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All Journal The Journal of Society Medicine (JSOCMED)
Lubis , Anggia Chairuddin
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Factors Related to Obstructive Sleep Apnea in Patients with Heart Failure and Atrial Fibrillation Masyab, Nadiah; Lubis , Anggia Chairuddin; Raynaldo , Abdul Halim
Journal of Society Medicine Vol. 4 No. 4 (2025): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.207

Abstract

Introduction: Obstructive sleep apnea (OSA) causes cardiovascular disturbances due to intermittent hypoxia, oxidative stress, systemic inflammation, excessive negative intrathoracic pressure, sympathetic activation, and increased blood pressure. These factors can impair myocardial contractility, leading to the development of heart failure and atrial fibrillation (AF). Epidemiological studies have shown a significant independent association between OSA, heart failure, and AF. This study aims to identify factors associated with obstructive sleep apnea (OSA) in patients with heart failure accompanied by atrial fibrillation. Method: This study was conducted on patients diagnosed with heart failure and atrial fibrillation hospitalized at the Integrated Heart Center of Adam Malik Hospital. Data collection began in August 2023 and continued until the required sample size was reached. This is an observational analytic study with a cross-sectional design. Results: A total of 51 patients participated in this study. The majority of respondents were male (66.7%), with most being aged between 60-69 years. The study found that the degree of OSA in heart failure patients with AF was predominantly mild (30.8%), followed by moderate (25.0%) and severe (17.3%). The average AHI value was 16.78 with a standard deviation of 14.359. Multivariate analysis identified two significant variables: smoking history and functional capacity (NYHA Class) (p > 0.05). Conclusion: A significant association was found between gender and smoking history with the occurrence of OSA in patients with heart failure and atrial fibrillation. The multivariate analysis also highlighted the significance of smoking history and functional capacity (NYHA Class) (p > 0.05).
The Relationship Between Elevated Systemic Immune-Inflammatory Index (SII) and the Severity of Coronary Lesions in Chronic Coronary Syndrome (CCS) Patients Undergoing Coronary Angiography at Haji Adam Malik Hospital Medan Fatraya, Qien Jovan; Safri , Zainal; Lubis , Anggia Chairuddin
Journal of Society Medicine Vol. 4 No. 6 (2025): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.219

Abstract

Introduction: This study examines the correlation between Systemic Immune Inflammation Index (SII) and coronary lesion severity in Chronic Coronary Syndrome (CCS) patients using the SYNTAX score. Inflammatory markers, including neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR), are associated with atherosclerosis and CAD. Methods: This retrospective observational study analyzed correlation between SII values and coronary lesion severity in CCS patients who underwent coronary angiography. Data were collected between June and August 2024. Patients were categorized based on the SYNTAX score, which evaluates coronary lesion severity. The study used statistical tests including mean tests, multivariate logistic regression, Spearman correlation, and ROC curve analysis to assess SII's sensitivity and specificity in predicting lesion severity. A p-value <0.05 was considered significant. Results: The study subjects were 115 samples with an average age of 59.41 ± 9.45, with 78 male samples (67,8%). It was found that the SII value has a strong correlation with the SYNTAX score, specifically with a mild SYNTAX score of 365.7 (183.45 - 853.91), a moderate SYNTAX score of 695.52 (534.83 - 1838.57), and a severe SYNTAX score of 1026.7 (413.57 - 3813.83; p value <0.001). Conclusion: The study found a significant relationship between SII value and coronary lesion severity, measured by SYNTAX score. Higher SII values were associated with more severe coronary lesions, suggesting SII can serve as an effective predictor of lesion severity in CCS patients.
The Left Atrioventricular Coupling Index as a Predictor of Major Cardiovascular Events in Chronic Heart Failure Patients at Adam Malik Hospital Medan Alfuadi , Rifki Mirza; Lubis , Anggia Chairuddin; Ade Putra , Yuke Sarastri-Hilfan
Journal of Society Medicine Vol. 4 No. 6 (2025): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.220

Abstract

Introduction: Kidney transplantation is the standard treatment for end-stage renal disease (ESRD), significantly improving survival rates and quality of life. However, pulmonary complications are a leading cause of morbidity and mortality post-transplant. Case Report: This case report presents a 50-year-old male with chronic kidney disease (CKD), diagnosed five months prior and undergoing regular hemodialysis. He had a history of hypertension and diabetes mellitus. The patient underwent a 9-hour kidney transplant surgery without complications. Post-operatively, urine output was minimal (5 mL), prompting vasopressor support to elevate the mean arterial pressure above 150 mmHg, which improved renal function. On days one and two post-surgery, the patient developed respiratory distress, with a chest X-ray revealing pulmonary edema. Continuous furosemide infusion was initiated to manage fluid overload, leading to improvement in the patient’s respiratory status. By day four, the patient was stable and transferred from the ICU to a regular room. Pulmonary complications, including pulmonary edema, affect up to 80% of kidney transplant recipients in the first year post-transplant and contribute to high morbidity and mortality. Conclusion: This case emphasizes the importance of early recognition and management of pulmonary edema through fluid management and vasopressors. Timely intervention, including diuretic therapy, is crucial for stabilizing kidney transplant recipients and improving patient outcomes. The report highlights the need for further research to establish evidence-based guidelines for fluid management in kidney transplant patients. Effective management is essential for enhancing post-operative recovery and quality of life in transplant recipients.
Co-Authors Ade Putra , Yuke Sarastri-Hilfan Alfuadi , Rifki Mirza Fatraya, Qien Jovan Masyab, Nadiah Raynaldo , Abdul Halim Safri , Zainal