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Saidi, Zaki
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Journal : Heart Science Journal

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SGLT2 inhibitor, a new bullet in heart failure management Saidi, Zaki; Widito, Sasmojo
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.5

Abstract

The global health landscape is confronted with substantial challenges stemming from diabetes mellitus and heart failure (HF). The escalating incidence of diabetes mellitus (DM), in correlation with HF, underscores the imperative necessity for efficacious strategies in the realm of prevention and management. The most recent advancements in therapeutic approaches, specifically Sodium-glucose transporter 2 inhibitors (SGLT2i), present a promising prospect for enhancing outcomes and addressing the existing gaps in HF management. This paper aims to elucidate the significance of SGLT2i in the therapeutic management of both reduced and preserved heart failure, with or without the presence of DM. SGLT2i are new heart failure drugs. In trials, SGLT2i improved diastolic dysfunction, reduced oxidative stress, inflammation, fibrosis, and myofilament rigidity. The first SGLT2 inhibitor studies, EMPA-REG OUTCOME, DECLARE-TIMI 58, and CANVAS, showed that Empagliflozin and Canagliflozin reduced HF mortality and rehospitalization in type 2 diabetes mellitus (T2DM) patients. Dapagliflozin reduces HF hospitalizations without impacting T2DM mortality. Canagliflozin avoided creatinine rises, kidney disease deaths, and cardiovascular deaths in the CREDENCE Study. SGLT2i improve health in heart failure with preserved ejection fraction (HFpEF). SGLT2i improved health status statistically in the PRESERVED-HF and EMPEROR-Preserved investigations. SGLT2i became known as a promising therapeutic choice in the treatment of HF. The substantial evidence from prominent large-scale clinical trials has substantiated the cardiovascular and renal protective effects of SGLT2i. Furthermore, the benefits of these medications are relevant for individuals who have been diagnosed with heart failure with reduced ejection fraction (HFrEF), as well as those who are experiencing heart failure with preserved ejection fraction (HFpEF).
Analysis of activated clotting time in patients receiving unfractionated heparin with and without continuous infusion during elective percutaneous coronary intervention Saidi, Zaki; Widito, Sasmojo
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.11

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  Background: Percutaneous coronary intervention (PCI) involves a risk of thrombotic events. Unfractionated heparin (UFH) remains a preferred antithrombotic agent during PCI, though the optimal administration method is still under debate. Given its narrow therapeutic range, UFH requires careful monitoring through the measurement of activated clotting time (ACT) Objective: The aim is to compare ACT value and the outcomes of administering a bolus of UFH at 70–100 IU/kgBW, with and without a continuous infusion of 2000 IU/hour Methods: An observational retrospective study was conducted on 133 patients who underwent elective PCI by meeting the inclusion and exclusion criteria during the period of July 2022–July 2024. Clinical information, ACT value and the outcome were gathered from medical records. Statistical analyses were performed using SPSS 22, employing univariate, bivariate, and multivariate logistic regression analyses to determine correlations. Result: The range of ACT results of administering an UFH bolus of 70-100 IU/kgBW with continuous infusion 2000 IU/hour was 191 to 426 seconds (mean 281.9 seconds). Among the 44 patients, 66.6% exhibited ACT levels below 300 seconds, 15 patients (22.7%) had ACT levels ranging from 300 to 350 seconds, while 6 patients (8.3%) had ACT levels exceeding this range. The percentage of patients who attained therapeutic success in the unfractionated heparin (UFH) infusion group (22.7%) was significantly higher than the UFH bolus group (5.9%) with statistically significant results (p = 0.000). Complications were observed in both groups, with 1 patient in each group experiencing acute thrombosis (p = 1.000) and no patients experienced bleeding complications. Conclusion: Administering a UFH bolus of 70-100 IU/kgBW with continuous UFH infusion at 2000 IU/hour achieved better optimal ACT values. No significant results were found regarding the risk of acute thrombosis with no bleeding complications.  
Co-Authors Widito, Sasmojo