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Janry A. Pangemanan
Universitas Sam Ratulangi
Health Professions

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Correlation of Earlobe Crease and Clinically Identified Forehead Wrinkles with Severity of Coronary Artery Lesions in Patients with Stable Angina Pectoris Agnes L. Panda; Janry A. Pangemanan; Fanny D. Kojansow
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.39347

Abstract

Abstract: Identification of high-risk subjects is crucial in prevention of coronary heart disease. Ear lobe crease and forehead wrinkles are easily identifiable physical signs that could potentially be an indicator of coronary artery lesion severity. This study aimed to determine the relationship between earlobe crease and forehead wrinkles morphology with severity of coronary artery stenosis in patients with stable angina pectoris using modified Gensini score. This was an observational study with a cross-sectional approach. All subjects who met the inclusion criteria were taken photos of their forehead area and both right and left ears. Assessment of scores and correlation analysis of earlobe crease and forehead wrinkles assessment with the severity of coronary artery stenosis using Gensini modification scores were later done. The results showed that from a total of 40 study subjects, 28 patients (70%) were male. Forehead wrinkle scores in patients with stable angina pectoris were mainly classified into score 1 and 2, totalling 32 (80%) patients. Earlobe crease form were dominated by type A (65% vs 35%). Patients with type B morphology on average have a Gensini value of 9 points lower than type A (reference) (p <0.001). As for the Gensini modified score in patients with non-zero forehead wrinkle scores, it was clearly 4−5 units greater than those with a zero score. However, the sample size of patients with zero forehead wrinkle score was indeed too small (n=3) to make the difference meaningful (p=0.507). In conclusion, there is a significant positive relationship between identification of earlobe crease and the severity of coronary artery stenosis but there is no strong relationship between the identification of forehead wrinkles and the severity of coronary artery stenosis in patients with stable angina pectoris, in this case with a modified Gensini score.Keywords: stable angina; earlobe crease; forehead wrinkles; modified Gensini score
Korelasi antara Neutrophil-To-Lymphocyte Ratio dengan Fraksi Ejeksi pada Pasien Penyakit Jantung Koroner: Studi di Sulawesi Utara, Indonesia Janry A. Pangemanan; Agnes L. Panda; Natalia C. I. Polii; Victor Bandana; Ira Posangi; Andrew E. P. Sunardi; Singgih S. Cahyadi; Filipus M. Yofrido
e-CliniC Vol. 11 No. 1 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i1.44305

Abstract

Abstract: Inflammation has a vital role in the pathogenesis of heart failure (HF) and coronary artery disease (CAD). Neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker proposed to have a correlation with ejection fraction (EF). This is a simple examination and can be obtained routinely in clinical practice. This study aimed to evaluate the correlation of NLR with EF in hospitalized patients with CAD. This was an observational and analytical study with a cross-sectional design. Samples were eligible CAD patients from May until August 2019 at Prof Dr. R. D. Kandou Hospital in North Sulawesi. All patients underwent echocardiography for EF calculation, and blood examination for NLR measurement and risk factor screening. The patients were treated according to the guideline. Data were analyzed using the Spearman test in SPSS v26. The results showed that the majority of patients were male (70.2%) with mean age of 60 years old. Hypertension was found in 76.6% and smoking history in 51.1% patients. NLR was shown to have a significant correlation with EF in patients with CAD (p=0.014). In conclusion, NLR has a significant correlation with EF. Moreover, it could be a useful tool for the clinicians to predict heart failure in a specific population. Keywords: neutrophil-to-lymphocyte ratio; ejection fraction; heart failure; coronary artery disease. Abstrak: Peradangan memiliki peran penting dalam patogenesis gagal jantung (HF) dan juga penyakit arteri koroner (CAD). Rasio neutrofil-limfosit (NLR) merupakan penanda inflamasi yang diduga berkorelasi dengan fraksi ejeksi (EF), serta merupakan pemeriksaan sederhana yang dapat diperoleh secara rutin dalam praktik klinis. Penelitian ini bertujuan untuk mengetahui korelasi NLR dengan EF pada pasien rawat inap dengan CAD. Jenis penelitian ialah observasional analitik dengan desain potong lintang. Sampel penelitian ialah pasien CAD yang memenuhi syarat dirawat dari bulan Mei hingga Agustus 2019 di Rumah Sakit Prof Dr. R. D. Kandou, Sulawesi Utara. Pasien diperiksakan dengan ekokardiografi untuk perhitungan EF, dan dilakukan pemeriksaan darah untuk penilaian NLR dan skrining faktor risiko. Semua pasien dirawat sesuai dengan pedoman. Data dianalisis menggunakan uji Spearman dengan SPSS v26. Hasil penelitian mendapatkan mayoritas sampel ialah laki-laki (70,2%) dengan usia rerata 60 tahun. Hipertensi ditemukan pada 76,6% dan riwayat merokok pada 51,1% pasien. NLR terbukti memiliki korelasi bermakna dengan EF pada pasien CAD (p=0,014). Simpulan penelitian ini ialah NLR terbukti memiliki korelasi bermakna dengan EF pada pasien CAD. Selain itu NLR dapat menjadi alat bantu yang berguna bagi klinisi untuk memrediksi gagal jantung pada populasi tertentu. Kata kunci: neutrophil-to-lymphocyte ratio; fraksi ejeksi; gagal jantung; penyakit arteri koroner
Co-Authors Agnes L. Panda Andrew E. P. Sunardi Fanny D. Kojansow Filipus M. Yofrido Ira Posangi Natalia C. I. Polii Singgih S. Cahyadi Victor Bandana