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Hubungan ear lobe crease dengan penyakit jantung koroner Fuzairi, Jacqueline A.; Djafar, Dewi U.; Panda, Agnes L.
e-CliniC Vol 4, No 1 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i1.10833

Abstract: Cardiovascular disease is a huge burden in terms of mortality, disability, and morbidity in this day. Prevention of cardiovascular disease is based on the physical signs. Waist circumference, Ankle Brachial Index (ABI) and Carotid Intima Media Thickness (CIMT) are useful to recognize occult atherosclerosis, so as ear lobe crease. However, medics have less attention about examination of ear lobe crease for detection of coronary artery disease. This study aimed to determine the relation of ear lobe crease and coronary artery disease. This was an analytical observational study with a case control design. The results showed that there were 45 samples for control group and 45 samples for case group. The statistical analysis showed the X2 = 21.78 with a p value <0,001 which indicated that there was a significant correlation between Ear Lobe Crease and Coronary Artery Disease. The OR = 8.9% (95% CI 3.4 -23.3) meant that if a person had ear lobe crease, the possibility of coronary artery disease was 8.9 times higher than a person without ELC. Conclusion: There was a significant correlation between Ear Lobe Crease and Coronary Artery Disease.Keywords: ear lobe crease, coronary artery diseaseAbstrak: Penyakit Kardiovaskular merupakan penyebab utama kematian, kecacatan dan kesakitan saat ini. Deteksi penyakit kardiovaskular sebagai tindakan pencegahan dapat dilihat melalui pemeriksaan fisik. Pengukuran lingkar pinggang, Ankle Brachial Index (ABI), dan Carotid Intima Media Thickness (CIMT) sangat berguna untuk penanda aterosklerosis subklinis, begitu pula dengan Ear Lobe Crease. Namun sampai saat ini, pemeriksaan Ear Lobe Crease untuk menilai penyakit jantung koroner kurang mendapat perhatian petugas medis. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner. Metode: Penelitian ini dilakukan menggunakan metode penelitian analitik observasional dengan case control. Hasil penelitian: Sampel penelitian terdiri dari 45 orang untuk kelompok kontrol dan 45 orang untuk kelompok kasus. Berdasarkan uji X2 diperoleh X2 = 21,78 dengan p < 0,001. Hasil ini menunjukkan bahwa adanya hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner (p < 0,001). Dalam uji ini, juga diperoleh OR = 8,9 (95% CI: 3,4 â€“ 23,3). Odd Ratio (OR) ini menyatakan bahwa bila seseorang ditemukan adanya ELC, maka orang tersebut berisiko 8,9 kali mendapat Penyakit Jantung Koroner dibanding dengan orang tanpa ELC. Simpulan: Terdapat hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner.Kata kunci: ear lobe crease, penyakit jantung koroner.

Gambaran jumlah leukosit pada pasien infark miokard akut di RSUP Prof. Dr. R. D.Kandou Manado periode Januari-Desember 2015 Sitepu, Ade M.; Djafar, Dewi U.; Panda, Agnes L.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i2.14467

Abstract: Coronary heart disease (CHD) is the leading cause of death in the world and marked by the existence of atherosclerotic plaque at the coronary artery that progressively blocks the blood stream to myocardium resulting in myocardial infarction. Elevated of leukocyte count typically indicates an infection or inflammation, and has a role in vascular injury and atherogenesis that is a development of an atherosclerotic ruptured plaque and trombosis. This study was aimed to obtain the profile of leukocyte count in patient with acute myocardial infarction (AMI) at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2015. This was an observational descriptive study with a retrospective approach using data of medical records of AMI patients who came to Prof. Dr. R. D. Kandou Hospital Manado from January to Desember 2015. The results showed that of totally 63 medical records of patients with AMI, there were 45 samples that fulfilled the inclusion criteria. The majority patients were in the age group 46-60 years, males, the risk factor was a combination of several major risks, and NSTEMI as the type of type of infarction. There were 57,77% of leukocyte count results ranged 10,000-14,900/mm3 and 8,88% were â‰¥15,000/mm3. Conclusion: There was an increase in the leukocytes count in more than half of the samples. Keywords: acute myocardial infarction, leukocyte, inflammationÂ Abstrak: Penyakit jantung koroner (PJK) merupakan penyebab kematian tersering di dunia dan ditandai adanya plak aterosklerosis pada arteri koroner yang secara progresif menghalangi aliran darah ke miokardium yang berakibat terjadinya infark miokard. Peningkatan jumlah leukosit secara tipikal mengindikasikan adanya suatu infeksi dan peradangan, serta juga berperan pada cedera vaskular dan aterogenesis yang merupakan perkembangan dari suatu ruptur plak aterosklerosis dan trombosis. Penelitian ini bertujuan untuk mengetahui gambaran jumlah leukosit pada pasien IMA di RSUP Prof. Dr. R. D. Kandou periode Januari sampai Desember 2015. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif menggunakan data rekam medik pasien IMA yang berobat di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2015 dengan eksklusi riwayat infeksi minimal 2 minggu sebelum masuk rumah sakit. Hasil penelitian mendapatlan 45 sampel dengan mayoritas kelompok usia 46-60 tahun, jenis kelamin laki-laki, faktor risiko kombinasi beberapa faktor risiko mayor, dan jenis infark NSTEMI. Sebanyak 57,77% hasil pemeriksaan leukosit berkisar 10.000-14.900/mm3 dan 8,88% pada â‰¥15.000/mm3. Simpulan: Lebih dari setengah jumlah sampel mengalami peningkatan jumlah leukosit.Kata kunci: infark miokard akut, leukosit, peradangan

Gambaran kadar troponin T berdasarkan waktu pemeriksaan dan lokasi infark pada pasien infark miokard akut di RSUP Prof Dr. R. D. Kandou periode Januari-Desember 2015 Sagala, Shendy G.L.; Pangemanan, Janry A.; Djafar, Dewi U.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i2.14465

Abstract: Acute myocardial infarction (AMI) causes high mortality and morbidity rates. AMI must be dealt quickly and efficiently for prolonged ischemia can cause irreversible damage and worsen the prognosis. The American College of Cardiology decided that the diagnosis of AMI required a combination of ischemic symptoms and/or electrocardiographic changes accompanied by myocardial necrosis markers, the biomarkers. Previous studies showed that there were variations in troponin levels based on examination time and location of infarction. This study was aimed to obtain the profile of troponin T levels based on time of troponin T examination and location of infarction in AMI patients at Prof. Dr. R. D. Kandou Hospital from January to December, 2015. This was a descriptive observational study with a retrospective approach. Samples were AMI patients with complete data that fulfilled the inclusion and exclusion criteria. The results showed that of the total 61 AMI patients there were 26 samples that fulfilled the criteria. The majority of samples were males, age group 55-64 years, and the risk factor was a combination of some of the major risk factors. Most infarctions of NSTEMI were dominated by anteroseptal and anterolateral infarct locations and levels of troponin T were in the range of >100-2000 ng / L (the average value of 475 ng / L). Levels of troponin T were influenced by the time of examination, but not by the location of the infarct.Keywords: acute myocardial infarction, troponin T, examination time, infarct locationÂ Abstrak: Infark miokard akut (IMA) menyebabkan angka mortalitas dan morbiditas tinggi. IMA harus ditangani dengan cepat dan efisien karena iskemia yang berkepanjangan dapat menyebabkan kerusakan yang ireversibel dan menentukan prognosis. The American College of Cardiology menetapkan bahwa untuk diagnosis infark miokard akut diperlukan kombinasi antara gejala iskemik dan/atau perubahan elektrokardiografi disertai penanda nekrosis infark yaitu biomarker. Berdasarkan penelitian sebelumnya didapatkan variasi troponin berdasarkan waktu pemeriksaan dan lokasi infark. Penelitian ini bertujuan untuk mengetahui gambaran kadar troponin T berdasarkan waktu pemeriksaan troponin T dan lokasi infark pada pasien infark miokard akut di RSUP Prof. Dr. R. D. Kandou periode Januari-Desember 2015. Jenis penelitian ialah observasional deskriptif dengan pendekatan studi retrospektif. Sampel ialah pasien infark miokard akut dengan data lengkap yang memenuhi kriteria inklusi dan eksklusi, diambil dari rekam medik. Hasil penelitian memperlihatkan dari total 61 pasien IMA didapatkan 26 sampel yang memenuhi kriteria. Mayoritas sampel ialah laki-laki, kelompok usia 55-64 tahun, faktor risiko yaitu kombinasi dari beberapa faktor risiko mayor, jenis infark NSTEMI didominasi oleh lokasi infark anteroseptal dan anterolateral dengan lebih dari setengah jumlah sampel memiliki kadar troponin T pada rentang >100-2000 ng/L (nilai rerata 475 ng/L). Kadar troponin T dipengaruhi oleh waktu pemeriksaan tetapi tidak dipengaruhi oleh lokasi infark. Kata kunci: infark miokard akut, troponin T, waktu pemeriksaan, lokasi infark

Hypocapnia and its relationship with in-hospital mortality in acute heart failure patients: Insights from the Indonesian multicenter ICCU registry Prasetya, Indra; Afifah, Yuri; Anjarwani, Setyasih; Juzar, Dafsah A.; Bagaswoto, Hendry P.; Muzakkir, Akhtar F.; Habib, Faisal; Astiawati, Tri; Wirawan, Hendy; Ilhami, Yose R.; Djafar, Dewi U.; Sungkar, Safir; Danny, Siska S.; Rohman, Mohammad S.
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.v5i1.1638

Acute heart failure (AHF) presents serious risks for hospitalized patients. The aim of this study was to explore the relationship between arterial partial pressure of carbon dioxide (PaCO2) levels and outcomes in AHF patients admitted to the intensive cardiovascular care unit (ICCU), utilizing data from the IndONEsia ICCU Registry (One ICCU Registry). A multicenter retrospective observational study was performed covering data between August 2021-2023. Participants were categorized by PaCO2 levels: hypocapnia (<35 mmHg), normocapnia (35–45 mmHg), and hypercapnia (>45 mmHg). The primary outcomes included ICCU mortality, in-hospital mortality, and 30-day mortality, whereas the length of the stays in the ICCU or hospital and ventilation requirement were set as the secondary outcomes. Mortality risks were assessed using Cox proportional hazards models. Of the 1,870 patients, 1,102 (58.96%) had hypocapnia, 645 (34.5%) had normocapnia, and 123 (6.5%) had hypercapnia. Hypocapnia patients had significantly higher ICCU, in-hospital, and at 30-day mortality rates compared to normocapnic patients (all p<0.001), along with longer lengths of stay in ICCU and in hospital (p<0.001). Hypocapnia significantly increased noninvasive and mechanical ventilation requirement compared to normocapnia patients. Multivariate analysis identified factors impacting patients’ survival, including age, treatment with angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARBs) drugs, and severity scores such as the quick sequential organ failure assessment (qSOFA) and simplified acute physiology score II (SAPS II). In conclusion, hypocapnia in AHF patients could increase in-hospital, ICU and 30-days mortality rates and length of hospital stays, as well as noninvasive and mechanical ventilation requirements.

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

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.

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