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All Journal Interaksi Online Journal of Politic and Government Studies Jurnal Mudarrisuna: Media Kajian Pendidikan Agama Islam Berkala Kedokteran Indonesian Journal of Cardiology Heart Science Journal Narra J Jurnal Abdimas Kartika Wijayakusuma JUSTIN (Jurnal Sistem dan Teknologi Informasi) Jurnal Klinik dan Riset Kesehatan Jurnal Penelitian Dan Pengkajian Ilmiah Sosial Budaya Eduvest - Journal of Universal Studies JRIIN :Jurnal Riset Informatika dan Inovasi Karimah Tauhid Adil Indonesia Journal
Indra Prasetya
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Journal : Heart Science Journal

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Impact of clinical features on in-hospital outcomes in premature coronary artery disease patients post percutaneous coronary intervention Noverike, Nikhen; Rohman, Mohammad Saifur; Rahimah, Anna Fuji; Rizal, Ardian; Prasetya, Indra
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.11

Abstract

Background: Premature coronary artery disease (PCAD) is a significant health concern globally, characterized by the onset of coronary atherosclerosis at an early age. The development of PCAD is influenced by a variety of risk factors and leading to substantial morbidity and mortality. Despite advancements in interventions, the clinical and angiographic characteristics influencing in-hospital outcomes for these patients remain underexplored.Objective: This study aims to investigate the relationship between clinical features and in-hospital outcomes in patients with premature CAD post-percutaneous coronary intervention (PCI) at Dr. Saiful Anwar Hospital.Method: A retrospective cohort study was conducted on 1279 patients who underwent PCI for premature CAD from January 2022 to December 2023. Clinical data, including risk factors and angiographic findings, were collected from medical records. Statistical analyses were conducted using SPSS 22, employing univariate, bivariate, and multivariate logistic regression analyses to determine correlations.Result: The study included 1279 patients, with 438 in the premature CAD group and 841 in the non-premature CAD group. Significant differences were observed in age, sex distribution, BMI, lipid profiles, smoking status, and family history between the groups. Premature CAD patients were younger (mean age 50 vs. 64.8, p<0.001) and had higher rates of smoking and dyslipidemia. Angiographic analysis showed significant differences in LAD and LCx involvement and occlusion rates. In-hospital outcomes indicated higher incidences of shock, cardiac complications, and in-hospital mortality in the non-premature CAD group.Conclusion: Clinical and angiographic characteristics significantly influence in-hospital outcomes for premature CAD patients. Younger age, smoking, and dyslipidemia were prevalent risk factors. Enhanced management strategies focusing on these factors could improve patient outcomes.Keywords: Premature coronary artery disease, percutaneous coronary intervention, clinical characteristics, angiographic findings, in-hospital outcomes. 
Increase Cardiovascular Event in Patient with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Millisani, Hayla Iqda; Prasetya, Indra; Rohman, Mohammad Saifur; Satrijo, Budi
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.5

Abstract

Diabetes mellitus (DM) associated with increase major risk factors of cardiovascular disease, such as peripheral arteriopathy, ischemic heart disease, or cerebrovascular accident. The Framingham study showed that patient with DM considerably increase coronary artery disease (CAD), particularly in old patient and women. Prevalence of DM is rising and cardiovascular mortality associated with DM is the main problem in the world. Additionally, there is a higher death rate among DM patients following a myocardial infarction with complications, such as stent thrombosis, instent restenosis, and no reflow phenomenon can worse overall long term prognosis with CAD. This review c onsiders the mechanism for diabetes mellitus in CAD patient, expecially patient with DM can increase risk of major complication in patient CAD undergoing percutaneous coronary intervention (PCI).
Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room Zunardi, Lutfi Hafiz; Anjarwani, Setyasih; Prasetya, Indra; Satrijo, Budi; Rahimah, Anna Fuji
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.7

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. 
Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Abstract

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.
A 56 Year Old Male with Acute Stent Thrombosis During Percutaneous Coronary Intervention, How to Resolve This Problem? Millisani, Hayla Iqda; Rohman, Mohammad Saifur; Prasetya, Indra; Widito, Sasmojo
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.8

Abstract

Background: Acute stent thrombosis is the complete occlusion of a coronary artery of the previously implanted stent. This unusual complication occurs in percutaneous coronary intervention (PCI), development of myocardial ischemia, and poor prognosis for the patient. After PCI, acute stent thrombosiscan occur within 0-24 hours and cause the symptoms like acute coronary syndrome. Incidents of stent thrombosis are about 0.6% to 3.4% for Drug Eluting Stent (DES) implantation, depending on the lesion and patient factors. The etiology of acute stent thrombosis is multifactorial, and early detectioncan reduce the mortality rate.Case Illustration: A 56 yo male visited Rumah Sakit Saiful Anwar Malang with stable angina pectoris (Class III symptoms with medical therapy) planned for elective cardiac catheterization with routine medical treatment. During PCI, he complained the chest pain, and from cine angiography evaluation showed no flow at the diagonal branch because of the acute thrombosis. Then got thrombosuction and got a white thrombus. After the PCI procedure, he got fibrinolytic with streptokinase 1.5 million units for 60 minutes. He was transferred to CVCU for observation and discharged after five days.Conclusion: Acute stent thrombosis is a severe complication during and after PCI because it is related to high mortality. The mechanisms by which ST arises are complex and multifactorial and must be early detection.
Hypothermia theraphy in patients post cardiac arrest Yudha, Tria; Prasetya, Indra; Tjahjono, Cholid Tri; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.5

Abstract

Cardiovascular disease is the leading cause of death in several developing countries, and many of these deaths occur before reaching the hospital due to cardiac arrest. Most patients who return to spontaneous circulation (ROSC) and are brought to the hospital experience severe neurological damage during cardiac arrest, and this damage is the cause of in-hospital mortality. Improvements in survival and neurologic improvement of patients with CA have focused on two main therapy areas. The first area is improved education and skills of medical and paramedical personnel to improve perfusion post CA. The second area is a greater emphasis on post-resuscitation care which includes optimizing oxygenation and ventilation, avoiding hypotension, treating causes of CA such as acute coronary ischemia, and initiating hypothermia therapy if necessary, as in the 2020 guidelines and recommendations from the American Heart Association (AHA), International Liaison Committee of Resuscitation, and European Resuscitation Council covering the entire spectrum of post-resuscitation care.  The AHA guidelines 2020 recommend optimizing hypothermia therapy for 24 hours with a target temperature between 320C - 360C in ROSC patients to improve clinical outcomes of neurological status after cardiac arrest. This is contrast to the study of Martinell et al in their research which concluded that there was no significant difference in survival rates within 30 days after cardiac arrest in patients who received either hypothermia therapy or those who did not. Hypothermia therapy, which is currently part of the post-resuscitation care recommendations, has varied variables and remains controversial in its implementation. Based on this, this referent will discuss the effects of hypothermia therapy on post-cardiac arrest patients, the stages, and the practical aspects of implementing hypothermia therapy.
Continous renal replacement therapy: revisited Aryanugraha, Teguh; Prasetya, Indra
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.7

Abstract

Patients in condition of acute kidney injury (AKI) and critically ill often benefit from renal replacement therapy (RRT). Patient with hemodynamically unstable in cardiac intensive care, such as those with congestive heart failure, acute myocardial dysfunction, or excessive hemodilution during cardiac surgery, continuous renal replacement therapy (CRRT) is considered to be the suitable renal replacement therapy modality. This paper discusses indications, techniques, and CRRT in cardiac critical care.
Use of SAPS 3, APACHE IV, and GRACE as prognostic scores for acute coronary syndrome patients in the cardiovascular care unit Yudha, Tria; Prasetya, Indra
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.3

Abstract

A grading system based on disease severity has been widely used in intensive care units (ICUs) since around 1980. These systems are used to predict mortality and assess severity in clinical trials. Simplified Acute Physiology Score 3 (SAPS3) and Acute Physiology and Chronic Health Evaluation Score (APACHE IV) are prognosis ratings that can predict in-hospital mortality within the first hour of ICU care. Although these technologies have been widely employed in the ICU, they have yet to be commonly deployed in the cardiovascular care unit (CVCU) due to different patient populations. Intensive care doctors typically employ the standard prognostic scores, SAPS3 and APACHE IV, which were generated from diverse populations of critically ill patients. Although these scores are the most widely used early versions, APACHE IV and SAPS 3 do not include acute coronary syndrome patients. The Global Registry of Acute Coronary Events (GRACE) score has performed the best; this may be because of its straightforward design, which does not distinguish between individuals with SCA and those without ST-segment elevation. Our review article attempts to evaluate the performance of standard predictor scores, namely SAPS 3, APACHE IV, and GRACE, on patients with cardiovascular emergencies. Thus, these score systems can precisely assess the relationship between mortality prediction scores and outcomes of patients admitted to the CVCU rapidly and comprehensively.    
The complex relationship between arterial carbon dioxide levels and acute heart failure: implications for prognosis and management Afifah, Yuri; Prasetya, Indra; Anjarwani, Setyasih; Pashira, Andranissa Amalia
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.2

Abstract

Acute Heart Failure (AHF) can affect carbon dioxide levels in the body by altering the balance between ventilation and carbon dioxide production, leading to either hypocapnia or hypercapnia. Arterial carbon dioxide (CO2) levels are essential for maintaining respiratory function and acid-base balance. However, the relationship between arterial CO2 levels and AHF remains complex and not fully understood. Diverse factors affect arterial CO2 levels in patients with AHF, including neurohormonal activation, respiratory compensation for hypoxemia, and changes in pulmonary perfusion. Hypocapnia, characterized by low arterial CO2 levels (PaCO2 < 35 mmHg), is commonly observed in AHF due to hyperventilation-driven respiratory alkalosis secondary to pulmonary congestion. It showed a strong connection with the survival rates of patients following a cardiac arrest. Nevertheless, elevated levels of carbon dioxide in the blood, known as hypercapnia, with a partial pressure of arterial carbon dioxide (PaCO2) exceeding 45 mmHg, can also arise in the later phases of acute heart failure (AHF), indicating fatigue in respiratory muscles or deterioration in pulmonary edema. Abnormal arterial CO2 levels have been associated with increased morbidity and mortality in AHF patients, serving as a valuable prognostic marker.  
Predictive value of PaCO2 on mortality in patients with acute heart failure Afifah, Yuri; Prasetya, Indra; Baskoro, Shalahuddin Suryo; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.9

Abstract

Background: Patients with AHF may experience fluctuations in carbon dioxide levels, resulting in either hypercapnia or hypocapnia. Recent research has highlighted the significance of the relationship between CO2 fluctuation and patient outcomes. Objective: The aim of this study was to explore the relationship between arterial carbon dioxide pressure (PaCO2) upon admission to the ICCU in patients with AHF. Methods: A single centre retrospective observational study was performed, the patient were enrolled from patient medical record between 2021 and 2023. Participants were divided into three groups based on PaCO2 levels. The study end point was length of hospitalization, mortality at ICCU and mortality in hospital. Statistical analysis used various tests to compare outcomes, with significance set at p<0.05, and ROC analysis evaluated mortality prediction. Result: The study included 150 patients: 97 with hypocapnia, 33 with normal PaCO2, and 19 with hypercapnia. In-hospital mortality was 37.5%, and 1-month mortality was 33.3% in the hypercapnia group. PaCO2 >45 mmHg was linked to higher in-hospital mortality (OR 6.900, p <0.001) and 30-day mortality (OR 5.600, p <0.001), PaCO2 <35 mmHg showing a protective association in ICCU and in-hospital mortality (OR 0.202, p<0.001) and 30-day mortality (OR 0.237, p<0.001). Length of stay was not significantly affected by either hypocapnia or hypercapnia. The ROC for predicting in-hospital mortality was 0.648 and for 30-day mortality was 0.626 in the PaCO2 >45 mmHg group. Conclusion: PaCO2 levels at ICCU admission predict mortality in AHF patients. Hypercapnia is associated with higher in-hospital and 30-day mortality, while hypocapnia appears protective.
Co-Authors Abadi, Sahlan Adlan El Fatih, Muhammad Afifah, Yuri Agung Sasongko Ahmad Aviv Mahmudi Aji, Nugroho Priyo Anjarwani, Setyasih Anna Fuji Rahimah Arista Candra Irawati Aryanugraha, Teguh Astiawati, Tri Atma Gunawan Bagaswoto, Hendry P. Bahar, Mokhamad Aswin Baskoro, Shalahuddin Suryo Burhan Burhan, Burhan Caesario, Fahreza Cholid Tri Tjahjono Cholid Tri Tjahjono Dadang Suprijatna Danny, Siska S. Dewi U. Djafar, Dewi U. Dewi Utari Djafar, Dewi Utari Dilla Maulida Dyah Puspita Saraswati Dzaki Ilhami, Muhammad Efendi, Rizki Arief Filano, Marco Firdaus, Achmad Jauhar firmansyah, Yoki Habib, Faisal Hakim, Dennis I. Hakim, Dennis Ievan Hedi Pudjo Santosa Hendry Purnasidha Bagaswoto Ilhami, Yose R. Ilhami, Yose Ramda Juzar, Dafsah A. Juzar, Dafsah Arifa Karolina, Wella Kuhn, Corinna Maria Kurnianingsih, Novi Kushandajani . Laukkanen, Noora Julia Lestari, Puspa Martini, Heny Millisani, Hayla Iqda Mohammad S. Rohman Mohammad Saifur Rohman Muhammad Sony Maulana Muzakkir, Akhtar F. Muzakkir, Akhtar Fajar Nita Sari, Nita Noverike, Nikhen Novi Rahmawati Nugraha, Tria Yudha Nugraha, Yudha Tria Nurudinulloh, Akhmad Isna Pamuna, Oktafin Srywati Pashira, Andranissa Amalia Perani Rosyani Prastya, Andhika Primada Qurrota Ayun Priyatno Harsasto Putri, Valerinna Yogibuana Swastika Raden Djuniarsono Rahimah, Anna Fuji Ratna Pancasari Rhiza Amdi, Muh Ririn Handayani Rizal, Ardian Rochmawati, Icmi Dian Rudi, Hasrian Sakti, Pradhika Perdana Saputri, Vemmy Lian Saskia Dyah Handari Satrijo, Budi Setiawan, Dion Setyowati, Danti Utami Siska Suridanda Danny Sungkar, Safir Wanty Eka Jayanti Widito, Sasmojo Windya Harieska Pramujati Wirawan, Hendy Yogibuana, Valerinna Yudha, Tria Zhao, Zihan zunardi, Lutfi hafiz