Soedarsono, Wahyu Aditya
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Protokol STEMI yang dimodifikasi untuk PPCI selama Pandemi COVID-19: Apakah itu memperpanjang kinerja Door-To-Balloon Putranto, Astri Yuniarsih; Putra, Teuku Muhammad Haykal; Soedarsono, Wahyu Aditya
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1325

Abstract

Background COVID-19 became a main health problem and causes heavy impact, especially for healthcare system. Managing ST-Segment Elevation Myocardial Infarction (STEMI) patients before COVID-19 pandemic was already challenging enough for Healthcare Professionals (HCP) to pursue time-sensitive treatment. After COVID-19 pandemic, the time-sensitive treatment of pursuing door-to-balloon (DTB) time put a lot more burden to HCP. In this study, We sought to analyze how a change in protocol of PPCI in STEMI patients before and during the pandemic influence the performance of DTB in the hospital. Methods This is a single-centered retrospective observational study among STEMI patients which was treated by PPCI. Secondary data from the medical record were collected consecutively from April 2018 to January 2022 (46 months). We compared DTB performances before and during the pandemic. Result During 46 months period, the total population of this research was 880 patients. There were total 358 patients underwent PPCI before the pandemic and 522 patients after the pandemic. Modified protocol with the addition step to prevent the spread of COVID-19 had been implemented since April 2020. DTB increased significantly during the pandemic (90 (70-124) minutes vs 97 (76-135) minutes, p 0.002). The proportion of the patients who achieved DTB under 90 min was also significantly decreasing (56.4% vs 47.9%, p 0.0013). Conclusion It is necessary for PPCI center to modify PPCI workflow during the pandemic. A decent workflow should consider practicality and simplicity without compromising HCP and patient safety. Implementing modified PPCI workflow during the pandemic significantly increased DTB time but it is still within the limit of being reasonable and acceptable for the benefit of the patients.
2023 Indonesian Guidelines for Heart Failure Treatment: Working Group on Heart Failure and Cardiometabolic Diseases, Indonesian Heart Association Hasanah, Dian Yaniarti; Zulkarnain, Edrian; Arifianto, Habibie; Prameswari, Hawani Sasmaya; Suciadi, Leonardo Paskah; Yamin, Paskariatne Probo Dewi; Pratikto, Rarsari Soerarso; Nauli, Siti Elkana; Putri, Vebiona Kartini Prima; Soedarsono, Wahyu Aditya; Sarastri, Yuke
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1671

Abstract

Heart failure is a health problem with high mortality and morbidity rates in developed and developing countries such as Indonesia. The prevalence of heart failure itself is increasing because patients who experience acute heart failure can progress to chronic heart failure. Guidelines-Directed Medical Therapy (GDMT) with recommended doses is still underutilized in heart failure patients with reduced ejection fraction (HFrEF). In Indonesia itself, even though it has a fairly high rate of use of ACE-inhibitors (ACE-I) or angiotensin receptor blockers (ARB), Indonesia has the lowest rate of use of β-blockers and aldosterone inhibitors (also called Mineralocorticoid Receptor Antagonists, MRA) of the entire ASIAN-HF registry.84 Therefore, the writing of this guideline was carried out as an effort to provide practical guidance regarding the diagnosis, assessment and management of acute and chronic heart failure. Thus, it is hoped that efforts can be made to prevent the increase in prevalence and reduce the number of rehospitalization with complete management. This book was written as an update to the 2020 Guideline for the Management of Heart Failure: Indonesian Heart Association. The sources of our updates came from many references and literatures carried out by each contributor and reviewed by EBM team.