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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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Comparative predictive value of APACHE-II, SAPS-II and GRACE scores for mortality in acute coronary syndrome (ACS) patients: Evidence from Indonesia intensive cardiovascular care unit registry Prasetya, Indra; Hakim, Dennis I.; Anjarwani, Setyasih; Bagaswoto, Hendry P.; Muzakkir, Akhtar F.; Habib, Faisal; Astiawati, Tri; Wirawan, Hendy; Ilhami, Yose R.; Djafar, Dewi U.; Sungkar, Safir; Danny, Siska S.; Juzar, Dafsah A.
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.v5i1.1911

Abstract

The Global Registry of Acute Coronary Events (GRACE) score is acknowledged for its ability to predict in-hospital mortality among patients with acute coronary syndrome (ACS). However, intensive care physicians often employ general prognostic scores such as Acute Physiologic and Chronic Health Evaluation II (APACHE-II) and Simplified Acute Physiology Score II (SAPS-II) to predict the mortality of ACS patients. However, their predictive values are not well-determined in predicting mortality in ACS treated in the cardiovascular care unit (CVCU). The aim of this study was to evaluate the performance of APACHE-II and SAPS-II scores in comparison with GRACE scores in predicting the CVCU mortality and in-hospital mortality of ACS patients admitted to CVCU. A multicenter retrospective cohort study was conducted using data from a registry of patients admitted to 10 hospitals in Indonesia between August 2021 and July 2023. This study evaluated the APACHE-II, SAPS-II, and GRACE scores for patients with ACS upon admission to CVCU. The area under the curve (AUC) of the receiver operating characteristic (ROC) was utilized to assess the discriminative ability for predicting mortality. Among the 12,950 admitted patients, 9,040 were diagnosed with ACS, and 6,490 patients were included in the final analysis. All three scoring systems had relatively good discriminative ability to predict CVCU mortality with APACHE-II having better results (AUC: 0.771; sensitivity: 63.9%; specificity: 78.7%) compared to GRACE (AUC: 0.726; sensitivity: 61.7%; specificity: 73.2%) and SAPS-II (AUC: 0.655; sensitivity: 38.9%; specificity: 85.2%). To predict in-hospital mortality, APACHE-II had better results (AUC: 0.815; sensitivity: 68.7%; specificity: 80.4%) compared to GRACE (AUC: 0.769; sensitivity: 64.6%; specificity: 77.5%) and SAPS-II (AUC: 0.683; sensitivity: 41.8%; specificity: 86.2%). APACHE-II had the best single risk factor for CVCU mortality (odds ratio (OR): 1.198; 95% confidence interval (CI): 1.181–1.214) and in-hospital mortality (OR: 1.259; 95%CI: 1.240–1.279). In conclusion, APACHE-II, SAPS-II, and GRACE scores moderately predict CVCU and in-hospital mortalities, with the APACHE-II score exhibiting the highest predictive capability in ACS patients admitted to CVCU.
Pemberdayaan Masyarakat Desa Dalam Meningkatkan Perekonomian Melalui Pendekatan Kuliah Kerja Nyata Tematik Di Desa Candimulyo Rembang Sari, Nita; Prasetya, Indra; Aji, Nugroho Priyo; Mahmudi, A. Aviv; Pramujati, Windya Harieska
Jurnal Abdimas Kartika Wijayakusuma Vol 6 No 1 (2025): Jurnal Abdimas Kartika Wijayakusuma
Publisher : LPPM Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26874/jakw.v6i1.469

Abstract

Pemberdayaan desa merupakan upaya kolaborasi atau kerjasama, baik antara pemerintah desa, masyarakat, dan pihak luar seperti perguruan tinggi. Salah satu peran penting perguruan tinggi dalam pemberdayaan desa adalah melalui program Kuliah Kerja Nyata Tematik (KKNT), dimana para mahasiswa dapat mengimplementasikan ilmu dan keahlianmereka dalam program tersebut. Prodi Sistem Informasi, Universitas YPPI Rembang turut serta dalam penyelenggaraan KKNT untuk mendorong mahasiswa agar berkontribusi langsung kepada masyarakat desa. Desa yang dipilih untuk pelaksanaan KKNT ini adalah Desa Candimulyo, Kecamatan Sedan, Kabupaten Rembang. Hasil observasi tim KKNT, didapatkan bahwa tingkat kesejahteraan masyarakat Desa Candimulyo masih cukup rendah, yang menyebabkan beberapa permasalahan, terutama dalam bidang ekonomi. Hal ini disebabkan oleh minimnya pengetahuan dalam mengembangkan potensi perekonomian desa. Oleh karena itu, tim KKNT merancang beberapa program kerja untuk mengatasi permasalahan tersebut. Program kerja yang dilaksanakan berupa sosialisasi dan pelatihan pembuatanecoprint, serta pembuatan desain grafis menggunakan aplikasi Canva. Program ini memberikan dampak positif dalam pemberdayaan masyarakat desa, dengan memberikan keterampilan dan pengetahuan baru kepada warga untuk memproduksi ecoprint, serta membuat desain produk yang menarik bagi konsumen. Dengan demikian, program ini diharapkan memberikan dampak bagi masyarakat, terutama dalam mengembangkan potensi desa dan meningkatkan perekonomian lokal.
Unveiling strategies in acute cardiac care for ventricular septal rupture following acute myocardial infarction: Lessons from cases Nurudinulloh, Akhmad Isna; Anjarwani, Setyasih; Prasetya, Indra; Yogibuana, Valerinna; Rahimah, Anna Fuji; Karolina, Wella
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.17

Abstract

Background: Ventricular septal rupture (VSR) following acute myocardial infarction (AMI) is drastically decreasing in the reperfusion era but mortality remains high. VSR correction is the definitive treatment and using mechanical support to delay closure is an attractive option despite data on success being limited. Case Illustration: A 60-year-old man presented with late presentation of anterior STEMI complicating hemodynamic deterioration. Echocardiography showed apical VSR 11-14 mm L-R shunt. Patient was given adequate fluids, multiple inotropic agents, and IABP insertion, then a successful PPCI procedure was performed immediately. IABP was maintained for hemodynamic stabilization and patient was scheduled for interventional closure. Unfortunately, the patient worsened due to cardiogenic shock and passed away on the 5th day of admission. In another case, a 61-year-old man came to our hospital also with a late presentation of anterior STEMI but stable in hemodynamics. Echocardiography showed apical VSR 9-11 mm L-R shunt. Coronary angiography showed CAD three vessel disease with critical stenosis at LAD. In hospital’s heart team discussion, patient was planned to be performed VSR closure percutaneously and continue with PCI procedure. Both procedures were performed successfully. Patient was improved and discharged on 20th day of admission. Conclusion: Rapid diagnosis and prompt treatment are the keys to optimal management of VSR complicating late presentation STEMI. Mechanical circulatory support and correction of VSR are required to optimize patient outcomes despite VSR is still a challenging case.
The influence of renal insufficiency on in-hospital major adverse cardiovascular events in STEMI patients receiving primary percutaneous coronary intervention Anjarwani, Setyasih; Nurudinulloh, Akhmad Isna; Widito, Sasmojo; Gunawan, Atma; Prasetya, Indra
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.12

Abstract

Introduction: Renal insufficiency (RI) is related to poor clinical results in STEMI patients receiving primary percutaneous coronary interventions (PCI). Objectives: This study evaluates the effect of RI on in-hospital major adverse cardiovascular events (MACE) in STEMI patients receiving primary PCI. Methods: The study was predicated on the registry of 1447 STEMI patients from January 2020–December 2023. Study samples were categorized into two groups: RI (eGFR<60mL/min/1.73m²) and no RI (eGFR≥60mL/min/1.73m²). Patients’ characteristics and in-hospital MACE in the two groups underwent analysis. Results: Among 848 consecutive subjects, 238 (28%) had RI, and 610 (72%) had no RI. Age (p = 0.000), diabetes mellitus (p = 0.007), and onset STEMI>12 hours (0.043) were correlated with RI. Dyslipidemia (p = 0.025), Onset STEMI>12 hours (p = 0.006), and RI (p = 0.000) were correlated with MACE. RI was correlated with MACE (OR 2.04, 95% CI: 1.46–2.85, p = 0.000). RI was correlated with sub-group analysis of MACE; cardiogenic shock (OR 2.00, 95% CI: 1.34-2.99, p = 0.001), acute heart failure (OR 1.80, 95% CI: 1.22-2.65, p = 0.003), malignant arrhythmia (OR 2.40, 95% CI: 1.61-3.58, p = 0.000), and mortality (OR 2.74, 95% CI: 1.78-4.24, p = 0.000). Conclusions: RI was correlated with in-hospital MACE in STEMI patients receiving primary PCI. In a sub-group analysis of in-hospital MACE, RI constituted a strong independent predictor of cardiogenic shock, acute heart failure, malignant arrhythmia, and mortality, respectively.
Hype or hope: The role of alcohol septal ablation in improving outcomes for young patients with obstructive hypertrophic cardiomyopathy: A case series Saputri, Vemmy Lian; Rizal, Ardian; Rahimah, Anna Fuji; Karolina, Wella; Yogibuana, Valerinna; Prasetya, Indra
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.19

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a disease that has a poor prognosis and a higher likelihood of death in young people. Alcohol septal ablation (ASA) is a minimally invasive procedure that involves the injection of ethanol through a septal perforator to lead to infarction of the hypertrophied septum. This case series aims to present data on the beneficial effects of ASA in promoting hope for enhanced outcomes in young patients with HCM. Case: Patient 1: A 32-year-old male with HCM has been suffering from chest discomfort and atrial fibrillation since 2020. Echocardiography detected an increased obstruction in the left ventricular outflow tract (LVOT), resulting in a gradient of 104 mmHg. The patient underwent ASA to decrease the gradient to 37 mmHg, reducing hospitalizations throughout a 12-month follow-up period. Patient 2: A 27-year-old female diagnosed with HCM has been frequently suffering episodes of near syncope and shortness of breath with light activity over the past 6 months. The echocardiography findings showed a significant increase in the resting gradient in the LVOT. Following ASA, the resting gradient decreased to 54 mmHg during a 3-month follow-up. The patient did not suffer further near syncope events, and her NYHA functional class improved throughout a 9-month follow-up period. Conclusion: The effectiveness of ASA as a treatment option is hope for young patients with obstructive HCM, which is demonstrated in this case series, leading to relieving symptoms, reduced repeated hospitalization, and improved functional capacity.
Successful unroofing of anomalous aortic origin of the left coronary artery with intramural course in patient with near syncope Firdaus, Achmad Jauhar; Handari, Saskia Dyah; Prasetya, Indra; Tjahjono, Cholid Tri
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.17

Abstract

BACKGROUND: Left Anomalous Coronary Artery from the Opposite Sinus of Valsalva (L-ACAOS) refers to a congenital heart defect in which the left coronary artery originates from the right coronary sinus of Valsalva. This condition may increase the risk of sudden cardiac death (SCD), especially for those participating in intense physical exertion. This paper presents a case of a malignant type L-ACAOS in a young male who underwent successful surgical correction. CASE: A 35-year-old male without any known coronary artery disease risk factors presents with angina and near syncope while competing in a marathon run. He regularly participates in endurance sporting events without any complaints. However, in the last two years, he has begun to complain of angina during exertion. The ECG examination showed early repolarization in the inferior and lateral leads with no significant lab abnormalities. This led to coronary computed tomography angiography (CCTA), which revealed that the left coronary artery originates from the right coronary sinus and runs between the pulmonary trunk and ascending aorta, indicating a malignant-type anomalous coronary artery. He then undergoes a surgical correction with unroofing of the left main coronary artery and relocate the LMCA orifice to the left sinus. The procedure proceeded uneventfully with satisfactory results. CONCLUSION: Anomalous coronary arteries are concerning because they are associated with increased risks of SCD. The intramural course is associated with a higher risk of SCD due to stenosis caused by lateral compression that leads to ischemia and potentially fatal arrhythmias, making early detection and intervention critical.
Predictive value of GRACE and APACHE-II scores on mortality in acute coronary syndrome patients admitted to CVCU Prasetya, Indra; Hakim, Dennis Ievan; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.16

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is correlated with elevated death and fatality rates. The Global Registry of Acute Coronary Events (GRACE) score is frequently employed for risk stratification in ACS. Nevertheless, intensive care physicians frequently utilize more comprehensive and general prognostic judgments derived from critically ill individuals, one of which is the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. OBJECTIVES: To compare the effectiveness of the score compared to APACHE-II score in predicting cardiovascular care unit () mortality. METHODS: A Retrospective cohort study was carried out at a single center, utilizing data from ACS patients admitted to the CVCU of RSUD Dr. Saiful Anwar Malang from 2021 to 2023. Both GRACE and APACHE-II scores were computed at the initial admission to hospital. The discriminative capability was computed using the area under the curve (AUC), and calibration was verified by the Hosmer-Lemeshow (HL) test. Multivariate logistic regression was performed to ascertain independent determinants of death. RESULTS: CONCLUSION: APACHE-II exhibited enhanced efficacy in predicting CVCU mortality in ACS patients, and both scoring systems continue to serve as valuable instruments.                
The effectiveness of supervised exercise training regarding NT-pro BNP level as a prognostic value among patients with congenital heart disease-related to pulmonary hypertension Setyowati, Danti Utami; Martini, Heny; Prasetya, Indra
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.5

Abstract

Congenital heart disease-related to pulmonary hypertension (CHD-PH) constitutes a significant subset of related Pulmonary Hypertension (PH), representing around 11% of all PH patients. Considering the emergence of novel medicines and enhanced patient outcomes in PH, it continues to be a life-shortening condition, and the time frame before diagnosis has not altered. Current strategies to enhance outcomes emphasize on early diagnosis and a treatment methodology designed to put individuals with PH into a low-risk category for one-year mortality. The N-terminal prohormone of BNP (NT-pro BNP) is secreted by cardiomyocytes in reaction to mechanical strain and wall stress. An increased concentration of NT-pro BNP is included in some PH risk stratification methods and screening protocols. The initial recommendation to restrict physical exertion in individuals with PH was based on its adverse impact on their clinical status. But clinicians have recently concentrated on the significance of physical exercise in those with PH. Consistent physical activity can enhance functional capacity, elevate quality of life (QoL), and increase prognosis and life expectancy as well. This literature review seeks to consolidate research about the impact of physical activity on NT-ProBNP levels in individuals with CHD-PH.  
Impact of supervised physical activity as adjunctive therapy on functional capacity and NT-pro BNP in patients with negative-reactivity test pulmonary hypertension related to congenital heart disease patient in Saiful Anwar Hospital Malang : A preliminary study Setyowati, Danti Utami; Martini, Heny; Prasetya, Indra; Tjahjono, Cholid Tri; Yogibuana, Valerinna
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.10

Abstract

Background: Appropriate levels of physical activity (PhA) provide health benefits to patients with chronic diseases, including patients with pulmonary hypertension-related to congenital heart disease (CHD-PH), representing around 4-10% of all PH patients. Objective: The purpose of this analysis was to determine the benefits and effectiveness of PhA as an additional therapy to optimal medication vs. control group on the functional capacity and N-terminal prohormone of B-type natriuretic peptide (NT-pro BNP) in patients with inoperable CHD-PH. Methods: A clinical preliminary study was conducted with 26 consecutive patients in stable condition before the study. Each patient was educated about the benefits of PhA and efficacy parameters of the six-minute walking distance (6MWD) and NT-Pro BNP levels have been evaluated at baseline and after 12 weeks. Results: The study included participants aged 33 ± 11 years, 84% of whom were female. All patients tolerated PhA without severe adverse events. Patients significantly improved the mean 6MWD compared to baseline by 382.9 ± 64.7 (p=0,000) and 318.3 ± 74 (p=0,041) meters after 12 weeks (training vs. control group). Ln NT-pro BNP improved significantly in the training group (p=0,002). There were no differences at week 12 in the delta 6MWD and NT-pro BNP levels, with all P values >0,05. Likewise, there is no correlation between the two variables Conclusions: PhA as an add-on to medical therapy may enhance work capacity and other prognostic relevant parameters in patients with inoperable CHD-PH. However, further larger, multi-center randomized controlled trials, is warranted to validate these preliminary findings
Predictors of prolonged use of mechanical ventilation in patients with acute respiratory failure and acute heart failure in the CVCU RSUD Dr. Saiful Anwar Malang Lestari, Puspa; Anjarwani, Setyasih; Kurnianingsih, Novi; Prasetya, Indra; Martini, Heny
Jurnal Kardiologi Indonesia Vol 46 No 3 (2025): July - September, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1335

Abstract

Background Acute respiratory failure (ARF) is a critical condition that often complicates hospitalization and commonly arises from cardiopulmonary dysfunctions such as acute heart failure. Prolonged mechanical ventilation (PMV) in these patients is associated with increased morbidity, mortality of about 30%, and greater healthcare resource utilization. Identifying predictors of PMV is essential to improve outcomes and optimize management strategies. Methods A retrospective cohort study was conducted on all patients who underwent endotracheal intubation in the Cardiovascular Care Unit (CVCU) of RSUD Dr. Saiful Anwar Malang from 2015 to 2021. Patients with incomplete medical records or who died within 14 days of mechanical ventilation were excluded. Univariate and multivariate logistic regression analyses identified independent predictors of PMV. Receiver operating characteristic (ROC) curves were generated to assess model discrimination using the area under the curve (AUC), with corresponding sensitivity and specificity. Data were analyzed using SPSS 22.0. Results Five independent predictors of PMV were identified: tachycardia (p = 0.013), metabolic acidosis (p = 0.002), impaired renal function (p = 0.009), shock (p = 0.006), and major bleeding (p = 0.002). Multivariate analysis showed the following odds ratios(OR, 95% CI): tachycardia 2.06 (1.09–5.99), metabolic acidosis 2.03 (1.09–6.33), impaired renal function 2.87 (1.28–6.46), shock 2.83 (1.13–7.06), and major bleeding 1.36 (1.18–2.15). The model demonstrated good discrimination with an AUC of 0.83 (95% CI 0.77–0.88), sensitivity 0.87, and specificity 0.73. Conclusion In patients with respiratory failure due to acute heart failure, tachycardia, metabolic acidosis, impaired renal function, shock, and major bleeding were independent predictors of prolonged mechanical ventilation. The predictive model showed high sensitivity and acceptable specificity, supporting its clinical usefulness for early identification of high-risk patients and targeted intervention.
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