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All Journal e-CliniC LEX CRIMEN JURNAL BIOMEDIK Jurnal Kedokteran Klinik Medical Scope Journal (MSJ)
Victor F. F. Joseph, Victor F. F.
FAKULTAS KEDOKTERAN UNSRAT
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health

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Hubungan Framingham Risk Score dengan Derajat TIMI Risk Score pada Pasien Infark Miokard Akut dengan Elevasi Segmen ST di RSUP Prof. Dr. R. D. Kandou Periode Januari–September 2018 Alitu, Moh. A. R.; Jim, Edmond L.; Joseph, Victor F.
e-CliniC Vol 6, No 2 (2018): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v6i2.22127

Abstract

Abstract: Myocardial infarction (MI) is one of the main manifestations of coronary heart diseases. ST segment elevation myocardial infarction (STEMI) is a symptomatic clinical syndrome characterized by myocardial ischemia associated with persistent ST segment elevation. The Framingham risk score (FRS) is designed to predict the risk of death due to coronary heart disease and myocardial infarction meanwhile the TIMI risk score is used as a tool to determine the mortality risk of STEMI patients. This study was aimed to determine the relationship between the FRS and the degree of TIMI risk score in STEMI patients at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective analytical study. Samples were patients diagnosed as STEMI at Prof. Dr. R. D. Kandou Hospital Manado from January to September 2018. There were 93 patients obtained by using total sampling. The Pearson correlation test of the relationship between the FRS and the degree of TIMI risk score in STEMI patients obtained an r of 0.097 with the P value of 0.177. Conclusion: There was no relationship between the Framingham risk score and the TIMI risk score among IMA-EST patients.Keywords: myocardial infarction, Framingham risk score, TIMI risk score, STEMI Abstrak: Infark miokard adalah salah satu manifestasi utama penyakit jantung koroner (PJK). Infark miokard akut dengan elevasi segmen ST (IMA-EST) adalah sindrom klinis dengan gejala karakteristik iskemia miokard yang berhubungan dengan elevasi segmen ST persisten. Framingham risk score (FRS) dirancang untuk memrediksi risiko kematian karena PJK dan infark miokard. TIMI risk score digunakan sebagai alat untuk menentukan risiko mortalitas pasien IMA-EST. Penelitian ini bertujuan untuk mengetahui hubungan FRS dengan derajat TIMI risk score pada pasien IMA-EST di RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah analitik retrospektif. Sampel penelitian ialah pasien IMA-EST di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-September 2018 sebanyak 93 pasien diambil dengan total sampling. Hasil uji korelasi Pearson terhadap hubungan antara FRS dan TIMI risk score pada pasien IMA-EST mendapatkan r=0,097 dengan nilai P=0,177. Simpulan: Tidak terdapat hubungan antara Framingham risk score dan TIMI risk score pada pasien IMA-EST.Kata kunci: infark miokard, Framingham risk score, TIMI risk score, IMA-EST
Prevalensi Atrioventrikular Blok di RSUP Prof. Dr. R. D. Kandou Manado Periode 2013 – 2014 Wambrauw, Jery; Jim, Edmond L.; Joseph, Victor F. F.
e-CliniC Vol 5, No 1 (2017): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v5i1.14763

Abstract

Abstract: AV Block conduction is an abnormality in which the impulse from the atrium has a delayed conduction or no conduction at all to the ventricle. This abnormality is classified as AV Block first degree, second degree, and third degree, depending on the severity of the abnormality. This was a descriptive retrospective study using second data as the reference. This study was aimed to obtain the prevalence of atrioventricular block at Cardiology Clinic Prof. Dr. R. D. Kandou Hospital Manado during 2013 – 2014. The results showed that of 40 patients, the highest percentage of cases had third degree AV block (21 patients; 53%), age group of 70-79 years (33%). Based on gender, there was the same number of cases of males and females, but the classification based on the degree of AV block showed that there were more male patients diagnosed as AV block first degree while there were more female patients diagnosed as third degree AV block. Hypertension was commonly found in the patients diagnosed as AV block as many as 18 patients (27%). Based on the chief complaint, most had difficulty of breathing (28%). However, each degree of the AV block had varied chief complaints and different kind of therapy. Based on the management, 77% of the patients had medical therapy with different kinds of medication.Keywords: AV block Abstrak: Blok konduksi AV merupakan kelainan yang mana impuls dari atrium dikonduksikan terlambat atau bahkan tidak dikonduksikan sama sekali ke ventrikel. Kelainan ini diklasifikasikan sebagai blok AV derajat satu, dua, dan tiga, tergantung pada keparahan abnormalitasnya. Penelitian dan bertujuan untuk mengetahui prevalensi blokade atrio-ventrikular di poli jantung RSUP Prof. Dr. R. D. Kandou Manado selama selang waktu 2013 – 2014. Jenis penelitian ialah deskriptif retrospektif menggunakan data sekunder sebagai acuan. Hasil penelitian mendapatkan dari 40 pasien, terbanyak ditemukan ialah AV blok derajat III (21 pasien; 53%); kelompok usia 70-79 tahun (33%). Berdasarkan jenis kelamin didapatkan jumlah yang sama antara pasien laki-laki dan perempuan, namun dalam pembagian berdasarkan derajat AV blok didapatkan pasien laki-laki lebih banyak dengan diagnosis AV blok derajat I sedangkan perempuan lebih banyak pada AV blok derajat III. Penyakit penyerta terbanyak ditemukan ialah hipertensi (18 pasien; 27%). Berdasarkan keluhan penyerta pada pasien AV blok terbanyak ditemukan ialah sesak nafas (28%) namun untuk masing-masing derajat AV blok keluhan yang paling sering dialami berbeda-beda, dan berdasarkan penatalaksanaan yang diberikan 77% pasien di terapi dengan obat-obatan.Kata kunci: AV blok
Hubungan neutrophyl to lymphocyte ratio dengan derajat disfungsi diastolik pada pasien hipertensi Dewanti, Lidia A. D.; Panda, Agnes L.; Joseph, Victor F. F.; Rotty, Monique
e-CliniC Vol 8, No 1 (2020): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v8i1.28607

Abstract

Abstract: Uncontrolled hypertension is the leading cause of the increased morbidity and mortality of congestive heart failure in developed countries. Moreover, diastolic dysfunction is the leading cause of heart failure in patients with hypertension. However, diagnosis as well as therapy of patients with hypertension and diastolic dysfunction is still a problem and the mechanism is still unclear, leading to the need of a parameter study as an initial predictor. In cardiovascular diseases, it is connected to the rise in neutrophil to lymphocyte ratio (NLR). This study was aimed to identify the relationship between NLR and the degree of diastolic dysfunction in patients with hypertension. This was an analytical and descriptive study with a cross sectional design. Variables included the NLR and the degree of diastolic dysfunction in patients with hypertension. The results obtained 31 patients, and highest percentages were males (24 patients; 77.42%), aged 61-65 years old (12 patients; 38.71%), and BMI scaling as overweight (17 patients; 54.83%). Most of the patients were categorized as normotension (12 patients; 38.71%). The majority of diastolic dysfunction degree was the 1st degree numbering 17 patients (54.84%). Minimum value of the NLR was 0.09 and the maximum was 19 with a standard deviation of 2.04. The Spearman’s parametric test showed a p-value of 0.315 and an r-value of 0.173 for the relationship between the NLR and the degree of diastolic dysfunction in patients with hypertension. In conclusion, there was no relationship between the NLR and degree of diastolic dysfunction in patients with hypertension.Keywords: neutrophil to lymphocyte ratio, diastolic dysfunction degree, hypertension Abstrak: Hipertensi yang tidak terkontrol merupakan penyebab utama meningkatnya morbiditas dan mortalitas gagal jantung kongesti di negara berkembang. Selain itu, disfungsi diastolik menjadi penyebab utama gagal jantung pada pasien hipertensi. Namun, penegakan diagnosis dan terapi pada pasien hipertensi dengan disfungsi diastolik masih menjadi masalah dan mekanismenya masih kurang dipahami sehingga diperlukan suatu parameter sebagai prediktor awal. Penyakit-penyakit kardiovaskular dikaitkan dengan peningkatan neutrophyl to lymphocyte ratio (NLR). Penelitian ini bertujuan untuk mengetahui hubungan NLR dengan derajat disfungsi diastolik pada pasien hipertensi. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Variabel yang dianalisis ialah NLR dan derajat disfungsi diastolik pasien hipertensi. Hasil penelitian mendapatkan 31 sampel, dan persentase tertinggi ialah jenis kelamin laki-laki (24 pasien; 77,42%), usia pada rentang 61-65 (12 pasien; 38,71%), dengan IMT overweight (17 pasien; 54,83%). Kategori hipertensi terbanyak ialah kategori normal (12 pasien; 38,71%). Derajat disfungsi diastolik terbanyak ditemukan pada derajat 1 (17 pasien; 54,84%). Nilai minimum NLR 0,09 dan maksimum 10 dengan simpangan baku 2,04. Uji parametrik Spearman mendapatkan nilai p=0,315 dan r=0.173 untuk hubungan antara NLR dengan derajat disfungsi diastolik pada pasien hipertensi. Simpulan penelitian ini ialah tidak terdapat hubungan antara NLR dengan derajat disfungsi diastolik pada pasien hipertensi.Kata kunci: neutrophil to lymphocyte ratio, derajat disfungsi diastolik, hipertensi
Gambaran kadar asam urat pada pasien sindrom koroner akut di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2015 Syahfitri, Annisa; Joseph, Victor; Rampengan, Starry H.
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.4.2.2016.14462

Abstract

Abstract: Acute coronary syndrome (ACS) is the term for symptoms due to disorder of blood flow inside the coronary arteries. ACS consists of unstable angina pectoris (UAP), non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). One predisposition factor of ACS that is still debated is uric acid. Its role in cardiovascular diseases is assumed due to endothelial disruption caused by elevated serum uric acid. This study was aimed to obtain the profile of uric acid serum in ACS patients at Prof. Dr. R. D. Kandou hospital Manado from January to December 2015. This was a retrospective study with a descriptive observational method using medical record of Prof Dr. R. D. Kandou Hospital Manado. The results showed that there were 97 patients with ACS, including 43 (44.33%) patients with NSTEMI, 43 (44.33%) patients with UAP, and 11 (11.34%) patients with STEMI. Males were more common than females. Most patient were aged 55-65 years old. Elevated serum uric acid was found in 52% of patients, generally in males and NSTEMI cases. More than half of the patients had history of elevated serum uric acid. The most risk factor in the cases were hypertension and smoking.Keywords: description, uric acid, acute coronary syndrome Abstrak: Sindrom koroner akut (SKA) merupakan sekelompok gejala akibat gangguan aliran darah pada arteri koroner. SKA terdiri dari unstable angina pectoris (UAP), infark miokard tanpa elevasi ST (NSTEMI), dan infark miokard dengan elevasi ST (STEMI). Salah satu faktor predisposisi SKA yang hingga kini masih diperdebatkan ialah asam urat. Diduga peran asam urat terhadap penyakit kardiovaskular terletak pada gangguan endotel pembuluh darah yang ditimbulkannya. Penelitian ini bertujuan untuk mengetahui gambaran kadar asam urat pada pasien SKA di RSUP Prof. Dr. R. D. Kandou Manado selama periode Januari-Desember 2015. Jenis penelitian ialah retrospektif dengan metode observasional-deskriptif yang dilaksanakan di Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 97 pasien SKA dengan data lengkap, diantaranya 43 kasus (44,33%) NSTEMI, 43 kasus (44,33%) UAP, dan 11 kasus (11,34%) STEMI. Pasien terbanyak terdapat pada laki-laki dan kelompok usia 55-65 tahun. Peningkatan kadar asam urat dijumpai pada 52% pasien, umumnya pada laki-laki dan kasus NSTEMI. Umumnya pasien juga memiliki riwayat asam urat. Faktor risiko terbanyak yang dimiliki ialah hipertensi dan merokok. Kata kunci: deskripsi, asam urat, sindrom koroner akut
Gambaran aritmia pada pasien penyakit jantung koroner di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2015 – 31 Desember 2015 Kalangi, Cathleen S.; Jim, Edmond L.; Joseph, Victor F.F.
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.4.2.2016.14556

Abstract

Abstract: Arrhythmia is an abnormal heart rhythm which refer to every disturbance in frequency, regularity, original location or electrical impulses conduction of the heart. Ischemic myocardium characterized by ionic and biochemical alterations creates an unstable electrical substrate capable of initiating and sustaining arrhythmias, meanwhile infarction creates areas of electrical inactivity and blocks conduction, which also promotes arrhythmogenesis. This study was aimed to obtain the description of arrhythmias in coronary artery disease patients at Prof. Dr. R. D. Kandou Hospital Manado from 1 January 2015 to 31 December 2015. This was a descriptive retrospective study. There were 101 data of patients with Coronary Artery Disease (CAD) associated with arrhythmia, as follows: 57 cases (56%) of Stable Angina Pectoris (SAP), 6 cases (6%) of Old Myocardial Infarction (OMI), 16 cases (16%) of Unstable Angina Pectoris (UAP), 20 cases (20%) of Non ST Segment Elevation Myocardial Infarction (NSTEMI), and 2 cases (2%) of ST Segment Elevation Myocardial Infarction (STEMI). The majority of cases were males (66%) and aged 51-60 years old (35%). There were 62 cases (41%) of CAD patients associated with arrhythmia that had hypertension as the highest risk factor and 19 cases (12%) for smoker as the lowest risk factor. The highest number of patients was Angina Pectoris Stabil (APS), and the dominant arrhythmia was Premature Ventricular Contraction (PVC).Keywords: description, arrhythmia, coronary artery disease Abstrak: Aritmia merupakan gangguan irama jantung yang merujuk kepada setiap gangguan frekuensi, regularitas, lokasi asal atau konduksi impuls listrik jantung. Iskemik miokardium ditandai dengan perubahan ion dan biokimiawi, mengakibatkan aktivitas listrik yang tidak stabil yang memicu dan mempertahankan aritmia, dan infark menciptakan daerah aktif dan blok konduksi listrik, yang juga memromosikan aritmogenesis. Penelitian ini bertujuan untuk mengetahui gambaran aritmia pada pasien penyakit jantung koroner (PJK) di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2015-31 Desember 2015. Jenis penelitian ialah deskriptif retrospektif. Hasil penelitian mendapatkan 101 data pasien PJK yang mengalami aritmia, diantaranya Angina Pektoris Stabil (APS) 57 kasus (56%), Old Myocardial Infarction (OMI) 6 kasus (6%), Unstable Angina Pectoris (UAP) 16 kasus (16%), Non ST Segment Elevation Myocardial Infarction (NSTEMI) 20 kasus (20%), dan ST Segment Elevation Myocardial Infarction (STEMI) 2 kasus (2%). Mayoritas kasus ialah jenis kelamin laki-laki (66%), usia 51-60 tahun (35%). Faktor risiko tertinggi pada pasien PJK dengan aritmia ialah hipertensi (41%) dan terendah ialah merokok (12%). Kasus tertinggi ialah APS, dengan aritmia terbanyak ialah Premature Ventricular Contraction (PVC), Kata kunci: gambaran, aritmia, penyakit jantung koroner
PREVALENSI SINDROM KORONER AKUT DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 1 JANUARI 2014 - 31 DESEMBER 2014 Tumade, Biancha; Jim, Edmond L.; Joseph, Victor F. F.
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.4.1.2016.10959

Abstract

Abstract: Acute Coronary Syndrome (ACS) is a syndrome that occurred due to pathological changes inside the coronary artery wall which cause myocardial ischemic, Unstable Angina Pectoris (UAP), and Acute Myocardial Infarct (AMI) such as Non ST Elevation Myocardial Infarct (NSTEMI) and ST Elevation Myocardial Infarct. The prevalence of coronary heart disease (CHD) in Indonesia is 0.5% from the total sample of non-communicable diseases and from the total sample diagnosed with CHD the highest is in Middle Sulawesi (0.8%) followed by North Sulawesi (0.7%). This study aimed to obtain the prevalence of ACS in Prof. Dr. R. D. Kandou Hospital from 1 January to 31 December 2014. This was a descriptive retrospective study. Data were obtained from the medical record and Cardiovascular and Brain Center (CVBC) of Prof. Dr. R. D. Kandou Hospital in Manado. The results showed that there were 126 cases of ACS, 72 cases (57.1%) of UAP, 35 cases (37.8%) of NSTEMI, and 19 cases (15.1%) of STEMI. From the 126 cases there were 90 males (71.4%) and 36 females (28.6%). Based on age there were 2 cases (1.6%) of 31-40 years old, 15 cases (11.9%) of 41-50 years old, 42 cases (33.3%) of 51-60 years old, 48 cases (38.1%) of 61-70 years old,  16 cases (12.7%) of 71-80 years old, and 3 cases (2.4%) of over 80 years old. Based on histories of ACS assisted diseases, there were 87 (69.0%) cases of hypertension, 32 cases (25.4%) of diabetes mellitus, 37 cases (29.4%) of dyslipidemia, 7 cases (5.6%) of obesity, 19 cases (15.1%) of smokers, and 122 cases (96.8%) of ACS patients had more than one risk factor. Conclusion: In this study, the most prevalence of ACS was UAP, males, aged 61-70 years, and had hypertension history. Keywords: acute coronary syndrome, prevalence   Abstrak: Sindrom Koroner Akut (SKA) merupakan keadaan terjadinya perubahan patologis dalam dinding arteri koroner, sehingga menyebabkan iskemik miokardium dan menimbulkan Unstable Angina Pectoris (UAP) serta Infark Miokard Akut (IMA) seperti Non ST Elevation Myocardial Infarct (NSTEMI) dan ST Elevation Myocardial Infarct (STEMI). Di Indonesia prevalensi penyakit jantung koroner (PJK) sebesar 0,5% dari total sampel penyakit tidak menular dan tertinggi di Sulawesi Tengah sebanyak 0,8% diikuti Sulawesi Utara 0,7% dari total pasien terdiagnosis PJK. Penelitian ini bertujuan untuk mengetahui prevalensi penderita SKA yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2014 sampai 31 Desember 2014. Penelitian ini merupakan studi deskriptif retrospektif dengan menggunakan data Bagian Rekam Medik dan Cardivascular and Brain Center (CVBC) RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan 126 kasus SKA, kasus UAP sebanyak 72 kasus (57,1%), NSTEMI 35 kasus (37,8%), dan STEMI 19 kasus (15,1%). Laki-laki sebanyak 90 kasus (71,4%) dan perempuan 36 kasus (28,6%). Kelompok umur 31-40 tahun sebanyak 2 kasus (1,6%), 41-50 tahun 15 kasus (11,9%), 51-60 tahun 42 kasus (33,3%), 61-70 tahun 48 kasus  (38,1%), 71-80 tahun 16 kasus (12,7%), dan >80 tahun 3 kasus (2,4%). Riwayat hipertensi sebanyak 87 kasus (69,0%), diabetes melitus 32 kasus (25,4%), dislipidemia 37 kasus (29,4%), obesitas 7 kasus (5,6%), dan merokok 19 kasus (15,1%). Simpulan: Prevalensi kasus SKA terbanyak adalah kasus UAP, berjenis kelamin laki-laki, berumur 61-70 tahun, serta memiliki riwayat hipertensi.Kata kunci: sindrom koroner akut, prevalensi
Angka Keberhasilan Terapi Reperfusi pada Pasien ST Elevasi Miokard Infark Ermiati, . .; Rampengan, Starry H.; Joseph, Victor F.F
e-CliniC Vol 5, No 2 (2017): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v5i2.18279

Abstract

Abstract: ST-Elevation Myocardial Infarction (STEMI) is a kind of acute myocardial infarctions (AMI) with a high rate of mortality. Patients with STEMI are usually treated with reperfusion therapy consisting of primary percutaneous coronary intervention (primary PCI) and fibrinolytic therapy. This study was aimed to determine the success rate of reperfusion therapy in patients with STEMI at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016. This was a descriptive observational study with a retrospective approach. Samples were patients with STEMI treated with reperfusion therapy at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016, obtained by using consecutive sampling method. There were 73 patients in this study consisted of 82.2% of males and 17.8% of females. Most patients were >60 years old; 39.0% treated with primary PCI and 43.8% with fibrinolytic therapy. According to duration of therapy administration, most primary PCI were given at >90 minutes (80.5%) and fibrinolytic therapy at >30 minutes (75%). The success rate of primary PCI was higher in patients treated at ≤90 minutes (100%) compared to patients treated at >90 minutes. Moreover, the success rate of fibrinolytic therapy was higher in patients treated at ≤30 minutes (100%) compared to patients treated at >30 minutes (75%). Ventricular tachycardia (34.6%) was the most common type of reperfusion arrhythmia. Conclusion: The success rate of reperfusion therapy (primary PCI and fibrinolytic) in STEMI patients was higher if it was administered according to the optimum recommendations and targets.Keywords: STEMI, success rate of reperfusion therapy Abstrak: ST elevasi miokard infark (STEMI) merupakan jenis infark miokard akut (IMA) dengan mortalitas yang tinggi. Penatalaksanaan pasien STEMI dilakukan dengan terapi reperfusi yang terdiri primary percutaneous coronary intervention (primary PCI) dan fibrinolitik. Penelitian ini bertujuan untuk mengetahui angka keberhasilan terapi reperfusi pada pasien STEMI di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif. Sampel penelitian ialah pasien STEMI yang menerima terapi reperfusi, dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016, yang diperoleh dengan teknik consecutive sampling. Dari total 73 pasien STEMI didapatkan pasien berjenis kelamin laki-laki (82,2%) lebih banyak dibandingkan perempuan (17,8%). Kelompok usia terbanyak ialah >60 tahun; 39,0% untuk terapi primary PCI dan 43,8% untuk terapi fibrinolitik. Waktu dilakukannya terapi reperfusi terbanyak dengan waktu terapi >90 menit untuk terapi primary PCI (80,5%) dan >30 menit (75%) untuk terapi fibrinolitik. Angka keberhasilan terapi primary PCI <90 menit lebih tinggi (100%) dibandingkan dengan terapi primary PCI >90 menit (96,6%), dan angka keberhasilan terapi fibrinolitik <30 menit lebih tinggi (100%) dibandingkan dengan terapi fibrinolitik >30 menit (75%). Jenis aritmia reperfusi ditemukan terbanyak ialah aritmia ventrikel takikardi 34,6%). Simpulan: Angka keberhasilan terapi reperfusi (primary PCI dan fibrinolitik) pada pasien STEMI lebih tinggi jika dilakukan tepat waktu sesuai dengan sasaran terapi optimal.Kata kunci: STEMI, angka keberhsilan terapi reperfusi.
GAMBARAN KADAR GLUKOSA DARAH PADA PASIEN SKA DI RSUP PROF DR. R.D. KANDOU MANADO PERIODE JANUARI – DESEMBER 2014 Malutu, Hisky; Joseph, Victor F. F.; Pangemanan, Janry
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.v4i1.10952

Abstract

Abstract: Acute Coronary Syndrome (ACS) is a collection of symptoms caused by acute myocardial ischemia. Over the past decade, several studies linking hyperglycemia on admission to higher mortality rate of patients with ACS, including acute myocardial infarction (AMI). This study aimed to obtain the profile of blood glucose levels among ACS patients at Prof. Dr. R.D. Kandou Hospital Manado from January to December 2014. This was an observational descriptive study with a retrospective approach. The results showed that there were 126 ACS patients; 21 patients were eligible for inclusion criteria. The number of male patients are higher than of female patients; most patients aged >60 years old; and the most type of ACS was unstable angina pectoris. Of the 21 patients, there were 6 patients with type 2 DM. Conclusion: Plasma glucose levels in ACS patients on admission tend to be normal, but fasting plasma glucose is higher in the NSTEMI and STEMI patients. Keywords: ACS, type 2 DM, stress hyperglycemia, admission, plasma glucose, fasting plasma glucose  Abstrak: Sindroma Koroner Akut (SKA) adalah kumpulan gejala yang disebabkan oleh iskemik miokard akut. Selama dekade terakhir ini, beberapa studi menghubungkan hiperglikemia pada saat masuk rumah sakit dengan angka mortalitas yang semakin tinggi pada pasien dengan SKA, termasuk Infark Miokard Akut (IMA). Penelitian ini bertujuan untuk mengetahui gambaran kadar glukosa darah pada pasien SKA di RSUP Prof Dr. R. D. Kandou Manado periode Januari – Desember 2014. Penelitian ini menggunakan metode deskriptif observasional dengan pendekatan studi retrospektif. Hasil penelitian mendapatkan 126 pasien SKA tetapi yang memenuhi kriteria inklusi hanya 21 saja. Penderita laki-laki lebih banyak dibandingkan perempuan, golongan usia terbanyak >60 tahun, dan jenis SKA terbanyak ialah angina pektoris tidak stabil. Didapatkan pula 6 pasien dengan riwayat DM tipe 2 sebelumnya dan 15 pasien tanpa riwayat DM tipe 2. Simpulan: Kadar glukosa darah sewaktu pada pasien SKA cenderung normal, tetapi kadar glukosa darah puasa meningkat pada jenis STEMI dan NSTEMI. Kata kunci: SKA, DM tipe 2, stres hiperglikemik, glukosa darah sewaktu, glukosa darah puasa
Terapi Reperfusi pada Infark Miokard dengan ST-Elevasi Bambari, Hana A; Panda, Agnes L; Joseph, Victor F.F.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.32850

Abstract

Abstract: Myocardial infarction is classified into ST-segment elevation myocardial infarction (STEMI) and Non-ST-segment elevation myocardial infarction (NSTEMI). STEMI patient is considered for a reperfusion therapy, consisting of percutaneous coronary intervention (PCI), fibrinolytic therapy, and coronary artery bypass grafting (CABG). This study was aimed to determine the effectiveness of reperfusion therapy in STEMI patients. This was a literature review study. The results described the effectiveness of reperfusion therapy in terms of the time action, as follows: effective PCI if <120 minutes, fibrinolytic therapy <90 minutes, and CABG within four to 30 days after angiography. In case of revascularization with PCI there was a decrease in mortality and complications of reinfarction, major bleeding, and stroke. There was a reduction in complications of cardiogenic shock with fibrinolytic therapy when given within the first 60 minutes of symptom onset. Fibrin-spesific fibrinolytics (accelerated infusion alteplase, tenecplase, and reteplase) were the most effective regimen associated with reduced mortality. CABG procedure is recommended in coronary anatomical conditions that was not suitable for PCI and several other indications; although the complications were high but the survival of 30 days and one year was very good. In conclusion, PCI is the first line choice and effective if performed less than the first 120 minutes. Fibrinolytics are effective if they are administered during the first 60 minutes in case the PCI is not performed. Moreover, CABG is recommended in anatomical coronary condition that is not suitable for PCI and other indications.Keywords: reperfusion therapy, acute myocardial infarction, STEMI  Abstrak: Infark miokard diklasifikasikan atas ST-segment elevation myocardial infarction (STEMI) dan Non-ST-segment elevation myocardial infarction (NSTEMI). Pada pasien STEMI diper-timbangkan untuk dilakukan terapi reperfusi yang terdiri dari percutaneous coronary intervention (PCI), terapi fibribolitik, dan coronary artery bypass grafting (CABG). Penelitian ini bertujuan untuk mengetahui efektivitas terapi reperfusi pada pasien STEMI. Jenis penelitian ialah literature review. Hasil penelitian ini menjelaskan efektivitas terapi reperfusi ditinjau dari waktu tindakan. Tindakan PCI efektif dilakukan <120 menit, terapi fibrinolitik <90 menit, dan CABG dalam empat hingga 30 hari setelah angiografi. Pada kasus revaskularisasi dengan tindakan PCI terdapat penurunan mortalitas dan komplikasi reinfark, perdarahan mayor, dan stroke. Terdapat penurunan komplikasi syok kardiogenik pada terapi fibrinolitik bila diberikan dalam 60 menit pertama setelah onset gejala. Fibrin-spesific fibrinolytics (accelerated infusion alteplase, tenecplase, dan reteplase) merupakan regimen yang paling efektif dikaitkan dengan penurunan mortalitas. Tindakan CABG direko-mendasikan pada kondisi anatomi koroner yang tidak sesuai untuk PCI dan beberapa indikasi lain; meskipun komplikasi tinggi namun kelangsungan hidup 30 hari dan satu tahun sangat baik. Simpulan penelitian ini ialah tindakan PCI merupakan pilihan lini pertama dan efektif diberikan dalam waktu <120 menit. Fibrinolitik efektif diberikan dalam 60 menit pertama bila PCI tidak dapat dilakukan sedangkan tindakan CABG direkomendasikan pada kondisi anatomi koroner yang tidak sesuai untuk PCI dan beberapa indikasi lain.Kata kunci: terapi reperfusi, infark miokard akut, STEMI
Hubungan Faktor Risiko Penyakit Jantung Koroner dengan Kejadian Henti Jantung Ghosalim, Aurell H.; Jim, Edmond L.; Joseph, Victor F. F.
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.59446

Abstract

Abstract: One of the causes of death from cardiovascular disease is cardiac arrest. The most common cause of cardiac arrest is coronary heart disease (CHD). This study aimed to determine the relationship between CHD risk factors and cardiac arrest events at Prof. Dr. R. D. Kandou Hospital.  This was an analytical and descriptive study with a retrospective cross-sectional approach. Samples were all patients with cardiac arrest at Gedung CVBC RSUP Prof. Dr. R. D. Kandou from August to November 2023 who had complete medical recors. The sampling technique used total sampling and research instruments using medical record data. The results obtained 37 patients as samples consisting of male (64.9%) and female (35.1%) patients. The chi-square test showed a significant relationship between sex variable and the incidence of cardiac arrest (p=0.011). There was no significant relationship (p>0.05) between the variables of age, family history, hypertension, hyperlipidemia, diabetes mellitus, obesity and smoking with the incidence of cardiac arrest. In conclusion, gender has a significant relationship with the incidence of cardiac arrest. Meanwhile, age, family history, hypertension, hyperlipidemia, diabetes mellitus, obesity and smoking were not significantly related to the incidence of cardiac arrest. Keywords: coronary heart disease risk factors; cardiac arrest    Abstrak: Salah satu penyebab kematian akibat penyakit jantung ialah henti jantung. Penyebab tersering terjadinya henti jantung dikarenakan oleh penyakit jantung koroner (PJK). Penelitian ini bertujuan untuk mengetahui hubungan antara faktor risiko PJK terhadap kejadian henti jantung di RSUP Prof. Dr. R. D. Kandou.  Jenis penelitian ini ialah deskriptif analitik dengan desain potong lintang retrospektif. Sampel penelitian ialah semua pasien henti jantung di Gedung CVBC RSUP Prof. Dr. R. D. Kandou pada bulan Agustus sampai November 2023 dengan data rekam medik lengkap. Teknik pengambilan sampel menggunakan total sampling dan instrumen penelitian menggunakan data rekam medik. Hasil penelitian mendapatkan 37 pasien sebagai sampel penelitian terdiri dari pasien berjenis kelamin laki-laki (64,9%) dan perempuan (35,1%). Hasil uji chi-square memperoleh hubungan bermakna antara variabel jenis kelamin terhadap kejadian henti jentung (p=0,011). Tidak terdapat hubungan bermakna (nilai p>0,05) antara variabel usia, riwayat keluarga, hipertensi, hiperlipidemia, diabetes melitus, obesitas, dan merokok terhadap kejadian henti jantung. Simpulan penelitian ini ialah jenis kelamin memiliki hubungan bermakna dengan kejadian henti jantung. Pada faktor usia, riwayat keluarga, hipertensi, hiperlipidemia, diabetes melitus, obesitas dan merokok tidak didapatkan hubungan bermakna dengan kejadian henti jantung di RSUP Prof. Dr. R. D. Kandou.  Kata kunci: faktor risiko penyakit jantung koroner; henti jantung
Co-Authors Agnes L. Panda Alitu, Moh. A. R. Baan, Jonathan Bambari, Hana A Biancha Tumade, Biancha Dewanti, Lidia A. D. Edmond L. Jim Ermiati, . . Ghosalim, Aurell H. Hisky Malutu, Hisky Janry Pangemanan Jim, Edmond L Kalangi, Cathleen S. Lumi, Axel P. Monique Rotty, Monique Panda, Agnes L Polii, Natalia C. I. Santoso, Richard L. Starry H. Rampengan Syahfitri, Annisa Toliu, Feiby C. Wambrauw, Jery