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Predictors of right subclavian artery tortuosity in trans-radial coronary angiography access Ermawan, Romi; Pintaningrum, Yusra; Rahmat, Basuki; Putra, AASM Meiswaryasti; Indrayana, Yanna
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.2025.006.03.13

Abstract

BACKGROUND: Trans-radial access has become the new standard and is increasingly in demand in coronary angiography. However, this method can fail due to tortuosity of the right subclavian artery. OBJECTIVES: This study aims to identify the predictors of right subclavian artery tortuosity. METHODS: This retrospective case-control study was conducted at two of the largest hospitals in West Nusa Tenggara, Indonesia. All research data were obtained from secondary sources, including video recordings of coronary angiographies, angiography reports, and patient medical records. Predictors included age, gender, smoking, height, body mass index, hypertension, diabetes mellitus, systolic and diastolic blood pressure, and random blood sugar. RESULTS: The study involved 80 subjects, divided into right subclavian artery tortuosity and normal group, with 40 subjects each. The prevalence of tortuosity was 8.1%, while the success rate of trans-radial access was 70.0%. Four significant predictors were identified: smoking (adjusted OR 0.26; p = 0.019), hypertension (adjusted OR 4.83; p = 0.020), diastolic blood pressure (adjusted OR 1.05; p = 0.044), and body mass index (adjusted OR 1.16; p = 0.035). The optimal cutoff points were determined to be a body mass index of ≥ 24.4 (sensitivity 60.0%; specificity 60.0%; p = 0.006; AUC = 0.665) and diastolic blood pressure of ≥ 78.5 mmHg (sensitivity 67.5%; specificity 67.5%; p = 0.002; AUC = 0.685). CONCLUSION: This study has identified smoking, hypertension, diastolic blood pressure, and body mass index as significant predictors of right subclavian artery tortuosity in trans-radial coronary angiography access. 
Quercetin Stabilizes Atherosclerotic Plaques by Reducing Matrix Metalloproteinase-9 Expression and Enhancing M2 Macrophage Activity in Wistar Rats Ermawan, Romi; Pikir, Budi Susetyo; Mulyanto, Mulyanto; Utomo, Budi; Widjiati, Widjiati; Oktaviono, Yudi Her
The Indonesian Biomedical Journal Vol 17, No 5 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i5.3790

Abstract

BACKGROUND: Quercetin has been shown to alleviate and prevent atherosclerosis. However, its role in stabilizing atherosclerotic plaques to prevent plaque rupture remains unclear. Therefore, this study was conducted to investigate the effects of quercetin on stabilizing atherosclerotic plaques.METHODS: Thirty-two Wistar rats were objected to a high-fat diet, along with an endothelial injury procedure conducted during the second week to create atherosclerotic plaque models. After six weeks, the subjects were randomly assigned to five groups consist of two control groups and three treatment groups treated with different quercetin dosages. Following the treatment, all subjects were euthanized to collect the left common carotid artery. The stability of the atherosclerotic plaques was evaluated by measuring the expression of matrix metalloproteinase-9 (MMP-9) using real-time polymerase chain reaction, assessing the activity of M1 and M2 macrophages along with the M1/M2 ratio using an enzyme-linked immunosorbent assay, and determining the maximum intima thickness through histopathological examination.RESULTS: Quercetin significantly reduced the expression of MMP-9, increased the activity of M2 macrophages, and lowered the M1/M2 ratio at doses of 10 and 50 mg/kg. However, there was no effect on M1 macrophage activity or maximum intima thickness. Path analysis indicated that quercetin primarily enhanced atherosclerotic plaque stability by reducing MMP-9 expression (p<0.001) and subsequently enhancing M2 macrophage activity (p=0.002).CONCLUSION: Quercetin administration significantly decreased the expression of MMP-9, enhanced the activity of M2 macrophages, and lowered the M1/M2 ratio at specific doses. These findings emphasize the significance of quercetin in stabilizing atherosclerotic plaques.KEYWORDS: atherosclerotic plaque, quercetin, stability, Wistar rats