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All Journal Indonesian Journal of Cardiology
Wicaksono, Sony Hilal
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Health Professions Medicine & Pharmacology

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Factors Influencing Mortality of Thoracic Aortic Surgery in The Third World Country Diansari, Rienna; Aligheri, Dicky; Herlambang, Bagus; Wicaksono, Sony Hilal; Mendel, Brian; Yaniarti, Dian; Alkatiri, Amir Aziz; Andriantoro, Hananto; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1494

Abstract

Background: A prominent increase of overall global death rate of aortic disease is seen on developing country, with South-east Asia having the highest increase of 41%. Lack of identification and prompt management of the diseases in conjunction with lack of facilities in third world countries that could perform aortic surgery made the procedure more complex when the patients admitted to tertiary hospitals Methods: The data was obtained through medical record of patients underwent thoracic aortic surgery from 2018 to 2021 in National Cardiovascular Center Harapan Kita (NCCHK). One-year and 3-year survival analysis was obtained through phone calls and digital messages. Statistical analysis was done to investigate the impact of surgical complexity as the main predictor and other variables on primary (in-hospital mortality) and secondary (mid-term survival) outcome. Results: A total of 208 patients were included in the analysis; 157 (75,5%) underwent complex surgery, and 51 (24,5%) underwent non-complex surgery. In-hospital mortality was similar across 2 groups (23,6% vs 13,7%; p = 0,1240). On multivariable analysis, malperfusion syndrome (OR 3,560; p = 0,002), CPB duration > 180 minutes (OR 4,331; p = 0,001), and surgical priority (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) were identified as independent predictor of in-hospital mortality. Cox regression identified diabetes (HR 4,539; p = 0,025) and emergency procedure (HR 9,561; p = 0,015) as independent predictors for 1-year mortality, and diabetes (HR 3,609; p = 0,004), aortic dissection (HR 2,795; p = 0,029), and maximum aortic diameter (HR 1,034; p = 0,003) for 3-year mortality. Surgical complexity was not associated with early and mid-term mortality. Conclusions: In patients undergoing thoracic aortic surgery, surgical complexity was not associated with early and mid-term survival. Early and mid-term survival was largely determined by patient comorbidities and intra-surgery factors.This article has a related Erratum.
Consensus Statements on the Use of High-Sensitivity Troponin I as the Assessment of Cardiac Risk in Apparently Healthy Population in Indonesia Ambari, Ade Meidian; Ng, Sunanto; Rejeki, Vidya Gilang; Rina Artha, I Made Junior; Raynaldo, Abdul Halim; Alsagaff, Mochamad Yusuf; Wicaksono, Sony Hilal; Dwiputra, Bambang; Desandri, Dwita Rian
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.1544

Abstract

Cardiovascular disease (CVD) is a growing burden in Indonesia, making primary prevention of utmost importance. High sensitivity cardiac troponin I (hsTnI) has been known as one of the biomarkers of choice for diagnosing acute myocardial infarction. Nonetheless, recent studies indicate that hsTnI assay has potential as a predictor of cardiac risk in asymptomatic individuals. An advisory board consisting of renowned cardiologists from the Indonesian Heart Association was convened in Jakarta in March 2023. The meeting aimed to explore the appropriate use of hsTnI for cardiovascular (CV) risk stratification in apparently healthy adults in Indonesia. The board reviewed relevant literature and developed key consensus statements, including hsTnI cut-off for identifying high-risk asymptomatic patients, the proposed algorithm, and monitoring after aggressive risk factor control. This article presents the resulting consensus statements to provide clinicians with a practical tool for planning primary prevention strategies. Furthermore, it is expected to raise awareness and advocacy among stakeholders in the healthcare infrastructure regarding the use of hsTnI as a guide for assessing CV risk in Indonesia.
Does Chronic Inflammation Play a Role in Rheumatic Mitral Valve Restenosis after Percutaneous Transvenous Mitral Commissurotomy? Butarbutar, Maruli; Soesanto, Amiliana M.; Firman, Doni; Ariani, Rina; Alkatiri, Amir Aziz; Wicaksono, Sony Hilal
Jurnal Kardiologi Indonesia Vol 43 No 3 (2022): Indonesian Journal of Cardiology: July - September 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1398

Abstract

Background: Mitral valve restenosis is defined as decreased mitral valve area (MVA) <1.5 cm2 or decreased MVA >50% after PTMC. It is time-dependent and associated with major adverse cardiovascular events (MACE), such as congestive heart failure, cardiac death, mitral valve replacement, and redo PTMC. The mechanism is not yet known; however, chronic inflammation may have a role. This research aims to determine the association between chronic inflammation and mitral valve restenosis after PTMC. Methods: A total of 40 patients with mitral valve stenosis who underwent successful PTMC were matched and classified into restenosis/case group (n=20) and no restenosis/control group (n=20). Secondary data was taken from electronic medical records such as patient characteristics (gender, age & 2nd prophylaxis), echocardiography data before PTMC (Wilkins’ score and MVA before PTMC), and echocardiography data after PTMC (MVA after PTMC). Follow-up echocardiography examination (follow-up MVA) and laboratory assessment of chronic inflammation marker (IL-6) were done on all patients. Statistical analyses were done to look for an association between the level of chronic inflammation marker & other independent variables with mitral valve restenosis. Results: Median IL-6 concentration was 2.39 (0.03 – 11.4) pg/mL. There was no statistically significant difference in IL-6 levels between both groups (p-value >0.05). MVA decrement was 0.13 (0 – 0.62) cm2/year with rate of MVA decrement ≥0.155 cm2/year was predictor of mitral valve restenosis (p-value <0.001, OR = 46.72, 95% CI 6.69 – 326.19). Conclusion: Chronic inflammation assessed by IL-6 was not associated with mitral valve restenosis.This article has a related Erratum.
Co-Authors Aligheri, Dicky Alsagaff, Mochamad Yusuf Ambari, Ade Meidian Amiliana M. Soesanto Amir Aziz Alkatiri Ariani, Rina Bagus Herlambang Butarbutar, Maruli Desandri, Dwita Rian Diansari, Rienna Doni Firman Dwiputra, Bambang Hananto Andriantoro Mendel, Brian Raynaldo, Abdul Halim Rejeki, Vidya Gilang Rina Artha, I Made Junior Suko Adiarto Sunanto Ng Yaniarti, Dian