukah kriteria hipertensi baru dan target pengendalian tekanan darah yang lebih agresif? Telaah paska studi SPRINT serta panduan ACC/AHA 2017 dan ESH/ESC 2018 Bambang Widyantoro
Jurnal Kardiologi Indonesia Vol 39 No 2 (2018): Indonesian Journal of Cardiology: April-June 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i2.765

Abstract

Physicians' awareness and practice of home blood pressure measurement in Indonesia: Asia home blood pressure monitoring survey 2020 Yuda Turana; Noriko Matsushita; Ebtehal Salman; Arieska Ann Soenarta; Vidya Gani Wijaya; Bambang Widyantoro; Eka Harmeiwaty; Rarsari Soerarso; Tunggul Diapari Situmorang
Universa Medicina Vol. 42 No. 2 (2023)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2023.v42.182-194

Abstract

BackgroundHypertension is a significant mortality risk factor. The knowledge and practice among physicians of hypertension management and home blood pressure monitoring (HBPM) in blood pressure control is important. We aimed to investigate the awareness and practice of HBPM among physicians in Indonesia after publishing of the local 2019 HBPM guidelines. MethodsThis was a cross-sectional study involving 611 physicians in Indonesia that was conducted between February and October 2020. The questionnaire covered awareness, knowledge, and practice of HBPM. ResultsA total of 330 male physicians (54.0%) aged 20-49 years participated in the survey. More than half were specialists (51.6%) and recommended HBPM to their patients with hypertension (89.0%). The awareness of HBPM benefits was substantial among the physicians; however, the knowledge of the home blood pressure (HBP) reference values of was low (7.9%). Around 54% of the respondents thought that the barriers to low recognition of HBPM are lack of HBPM guidelines or lack of understanding of HBPM among physicians. A considerable percentage provided instruction on HBPM that aligned with the local guidelines, but between 7.5-29.5% gave no instruction on HBPM. ConclusionMost physicians recommend HBPM, but there is still a lack of knowledge and attitude toward HBPM. In Indonesia, local HBPM guidelines were published in 2019, but have not yet sufficiently penetrated the country, therefore robust dissemination of the published HBPM guidelines is still needed. For efficient utilization of HBPM by physicians in clinical practice, developing user-friendly educational tools such as physicians’ pocket guide on HBPM instructions is essential.
Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry Juzar, Dafsah Arifa; Muzakkir, Akhtar Fajar; Ilhami, Yose Ramda; Taufiq, Nahar; Astiawati, Tri; R A, I Made Junior; Pramudyo, Miftah; Priyana, Andria; Hakim, Afdhalun; Anjarwani, Setyasih; Endang, Jusup; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1406

Abstract

Background Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. Methods IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. Results Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients. Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). Conclusion Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy. This article has a related Erratum.
Role of regulatory T cells and T helper 17 cells in the pathogenesis of hypertension: a review Muliawan, Hary Sakti; Dwi Putra, Swastya; Amin, Hilman Zulkifli; Widyantoro, Bambang
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.rev.247521

Abstract

The discovery of autoantibodies in artery samples from cadavers with hypertension over 50 years ago suggested a potential link between the immune system and hypertension. Since then, research exploring the role of the immune system in hypertension has emerged. Animal studies have demonstrated a strong correlation between regulatory T cells (Tregs) and T helper 17 (Th17) cells in hypertension development, yet studies on human hypertension remain limited. Tregs produce inhibitory cytokines such as interleukin (IL)-10 and transforming growth factor-β to act as anti-inflammatory cells that protect against hypertension. In contrast, Th17 cells, by producing IL-17A, function as pro-inflammatory cells that promote hypertension. Recently, a subset of cells known as IL-17A+FOXP3+Treg cells have been identified, which can produce IL-17 and act as inflammatory cells under certain conditions. Understanding the basic mechanisms by which the immune system influences hypertension could lead to targeted immunotherapies for hypertension in the future. Thus, we highlighted the role of Tregs and Th17 cells in the development of hypertension and their potential as targets for therapy. Our findings confirmed the role of Tregs and Th17 cells in the pathogenesis of hypertension.
Divergent roles of circulating miR-133 and miR-155 in modulating angiotensin II levels among hypertensive patients in Melanesian and non-Melanesian populations Wijaya, Shoma A.; Pujianto, Dwi A.; Prijanti, Ani R.; Widyantoro, Bambang
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1759

Abstract

The therapeutic approach to hypertension often varies across racial and ethnic groups; however, antihypertensive treatments have not yet been tailored to account for these variations in Indonesia, a country with diverse racial and ethnic groups. In addition, microRNA-133 (miR-133) and microRNA-155 (miR-155) play critical roles in cardiac muscle homeostasis and inflammatory responses, but their specific functions in hypertension remain unclear. The aim of this study was to investigate the correlation between circulating miR-133 and miR-155 levels and angiotensin II (ANG-II) levels in hypertensive patients from Melanesian and non-Melanesian populations in Indonesia. A cross-sectional study was conducted in Jayapura, Indonesia among Melanesian and non-Melanesian hypertensive patients. The levels of ANG-II were quantified using sandwich ELISA, while the relative expression of miR-133 and miR-155 levels were measured by real-time PCR. Differences between the two groups were assessed using the Mann-Whitney test, and correlations between miR and ANG-II levels were determined using the Spearman correlation test. The relative expression levels of miR-133 and miR-155 in the Melanesian group were significantly higher than in the non-Melanesian group; 6.94-fold (3.85 vs 0.55) and 2.1-fold higher (0.19 vs 0.09), respectively. MiR-133 had a moderate negative correlation with ANG-II in both Melanesian (r=-0.538; p<0.001) and non-Melanesian (r=-0.649; p<0.001). However, miR-155 had no significant correlation with ANG-II levels in either the Melanesian group (p=0.551) or non-Melanesian group (p=0.159). This study highlights that miR-133 levels are significantly correlated with ANG-II concentrations in both Melanesian and non-Melanesian hypertensive patients, suggesting that miR-133 may play a regulatory role in the ANG-II pathway. These findings provide insights into the potential of miR-133 as a biomarker for hypertension management in diverse populations.
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Bagaswoto, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1381

Abstract

As the primary cause of hospitalization in acute heart failure (AHF) patients, congestion was responsible for a higher risk of mortality, rehospitalization, and renal dysfunction in AHF patients. Although loop diuretic was routinely used as the mainstay of AHF therapy, it is still ineffective to obtain the euvolemic state in most hospitalized AHF patients. Therefore, a higher loop diuretic dose was often required to increase the decongestion effect. However, consequently, it can cause several detrimental complications, including renal dysfunction, neurohormonal activation, hyponatremia, hypokalaemia, and reduced blood pressure, which eventually result in poor prognosis. Hence, the new approach may be proposed to optimize decongestion in acute phase, including the use of arginine vasopressin V2 receptor antagonist – Tolvaptan. As an additive therapy to loop diuretic in AHF patients, it can be considered due to its several beneficial effects, including greater decongestion effect, lowered worsening renal function incidence, counteract neurohormonal activation, neutralized hyponatraemic state, no alteration of potassium metabolism, stabilize the blood pressure, and reduced requirement of a higher dose of loop diuretic to achieve an equal or even greater decongestion effect compared to a high dose of loop diuretic alone. Tolvaptan provided favourable outcomes in several specific populations and was considered safe with several mild adverse effects. Several guidelines across countries have approved the use of Tolvaptan in AHF patients with or without hyponatremia. The initial dose of Tolvaptan was 7.5 to 15 mg and can be titrated up to 30 mg. However, further studies were still required to determine the timing dose and optimal dose of Tolvaptan in general and elderly populations with AHF, respectively.This article has a related Erratum.
Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure Rezeki, Arindya; Widyantoro, Bambang; Rossimarina, Vienna; Dwiputra, Bambang; Danny, Siska Surinanda; Sukmawan, Renan; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2029

Abstract

In “Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure” (Indonesian Journal of Cardiology, 44(2), 53-60. https://doi.org/10.30701/ijc.1380), there are an errors noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1380. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. An error also occurred in the author’s name. We have corrected the author’s name from “Vienna Rossiamarina” to “Vienna Rossimarina.” There is also an error in the page numbering on the first page of the article. At the top, it says “57-64,” but we have changed it to the correct page numbers (53-60). The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1380
Co-Authors Afdhalun Hakim Akhtar Fajar Muzakkir Akhtar Fajar Muzakkir Akhtar Fajar Muzakkir Andi Alfian Zainuddin Andria Priyana Andria Priyana Ani R. Prijanti Anjarwani, Setyasih Anwar Santoso Anwar Santoso Arieska Ann Soenarta Astiawati, Tri Bagus Herlambang Celly Anantaria Atmadikoesoemah Dafsah Arifa Juzar Daniel PL Tobing Danny, Hendry Purnasidha Danny, Siska Surinanda Daondy Friarsa Soeharto Dian Zamroni Dony Yugo Hermanto Dwi A. Pujianto Dwi Putra, Swastya Dwi Yuda Herdanto Dwiputra, Bambang Ebtehal Salman Eka Harmeiwaty Endang, Jusup Erwinanto Erwinanto Faisal Habib Habib, Faisal Hakim, Afdhalun Hendry Purnasidha Bagaswoto Hendry Purnasidha Bagaswoto Hilman Zulkifli Amin, Hilman Zulkifli Hiradipta Ardining I Made Junior R A Ilhami, Yose Ramda Irmalita Irmalita Isman Firdaus Ispar, Akhtar Fajar Muzakkir Ali Jusup Endang Mazwar, Irmaliyas Miftah Pramudyo Miftah Pramudyo Muliawan, Hary Sakti Muzakkir, Akhtar Fajar Nahar Taufiq Nahar Taufiq, Nahar Noriko Matsushita Pratama, Vireza Putra, Iwan Cahyo Santosa R A, I Made Junior Rarsari Soerarso Rarsari Soerarso Renan Sukmawan Rezeki, Arindya Rido Mulawarman Rita Zahara Rossimarina, Vienna Sarastuti, Arum Widi Setyasih Anjarwani Siska Suridanda Danny Sugisman Sugisman Sunanto Ng Tri Astiawati Tunggul Diapari Situmorang Vidya Gani Wijaya Wijaya, Shoma A. Yose Ramda Ilhami Yuda Turana Zulkarnain, Edrian