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INDONESIA
Indonesian Journal of Cardiology
Published by Indonesian Heart Association
ISSN : 28303105     EISSN : 29647304     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Indonesian Journal of Cardiology (IJC) is a peer-reviewed and open-access journal established by Indonesian Heart Association (IHA)/Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) [www.inaheart.org] on the year 1979. This journal is published to meet the needs of physicians and other health professionals for scientific articles in the cardiovascular field. All articles (research, case report, review article, and others) should be original and has never been published in any magazine/journal. Prior to publication, every manuscript will be subjected to double-blind review by peer-reviewers. We consider articles on all aspects of the cardiovascular system including clinical, translational, epidemiological, and basic studies. Subjects suitable for publication include but are not limited to the following fields: Acute Cardiovascular Care Arrhythmia / Cardiac Electrophysiology Cardiovascular Imaging Cardiovascular Pharmacotherapy Cardiovascular Public Health Policy Cardiovascular Rehabilitation Cardiovascular Research General Cardiology Heart Failure Hypertension Interventional Cardiology Pediatric Cardiology Preventive Cardiology Vascular Medicine
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 712 Documents
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Hemodynamic and Clinical Outcomes of Milrinone Compared to Dobutamine in Cardiogenic Shock: A-Systematic Review and Meta-Analysis Bahagia, William; Santoso, Jimmy Oi
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.1296

Abstract

Background Despite years of clinical experience with the two most commonly used inotropes i.e dobutamine and milrinone, in the cardiogenic shock setting, there is a lack of head-to-head comparison between inotropes in cardiogenic shock. We conducted a systematic review and meta-analysis on the comparison of hemodynamic and clinical effects of dobutamine and milrinone in cardiogenic shock. Methods A comprehensive literature search using PubMed and Scopus was performed. Among 40 studies retrieved from the database, 3 studies were included for hemodynamic comparison outcome and 2 studies for clinical outcomes. Results Three studies with 101 patients were included for hemodynamic analysis and two studies with 146 patients for clinical analysis. We observed no significant difference between cardiac index, pulmonary capillary wedge pressure, and mean arterial pressure at 1 hour after milrinone and dobutamine administration. However, there is significantly lower mPAP after milrinone infusion compared to dobutamine (mean difference -8,7 (-9,97 to -7,43) mmHg, p<0,01). We also observed no significant difference in in-hospital mortality but significantly shorter ICU length of stay in the milrinone group (mean difference -1 (-1,92 to -0,08) days). Conclusion Administration of milrinone resulted in lower PA pressure and shorter ICU LOS compared to dobutamine in patients with cardiogenic shock. This article has a related Erratum.
Rare Case of Ventricular Standstill and High-Grade AV Block in Patient with Thyrotoxicosis Aryaputra, Achmad Bima; Bagaswoto, Hendry Purnasidha
Jurnal Kardiologi Indonesia Vol 43 No 4 (2022): Indonesian Journal of Cardiology: October - December 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1299

Abstract

Background Stokes-Adams Syndrome can be caused by high-grade AV Block, ventricular tachycardia, and one of the uncommon cause, ventricular standstill. Although thyrotoxicosis is commonly presented as tachycardia, it’s unusual for AV blocks to occur, especially a high-grade one. Case Illustration A 45-year-old female was admitted with fatigue, dizziness, and recurrent episodes of unconsciousness. She had a history of hyperthyroid, routinely managed with Propylthiouracil and Propranolol. Physical examination showed HR: 30 x/min, and other unremarkable systemic examinations. Initial ECG showed 3:1 AV Block. Patient was managed with Dopamin and moved to ICU for further observation. In the ICU, suddenly she had a Stokes-Adam episode presented as a seizure, her monitor showing P waves with an absence of ventricular activity lasting for few seconds. Due to the condition of ventricular standstill, a Temporary Pacemaker (TPM) was installed urgently, and so patient’s vital sign was stable with pacing rhythm. We found Free Thyroxine (T4) level of 46.85 pmol/l, TSH of 0.005 ulU/ml, and unremarkable echocardiographic findings. Considering these results, we suspect that the cause of the ventricular standstill was due to thyrotoxicosis. Propylthiouracil and dexamethasone were given to manage the disease. After 7 days of treatment, she was discharged with sinus rhythm on her ECG. Conclusion Ventricular standstill is frequently associated with conduction blockages, but it can sometimes occur without them. Ventricular standstill treatment often necessitates the use of temporary pacing wires or a pacemaker. In thyroid crises, high-degree AV-block is uncommon, but when the euthyroid condition is restored, clinical status and conduction problems can be reversible.This article has a related Erratum.
inggris Asrial, An Aldia; Pudjiastuti, Anggit; Herry, Yan; Bahrudin, Udin
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1324

Abstract

Background Zwolle, TIMI, and GRACE risk scores have been proven to predict mayor adverse cardiovascular events (MACE) in STEMI patients undergoing primary percutaneous coronary intervention (PCI). However, they were developed over a long time ago which many advances have been made in the cardiovascular field today. The scores were also developed in the non-Asian majority population and their accuracy for Indonesian population remains unknown. We aimed to validate and compare these scores for Indonesian population. Methods An analytical observational study was conducted on 193 patients undergoing primary PCI. The Zwolle, GRACE, and TIMI risk scores were calculated for each patient. Then, the risk score validation was carried out with the calibration test using Hosmer Lemeshow test and discrimination test using the AUC ROC. Furthermore, the comparisons between the risk scores were carried out using the DeLong test. Results The three scores have good results in the Hosmer Lemeshow calibration test (p > 0.05). The discrimination test also indicated good results with AUC ROC Zwolle, TIMI and GRACE risk scores respectively 0.776; 0.782; 0.831 (p<0.05). There was no significant difference in the prediction accuracy of the three risk scores in the DeLong test. Conclusions The Zwolle, TIMI, and GRACE risk scores had good validity for predicting major adverse cardiovascular events in STEMI patients undergoing primary PCI. There was no significant difference in the prediction accuracy of the three risk scores. This article has a related Erratum.
The Importance of Hyperthyroid Screening in Acute Decompensated Heart Failure with Persistent Tachycardia Despite Optimal Decongestion: A Case Report Myrtha, Risalina; Wijayanto, Matthew Aldo; Prabowo, Nurhasan Agung
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.1328

Abstract

Background: Hyperthyroid has various effects on the cardiovascular system. Cardiac arrhythmias ranging from sinus tachycardia to atrial fibrillation and low/high cardiac output state to congestive heart failure are observed in patients with hyperthyroidism. If hyperthyroidism is recognized and treated early, the cardiac dysfunction could be corrected. This case presentation will discuss the importance of thyroid function screening. Case Illustration and Discussion: A man was admitted to the emergency department with signs and symptoms of acute decompensated heart failure. Further examination was performed to confirm the diagnosis, namely ECG, laboratory examination including thyroid function test, and echocardiography. During hospitalization, heart failure medication was given and up titrated. The patient was still tachycardia until hyperthyroid was corrected with anti-thyroid medicines. Conclusion: Hyperthyroidism can cause or worsen left ventricular dysfunction, especially in individuals with a history of cardiovascular disease. Thus, thyroid function tests should be assessed during initial laboratory examination, especially on patients with acute decompensated heart failure.This article has a related Erratum.
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Bagaswoto, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1381

Abstract

As the primary cause of hospitalization in acute heart failure (AHF) patients, congestion was responsible for a higher risk of mortality, rehospitalization, and renal dysfunction in AHF patients. Although loop diuretic was routinely used as the mainstay of AHF therapy, it is still ineffective to obtain the euvolemic state in most hospitalized AHF patients. Therefore, a higher loop diuretic dose was often required to increase the decongestion effect. However, consequently, it can cause several detrimental complications, including renal dysfunction, neurohormonal activation, hyponatremia, hypokalaemia, and reduced blood pressure, which eventually result in poor prognosis. Hence, the new approach may be proposed to optimize decongestion in acute phase, including the use of arginine vasopressin V2 receptor antagonist – Tolvaptan. As an additive therapy to loop diuretic in AHF patients, it can be considered due to its several beneficial effects, including greater decongestion effect, lowered worsening renal function incidence, counteract neurohormonal activation, neutralized hyponatraemic state, no alteration of potassium metabolism, stabilize the blood pressure, and reduced requirement of a higher dose of loop diuretic to achieve an equal or even greater decongestion effect compared to a high dose of loop diuretic alone. Tolvaptan provided favourable outcomes in several specific populations and was considered safe with several mild adverse effects. Several guidelines across countries have approved the use of Tolvaptan in AHF patients with or without hyponatremia. The initial dose of Tolvaptan was 7.5 to 15 mg and can be titrated up to 30 mg. However, further studies were still required to determine the timing dose and optimal dose of Tolvaptan in general and elderly populations with AHF, respectively.This article has a related Erratum.
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.
Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry Juzar, Dafsah Arifa; Muzakkir, Akhtar Fajar; Ilhami, Yose Ramda; Taufiq, Nahar; Astiawati, Tri; R A, I Made Junior; Pramudyo, Miftah; Priyana, Andria; Hakim, Afdhalun; Anjarwani, Setyasih; Endang, Jusup; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1406

Abstract

Background Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. Methods IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. Results Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients. Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). Conclusion Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy. This article has a related Erratum.
Cardiogenic Shock Bagaswoto, H. P.; Juzar, D. A.; Habib, F.; Bramantyo, Y. S.; Sanggula, P. N. P. P.; Widiastuti, A. Z.
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1505

Abstract

Cardiogenic shock (CS) is the most common cause of death in hospitalized patients with acute myocardial infarction (AMI). The incidence and mortality of CS in hospitals is also high, although advanced therapy is widely used in CS patients. CS is a condition characterized by inadequate cardiac output due to primary cardiovascular diseases, leading to clinical and biochemical manifestations of insufficient tissue perfusion. CS complicates 5–10% of AMI. STEMI increases the risk of CS approximately twice as much as NSTEMI. In the last 10 years, in-hospital mortality due to CS that occurs in AMI has not changed, that is at 40-50%. The pathophysiology of CS shows several overlaps and can occur simultaneously, that is starting with a cardiac insult that reduces cardiac output, central hemodynamic changes, microcirculatory dysfunction, systemic inflammatory response syndrome, and multi-organ dysfunction. CS classification based on SCAI, divided into 5, that’s A(at risk), B(beginning CS), C(classic CS), D(deteriorating), and E(extremis). The key to managing CS is treating the patient as soon as possible, as each higher SCAI shock stage was associated with increased hospital mortality. All patients with suspected ACS-associated CS should have an early invasive strategy with appropriate revascularization. Vasoactive medicines have the potential to improve hemodynamics but at the expense of increased myocardial oxygen consumption and arrhythmogenic risk. Mechanical circulatory support (MCS) has insufficient data as the first-line device solution for CS patients. However, the use of durable MCS devices in a bridge-to-bridge strategy is becoming more prevalent and is supported by clinical recommendations. APACHE-III and SAPS-II, had the best mortality discrimination values to assess the outcome in CS patients.
Ratio C-Reactive Protein Terhadap Albumin Dalam Memprediksi Lauren Rumah Sakit Dan Jangka Panjang Pasien STEMI Dengan Infeksi SARS-CoV2 Yang Menjalani Terapi Fibrinolitik Prana Jagannatha, Gusti Ngurah; Rina Artha, I Made Junior; Surya Pradnyana, I Wayan Agus; Kamardi, Stanly; Kosasih, Anastasya Maria
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1305

Abstract

Background: The choice of reperfusion therapy in STEMI patients with COVID-19 is unclear. CRP to Albumin ratio (CAR) found to be a predictor of thrombus burden. This study was to determine the relationship and predictive value of CAR to in-hospital and long-term outcome of STEMI patients with COVID-19 treated with fibrinolytic. Methods: 297 COVID-19 patients with STEMI underwent fibrinolytic were enrolled. In-hospital outcomes were in-hospital mortality due to cardiovascular death which was divided into mortality <48 hours and >48 hours, fibrinolytic failure, and cardiogenic shock. The presence of reinfarction post fibrinolytic and mortality after the patient discharged was assessed as the long-term outcome. Results: During follow-up, 19.8% experienced in-hospital mortality and 16.1% had reinfarction. In the in-hospital outcome, patients with in-hospital death, failed fibrinolytic and cardiogenic shock had higher CAR (6.7+2.4 vs 4.7+1.9; 6.3+1.9 vs 2.1+1.6; 5.5+2.1vs1.8+1.5) with all p-value <0.05. CAR with an optimal cut-off >4.46 can be a predictor of fibrinolytic failure with sensitivity of 86.7% and specificity of 93.6% (PR19.82; 95%CI 10.32-38.06) and predictor of in-hospital death <48 hours with sensitivity of 84.6% and specificity of 82.7% (PR5.02; 95%CI 3.20-7.90). In the long-term outcome, patients who experienced reinfarction and out-hospital death had higher CAR (5.1+1.2vs2.5+2.4; 5.2+1.3vs2.6+2.4) than those who did not experience the event respectively with all p-value <0.05. CAR with an optimal cut-off >3.67 can be predictor of reinfarction with sensitivity of 87.5% and specificity of 73.5% (PR12.250; 95%CI 5.38-27.87). The Cox regression model showing CAR >3.67 was also associated with higher reinfarction event (p=0.001). Conclusion: CAR has the potential to be a predictor of in-hospital and long-term outcomes for STEMI patients with COVID-19 which can help determine which patients need more invasive strategy to prevent mortality and morbidity. This article has a related Erratum.
Original Research ASMIHA, ASMIHA
Jurnal Kardiologi Indonesia Vol 44 No Suppl_A (2023): Abstracts of the 32nd Annual Scientific Meeting of the Indonesian Heart As
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1535

Abstract

Abstracts of the 32nd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2023

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