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All Journal Indonesian Journal of Cardiology Indonesian Journal of Biomedicine and Clinical Sciences
Nahar Taufiq, Nahar
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Simplified Selvester QRS Score as an Infarct Size Parameter in STEMI Patients Undergoing Pharmacoinvasive or Primary Percutaneous Coronary Intervention Prasetia, Arif Eka; Hartopo, Anggoro Budi; Taufiq, Nahar; Bagaswoto, Hendry Purnasidha; Setianto, Budi Yuli
Jurnal Kardiologi Indonesia Vol 43 No 4 (2022): Indonesian Journal of Cardiology: October - December 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1186

Abstract

Background:Cardiovascular disease especially acute myocardial infarct (AMI) is one of the highest cause of mortality worldwide. Majority of AMI comes in the form of ST elevation myocardial infarct (STEMI) that requires timely diagnosis and revascularization management to restore myocardial circulation. The simple method to estimate infarct size is by using simplified Selvester QRS Score to electrocardiogram records, which is a tested method that have good correlation with gold standard, namely cardiac magnetic resonance imaging. Objectives : To investigate difference of infarct size with simplified Selvester QRS score parameter between STEMI patients undergoing pharmacoinvasive compared to primary PCI. Methods: Eighty-two STEMI patients, 41 of pharmacoinvasive and 41 of primary PCI was scored with simplified Selvester QRS score from electrocardiogram recording. Patient data are retroactively taken form Sardjito Cardiovascular Intensive Care (SCIENCE) registry. Scoring of simplified Selvester QRS Score was done by two experienced cardiologist blinded to patient procedure, and results then measured for interobserver agreement with Bland-Altman test. Comparison of QRS Score in pharmacoinvasive and primary PCI group was done with independent sample T test followed with multivariable linear regression test. Results: The means of simplified Selvester QRS score in pharmacoinvasive and primary PCI group is 7.240±3.015 and 8.900±4.188, p=0.043, respectively. Independent sample T test shows significant difference in the simplified Selvester QRS score in pharmacoinvasive and primary PCI group. The multivariable analysis shows that variables other than revascularization method independently influences QRS score are onset, anterior segment ST elevation and ST segment elevation in more > 3 leads in electrocardiogram. Conclusion: There is significant difference in infarct size measured by simplified Selvester QRS score betweem STEMI patient undergoing pharmacoinvasive method compared to primary PCI procedure, which is lower in the pharmacoinvasive group
Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry Juzar, Dafsah Arifa; Muzakkir, Akhtar Fajar; Ilhami, Yose Ramda; Taufiq, Nahar; Astiawati, Tri; R A, I Made Junior; Pramudyo, Miftah; Priyana, Andria; Hakim, Afdhalun; Anjarwani, Setyasih; Endang, Jusup; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1406

Abstract

Background Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. Methods IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. Results Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients. Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). Conclusion Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy.
Impact of multivessel coronary artery disease on early and late clinical outcome in ST-Segment elevation myocardial infarction patients who underwent percutaneous coronary intervention: insight from Indonesia Damarkusuma, Arditya; Taufiq, Nahar; Bagaswoto, Hendry Purnasidha; Saputra, Firandi; Sukmadja, Daniel; Setianto, Budi Yuli
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 01 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i01.12536

Abstract

It is estimated that 15 people for every 1000 Indonesian residents suffer from cardiovascular disease (CVD) including ST-segment elevation myocardial infarction (STEMI). Percutaneous coronary intervention (PCI) is often performed in patients with STEMI. Several factors affect clinical outcome after PCI procedure including multivessel coronary artery disease. This study aimed to measure the impact of multivessel coronary artery disease on the early and late outcomes of STEMI patients undergoing PCI procedures. This was a prospective cohort study on STEMI patients undergoing PCI procedures from the period of August to December 2021. Two expected cohorts were performed i.e. patients who suffered from single-vessel disease (SVD) and patients who suffered from multivessel disease (MVD). Forty six patients with STEMI were enrolled in this study consisting of 24 (52.17%) patients with MVD and 22 (47.83%) patients with SVD. No significant difference in baseline characteristics between MVD and SVD groups was observed (p > 0.05). The MVD group (91.67%) used a more radial percutaneous approach compared with the SVD group (54.55%; p = 0.04). In addition, no significant difference between the SVD group and the MVD group in major adverse cardiovascular events (MACE) and echocardiographic outcome after 90-d follow up was observed (p > 0.05). In conclusion, MVD has similar impacts on early and late clinical outcomes compared with SVD in STEMI patients undergoing PCI procedures.
Co-Authors Andria Priyana Anggoro B Hartopo, Anggoro B Anggoro Budi Hartopo Anjarwani, Setyasih Astiawati, Tri Bambang Widyantoro Budi Y Setianto, Budi Y Budi Yuli Setianto Damarkusuma, Arditya Endang, Jusup Firandi Saputra, Firandi Hakim, Afdhalun Hendry Purnasidha Bagaswoto Heri Hernawan, Heri Ilhami, Yose Ramda Irsad A Arso, Irsad A Juzar, Dafsah Arifa Muzakkir, Akhtar Fajar Pramudyo, Miftah Prasetia, Arif Eka R A, I Made Junior Sukmadja, Daniel