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All Journal Medical Journal of Indonesia Universa Medicina Indonesian Journal of Cardiology Narra J Cermin Dunia Kedokteran 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

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | 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.
Latihan Fisik bagi Penderita Hipertensi Arum Widi Sarastuti; Bambang Widyantoro
Cermin Dunia Kedokteran Vol 45 No 12 (2018): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i12.687

Abstract

Hipertensi merupakan faktor risiko utama penyakit kardiovaskular, yang jika tidak diterapi secara tepat 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.
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.
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 Suridanda; Sukmawan, Renan; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1380

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear. Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients. Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects. Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320). Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.
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.
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.
Co-Authors Akhtar Fajar Muzakkir Andi Alfian Zainuddin Andria Priyana Ani R. Prijanti Anjarwani, Setyasih Anwar Santoso Arieska Ann Soenarta Arum Widi Sarastuti Arum Widi Sarastuti Astiawati, Tri Daniel PL Tobing Dian Zamroni Dwi A. Pujianto Dwi Putra, Swastya Dwi Yuda Herdanto Dwiputra, Bambang Ebtehal Salman Eka Harmeiwaty Endang, Jusup Habib, Faisal Hakim, Afdhalun Hendry Purnasidha Bagaswoto Hilman Zulkifli Amin, Hilman Zulkifli Ilhami, Yose Ramda Irmalita Irmalita Isman Firdaus Ispar, Akhtar Fajar Muzakkir Ali Juzar, Dafsah Arifa Mazwar, Irmaliyas Muliawan, Hary Sakti Muzakkir, Akhtar Fajar Nahar Taufiq, Nahar Noriko Matsushita Pramudyo, Miftah Pratama, Vireza Putra, Iwan Cahyo Santosa R A, I Made Junior Rarsari Soerarso Renan Sukmawan Rezeki, Arindya Rossimarina, Vienna Sarastuti, Arum Widi Siska Suridanda Danny Siska Suridanda Danny Tunggul Diapari Situmorang Vidya Gani Wijaya Wijaya, Shoma A. Yuda Turana Zulkarnain, Edrian