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Lusiani Rusdi, Lusiani
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Medicine & Pharmacology

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Vaksin Influenza sebagai Modalitas Pencegahan Kejadian Rawat Inap Akibat Penyakit Kardiovaskular Rusdi, Lusiani; Adnan, Nurhayati; Suhardi, Kevin Fernando
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Modifikasi Skor TIMI sebagai Model Prediksi Mortalitas 30 Hari Pasien STEMI Muda Mansur, M. Tasrif; Yamin, Muhammad; Rusdi, Lusiani; Abdullah, Murdani; Karim, Birry; Rumende, Cleopas Martin; Marbun, Maruhum Bonar H.; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 4
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Introduction. Cardiovascular disease is a leading cause of death worldwide. Three-quarters of these deaths occur in lowand middle-income countries among individuals in their productive years. ST-segment elevation myocardial infarction (STEMI) is a dangerous manifestation of coronary artery disease (CAD) and can lead to sudden death. Smoking and a family history of early CAD are major risk factors for STEMI cases. However, their role in any risk stratification system for patients has not been clearly established. The most widely used score in assessing the prognosis of STEMI patients is the TIMI score, but its accuracy in the young patient population is still unknown. The objectives of this study were to determine the proportion of mortality in young STEMI patients at RSCM, validate the TIMI score in young patients, and develop a risk stratification system for young STEMI patients. Methods. This research is a retrospective cohort study using medical record data from the Dr. Cipto Mangunkusumo National General Hospital (RSCM) on patients aged ≤50 years who were treated for ST-elevation myocardial infarction (STEMI) from 2018 to 2022. Univariate analysis was conducted to obtain subject characteristics and the 30-day mortality proportion of young STEMI patients. Bivariate Cox regression analysis was performed to examine the relationship between smoking and a family history of early coronary artery disease (CAD) with 30-day mortality. The TIMI score was validated in the study subjects of young patients. Multivariate analysis was conducted to obtain a new prediction model, and the model’s discriminatory performance was assessed using the area under the ROC curve (AUC), and model calibration was modified using the Hosmer-Lemeshow test. Results. A total of 164 study subjects were included. There were 107 patients (65.2%) with a smoking risk factor, while 39 patients (23.9%) had a family history of early CAD. The proportion of 30-day mortality among young patients was 7.9% (13 individuals). Statistical analysis showed that there was no correlation between 30-day mortality in young STEMI patients and a history of smoking (HR 0.0441 (95% CI 0.148-1.312)) or a family history of early CAD (HR 0.567 (95% CI 0.126- 2.559)). The TIMI score showed good predictive ability for 30-day mortality in young STEMI patients, with an AUC value of 0.836 (95% CI 0.717- 0.956). The combination of the TIMI score with the smoking history variable demonstrated good discriminatory performance in predicting 30-day mortality among young STEMI patients, with an AUC value of 0.875. However, when comparing the AUC values between the TIMI score and the TIMI score with the addition of the smoking history factor, no significant increase in accuracy was observed (p-value=0.215). Conclusions. The TIMI score demonstrates good discrimination and calibration in predicting 30-day mortality among young STEMI patients. The TIMI score, when combined with the smoking history factor, shows improved discriminatory performance and calibration in predicting 30-day mortality among young STEMI patients compared to the pure TIMI score but does not significantly enhance the accuracy.
Efektivitas Sacubitril/Valsartan dalam Mencegah Gagal Jantung pada STEMI Pasca Percutaneous Coronary Intervention Andre, Nobian; Adila, Lana; Rizka, Aulia; Rusdi, Lusiani
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 4
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Heart failure is a possible complication following ST-elevation myocardial infarction (STEMI) even after revascularization. Neuroendocrine activation in the process of ventricular remodeling can be regulated by angiotensin receptor-neprilysin inhibitor (ARNI) as well as angiotensin-converting enzyme (ACE) inhibitor. The use of ARNI in heart failure with reduced ejection fraction has been found to be superior to ACE inhibitor. The role of ARNI on cardiac function in STEMI has not been established. A clinician treating a patient with STEMI considered giving sacubitril/valsartan to reduce the risk of developing heart failure. Literature search was performed in three electronic databases: PubMed, Embase, and Cochrane. Keywords in the form of text words and MeSH terms were arranged using Boolean operator technique. Critical appraisal of selected articles was carried out according to the guideline from Oxford Centre for Evidence-Based Medicine. Four relevant randomized clinical trials were obtained. There was a reduced risk of heart failure events at 6 months following STEMI who underwent percutaneous coronary intervention (PCI) in the sacubitril/valsartan group compared to ACE inhibitor group, with a relative risk (RR) of 0.35 (95%CI 0.15 – 0.84; p=0.037); RR 0.5 (95%CI 0.31 – 0.82; p=0.004); and number needed to treat (NNT) of 6. Similar results were also found in STEMI patients complicated by cardiogenic shock: RR 0.47 (95%CI 0.24 – 0.94; p=0.044). Sacubitril/valsartan is more effective than ACE inhibitor in reducing the risk of heart failure at 6 months following STEMI post-PCI.
Hubungan Heart Rate Variability dengan Global Longitudinal Strain pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Jakarta Hadi, Dwi Rendra; Rusdi, Lusiani; Tarigan, Tri Juli Edi; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia
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Introduction. Diabetes mellitus (DM) remains a major global health issue due to its direct consequences and complications, particularly cardiovascular complications. These complications are influenced by autonomic neuropathy, which can be assessed by Heart Rate Variability (HRV). Autonomic dysfunction is thought to impair heart function, which can potentially be predicted early by observing Global Longitudinal Strain (GLS). The relationship between HRV and GLS has not been extensively studied. Therefore, this study aimed to identify the relationship between HRV and GLS. Methods. A cross-sectional study with a population of adult type 2 DM patients residing in Jakarta in December 2020. HRV parameters included RR interval, Standard Deviation of NN Intervals (SDNN), Root Mean Square of Successive Difference (RMSSD), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Global longitudinal strain was analyzed using echocardiography. Results. Analysis was conducted on 167 samples. The mean value of GLS was -20.30 (SD 1.57). There were no correlation between RR interval (r = -0.07, p = 0.377), SDNN (r = -0.10, p = 0.189), RMSSD (r = -0.12, p = 0.098), LF (r = -0.003, p = 0.968), HF (r = -0.09, p = 0.21), and LF/HF ratio (r = -0.10, p = 0.189) with GLS. No association was found between hypertension, history of smoking, dyslipidemia, duration of diabetes, and HbA1C with GLS. Conclusion. There is no correlation between heart rate variability and global longitudinal strain in type 2 DM patients.
Co-Authors Adila, Lana Adnan, Nurhayati Andre, Nobian Arif Mansjoer Astrid Karina, Astrid Aulia Rizka, Aulia Birry Karim Christopher Suwita, Christopher Cleopas Martin Rumende E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Hadi, Dwi Rendra Mansur, M. Tasrif Maruhum B.H. Marbun Muhammad Yamin Murdani Abdullah Sally A Nasution, Sally A Suhardi, Kevin Fernando Syahrir Azizi, Syahrir Tri Juli Edi Tarigan