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All Journal International Islamic Medical Journal Jurnal Widya Medika
Angkasa, Irwan Surya
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Religion Humanities Health Professions Medicine & Pharmacology Public Health

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Primary Percutaneous Coronary Intervention in a 24-hour PCI Capable Hospital in Indonesia Laksono, Sidhi; Hosanna, Cliffian; Angkasa, Irwan Surya; Nurbaeti, Putri
Jurnal Medis Islam Internasional Vol 7 No 1 (2025): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v7i1.6531

Abstract

Introduction: Chest pain may be a symptom of a life-threatening disease such as S ST-Elevation Myocardial Infarction (STEMI). Immediate primary percutaneous coronary intervention (PPCI) is recommended for virtually all STEMI patients who present in a PCI-capable hospital. Objective: We would like to present data on Door-to-Balloon (DTB) times and the factors affecting it. Methods: This is a single-center retrospective study. Patients are STEMI patients, undergoing primary PCI from 1st January 2024 to 30th April 2024. Secondary data are obtained from the medical records and analyzed. Results: A total of 60 patients undergo PPCI during the study period. Patients are generally male patients, aged 53.67 years old, with 2 traditional cardiovascular risk factors, presenting to the emergency department (ED) with an average of 5.88 hours of chest pain. DTB time was 86.25 minutes during the study period. We identified the onset of chest pain and referred patients to be associated with DTB time. Referred patients had longer onset since chest pain but faster DTB time. We found no association between age, gender, presenting time, diagnosis, Killip class, and physician factor to significantly affect DTB time. Conclusions: We have identified factors that may help us improve our DTB time. Patient knowledge should also be improved to increase awareness of symptoms of chest pain, minimizing patient delay and improving total ischemic time. 
A SILENT THREAT: VERY LATE STENT THROMBOSIS IN BARE METAL STENTS AFTER A DECADE Laksono, Sidhi; Zheng, Tonny; Angkasa, Irwan Surya
JURNAL WIDYA MEDIKA Vol. 12 No. 2 (2026): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v12i2.8074

Abstract

Very late stent thrombosis (VLST) in bare-metal stents (BMS) is a rare but potentially life-threatening complication occurring more than one year after stent implantation. Traditionally, BMS were believed to achieve full endothelialization within months, thereby minimizing late thrombotic risk. However, emerging evidence highlights mechanisms such as neoatherosclerosis and neointimal proliferation as key contributors to VLST, which can present as acute coronary syndrome even many years post-implantation. We report on a 76-year-old male with a history of percutaneous coronary intervention (PCI) using a BMS in the left anterior descending artery (LAD) 10 years prior. He presented with sudden severe chest pain, nausea, and diaphoresis. Electrocardiography revealed an ST-segment elevation myocardial infarction (STEMI) in the inferior-anterior leads. Emergency coronary angiography demonstrated very late thrombosis within the BMS segment of the LAD, accompanied by significant in-stent restenosis. The patient underwent successful primary PCI with the implantation of a new drug-eluting stent overlapping the previous stent, restoring TIMI 3 flow. Notably, risk factors included advanced age, chronic kidney disease, active smoking, and dyslipidemia, despite the patient maintaining daily aspirin therapy. This case underscores that VLST in BMS, although uncommon, remains a critical cause of late myocardial infarction, primarily driven by neoatherosclerosis and neointimal changes within the stented segment. Prompt recognition and emergent PCI can achieve favorable outcomes. Moreover, continuous secondary prevention with long-term antiplatelet therapy and aggressive risk-factor modification is essential to mitigate the risk of VLST, even many years after initial stent placement. Ongoing vigilance is warranted in managing patients with historic BMS to improve prognosis and prevent fatal events.
Co-Authors Hosanna, Cliffian Laksono, Sidhi Nurbaeti, Putri Zheng, Tonny