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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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Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Pratama, Fahmi Bagus; Pranata, Raymond
Jurnal Kardiologi Indonesia Vol 44 No 1 (2023): Indonesian Journal of Cardiology: January - March 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1294

Abstract

BackgroundAlthough the GRACE risk score is widely accepted as an established scoring system to predict in-hospital mortality in acute coronary syndrome (ACS) patients, this scoring system still depends on electrocardiography and laboratory findings to determine the results. Therefore, we aim to retrospectively evaluate the association between the CHADS2 and CHA2DS2-VASc score as an anamnesis-only mediated scoring system and in-hospital mortality in hospitalized ACS patients. MethodsThis retrospective cohort study analyzed data of ACS patients from the ACS registry in Dr. Hasan Sadikin Central General Hospital from 2018 to 2021. The outcome of this study was in-hospital mortality. The association between these scoring system and in-hospital mortality were evaluated using binary logistic regression analysis. Receiver operating characteristics (ROC) analysis was also performed to assess the success rate of this scoring system in predicting in-hospital mortality. ResultsA total of 1339 patients were included in this study, and 162 (12.1%) of them died in the hospital. High CHA2DS2-VASc score group (cut-off >2) was significantly associated with higher risk of in-hospital mortality before (OR=2.56 [1.75,3.75]; p<0.001) and after adjustment of several confounding factors (OR=3.39 [1.73,6.64]; p<0.001). Meanwhile, the high CHADS2 score (cutoff >2) was only significantly increased the risk of in-hospital mortality in univariate analysis (OR=2.05[1.47,2.87];p<0.001), but was not significantly associated with in-hospital mortality after multivariate analysis (OR=1.31 [0.92,1.86];p=0.129). ROC analysis revealed that predictive accuracy of CHA2DS2-VASc score was significantly greater compared to CHADS2 score (AUC: 0.653 vs 0.609, p<0.001). However, the predictive value of CHA2DS2-VASc score was significantly lower than the GRACE risk score (AUC: 0.789 vs 0.653, p<0.001). ConclusionOur study showed that the CHA2DS2-VASc score >2 was significantly and independently associated with higher in-hospital mortality in ACS patients compared to the CHA2DS2-VASc score of 1 or lower. Despite its lower predictive accuracy compared to the GRACE risk score, CHA2DS2-VASc score can still be used in practical situations as an alternative scoring system in predicting in-hospital mortality in ACS patients, especially in primary health care settings located in rural areas that lack the diagnostic facilities.This article has a related Erratum.
Hyperkalemia Mimicking Anteroseptal Myocardial Infarction Nugraha, Raka Aldy; Husen, Auliya; Muliawan, Hary Sakti; Zamroni, Dian
Jurnal Kardiologi Indonesia Vol 44 No 1 (2023): Indonesian Journal of Cardiology: January - March 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1297

Abstract

Background: Hyperkalemia often results in cardiac emergency associated with fatal cardiac arrhythmias. However, the presence of ST segment elevation in hyperkalemia is rare and could potentially subject the patients to unnecessary risk of intervention. Most commonly, ST elevation in hyperkalemia presents in a down-sloping fashion compared to the typical convex or upsloping pattern in myocardial infarction. However, in some cases, the ST elevation morphology can be very identical and difficult to distinguish. Herein, we describe a hyperkalemic patient presenting with non-ischemic ST segment elevation that resolved spontaneously following therapy. Case illustration: A 77-year-old, bed-ridden, inarticulate woman was admitted to emergency department with acute dyspnea perceived for 1.5 hours. The patient’s past clinical history included craniotomy for subdural hematoma, poorly controlled hypertension, hypertensive heart disease, rheumatoid arthritis, and dementia and was under candesartan, amlodipine, nebivolol, spironolactone, and atorvastatin treatment. The 12-lead electrocardiography (ECG) recording showed wide QRS complex with left bundle branch block pattern, slow atrial fibrillation with total atrioventricular block, ST segment elevation and Q wave in anteroseptal leads, and peaked T wave (Figure 1A). The pattern of ST elevation was indistinguishable from that of myocardial infarction which necessitated further laboratory confirmation. Laboratory results showed severe hyperkalemia (K+ 7.93 mmol/L) and normal troponin level (45.0 ng/L). The patient was given serial insulin-based therapy and calcium gluconate immediately. The follow-up ECG pictured normal sinus rhythm with no sign of bundle branch block, resolution of ST segment elevation, and reduction in T wave amplitude (Figure 1B). However, the reduction in potassium level was not significant and the patient also experienced an acute kidney injury. The patient was transferred to intensive care unit and was prepared for hemodialysis. Conclusion: ST segment elevation is a rare feature of hyperkalemia that could mislead the patient’s treatment. Thorough ECG evaluation is the key to narrow down the differential diagnosis. Every deviant feature should not be interpreted separately. Laboratory tests could help confirm the diagnosis, particularly in patients with atypical presentation and could help avoid unnecessary risk of intervention.This article has a related Erratum.
Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients Wijaya, Michael Asby; Haykal Putra, Teuku Muhammad; Widodo, Wishnu Aditya
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.1321

Abstract

Background: Non-ST-Elevation ACS (NSTE-ACS) is a part of ACS which require some special attentions. Multivessel coronary disease (MVD) is common in patients with NSTE-ACS and associated with difficulties in determining the main target of revascularization. ECG is the first-line diagnostic tool in the assessment of patients with suspected ACS. However, the utility of the ECG in localizing coronary culprit lesions in NSTE-ACS is not well established. This study was conducted to evaluate whether the pattern of the ischemic signs in ECG can be used to identify the coronary culprit vessel in patients with NSTE-ACS. Methods: This is a single-centered cross-sectional study using secondary data. The data of all 101 patients with NSTE-ACS who were planned for revascularization procedure between January 2021 and December 2021 were collected from medical record. ECG with ischemic signs were classified to three locations of suspected coronary vessel with culprit lesions and it will be compared to its corresponding angiographic data. The accuracy data will be presented including both sensitivity and specificity. Results: This study involved 75 men (74.3%) and 26 women (25.7%) with mean age 61.2±9.1 years old. There were 72 patients presented with ischemic signs form ECG with identifiable culprit vessel to be suspected. The sensitivity and specificity of ischemic signs ECG in localizing culprit vessels from angiography were 37.0% and 85.5% in LAD distribution, 38.1% and 81.3% in LCX distribution, and 41.1% and 85.1% in RCA distribution, respectively. Conclusion: Overall ischemic signs in ECG gave impression of modest accuracy with conspicuous key points that ECG distribution have high specificity in detecting culprit vessels but with low sensitivity. Thus, ischemic signs from initial ECG can be used to detect culprit vessels in NSTE-ACS patients.This article has a related Erratum.
Protokol STEMI yang dimodifikasi untuk PPCI selama Pandemi COVID-19: Apakah itu memperpanjang kinerja Door-To-Balloon Putranto, Astri Yuniarsih; Putra, Teuku Muhammad Haykal; Soedarsono, Wahyu Aditya
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.1325

Abstract

Background COVID-19 became a main health problem and causes heavy impact, especially for healthcare system. Managing ST-Segment Elevation Myocardial Infarction (STEMI) patients before COVID-19 pandemic was already challenging enough for Healthcare Professionals (HCP) to pursue time-sensitive treatment. After COVID-19 pandemic, the time-sensitive treatment of pursuing door-to-balloon (DTB) time put a lot more burden to HCP. In this study, We sought to analyze how a change in protocol of PPCI in STEMI patients before and during the pandemic influence the performance of DTB in the hospital. Methods This is a single-centered retrospective observational study among STEMI patients which was treated by PPCI. Secondary data from the medical record were collected consecutively from April 2018 to January 2022 (46 months). We compared DTB performances before and during the pandemic. Result During 46 months period, the total population of this research was 880 patients. There were total 358 patients underwent PPCI before the pandemic and 522 patients after the pandemic. Modified protocol with the addition step to prevent the spread of COVID-19 had been implemented since April 2020. DTB increased significantly during the pandemic (90 (70-124) minutes vs 97 (76-135) minutes, p 0.002). The proportion of the patients who achieved DTB under 90 min was also significantly decreasing (56.4% vs 47.9%, p 0.0013). Conclusion It is necessary for PPCI center to modify PPCI workflow during the pandemic. A decent workflow should consider practicality and simplicity without compromising HCP and patient safety. Implementing modified PPCI workflow during the pandemic significantly increased DTB time but it is still within the limit of being reasonable and acceptable for the benefit of the patients.This article has a related Erratum.
Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure Rezeki, Arindya; Widyantoro, Bambang; Rossimarina, Vienna; Dwiputra, Bambang; Danny, Siska Suridanda; Sukmawan, Renan; Santoso, Anwar
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.1380

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear. Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients. Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects. Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320). Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.This article has a related Erratum.
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.
Added Value of CHA2DS2-VASc Score to Safe Contrast Volume for Contrast Induced Nephropathy Prediction after Percutaneous Coronary Intervention khalil, Wael Ali; Mohammad, Mohammad Gouda; Alshaer, Mohammad Hossam; Mageed, Mohammad Gamal Abd El
Jurnal Kardiologi Indonesia Vol 44 No 1 (2023): Indonesian Journal of Cardiology: January - March 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1516

Abstract

Background: The CHA2DS2-VASc score is utilized to order the danger of embolization in atrial fibrillation (AF). Also, it has been assessed the worse clinical scenario in acute coronary syndrome patients, regardless of having AF. The study aim was to use CHA2DS2-VASc score added to the safe contrast volume (Volume /CrCl) for contrast-induced nephropathy (CIN) early prediction post PCI. Patients and Methods: The study included two hundred fifty nine patients who underwent percutaneous coronary intervention . For each patient, The CHA2DS2-VASc score and Volume /CrCl were evaluated. The patients in our study were divided, according to CIN development into two groups. CIN was identified as a rise in serum creatinine >0.5 mg/dl or >25% increase in baseline within48 to 72 hours after PCI. Statistical analysis: the receiver operating characteristic analysis was used to detect the best cut off values to predict CIN, and we concluded the predictors of CIN through multivariate logistic regression analysis. Results: There was a positive correlation between Mehran score and CHA2DS2-VASc score. Independent predictors of CIN were Mehran score, Volume/CrCl ratio>3.2 and CHA2DS2-VASc >3, CHF or EF < 40%, hypotension, anemia, primary PCI and weight. If the patient had (CHA2DS2-VASc score>3 or Volume/CrCl >3.2), as a single predictor, we could predict CIN with (sensitivity 96.97 %, 95% CI 0.71 to 0.82). Conclusion: The CHA2DS2-VASc score and Volume/CrCl ratio are new predictor of CIN, and we can use the CHA2DS2-VASc score , safe contrast volume for early detection of CIN after PCI.This article has a related Erratum.
Hubungan Peak Left Atrial Longitudinal Strain dengan Derajat Keparahan Penyakit Jantung Katup Mitral di RSUP Haji Adam Malik Medan Ryanti, Dina; Ketaren, Andre Pasha; Mukhtar, Zulfikri; Akbar, Nizam Zikri; Lubis, Anggia Chairuddin; Ardini, Tengku Winda
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.1541

Abstract

Introduction: Mitral stenosis and regurgitation, are common throughout the world. Peak Left Atrial Strain (PALS) is a parameter for assessing left atrial deformation in the evaluation of atrial function and a predictor of long-term outcome of various heart diseases. In this study, we assessed the relationship between PALS and the severity of mitral stenosis and mitral regurgitation Methods: This is a cross-sectional study on 119 subjects with mitral stenosis and 103 mitral regurgitation who met the inclusion criteria at Haji Adam Malik General Hospital. PALS measurements were taken. Data were analyzed univariate, bivariate, correlate to assess the relationship between PALS and the severity of mitral valve disease Results: 119 patients with severe mitral stenosis. In mitral stenosis, the mean PALS is 8.2 (4.9-22.8). PALS was significantly higher in patients with sinus rhythm than in the group with AF (10.29 ± 3.89 vs 8.63 ± 7.8%; P = 0.002). PALS had a significant correlation with MVA, pressure gradient, and PHT (r = 0.676, P = <0.001; r=-0.594, P= 0.001 and r=-0.594, P= 0.001). Whereas in mitral regurgitation, it has an average PALS of 15.2 (7.8-19.2). PALS was also significantly higher in patients with sinus rhythm than in the group with AF (16.36 ± 2.43 vs 11.64 ± 2.89%, P = 0.001). PALS has a correlation with VC, PISA, EROA and RVol (r = -0.533, P=0.001; r=-0.618; r=-0.563, P=0.001; r= -0.528, P=0.001). Conclusion: PALS has a significant correlation with the assessment of the severity of mitral stenosis and regurgitation.This articles 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.
The Sub-Analysis of HFmrEF and HFrEF Group in CORE-HF Registry : When being Good is Not Enough Wasyanto, Trisulo; Irnizarifka, Irnizarifka; Chau, Titus H.; Arifianto, Habibie
Jurnal Kardiologi Indonesia Vol 44 No 1 (2023): Indonesian Journal of Cardiology: January - March 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1545

Abstract

Background : As the prevalence of heart failure (HF) kept rising each year, the burden caused by it also escalating, especially in terms of economic burden. This is urging the physician to quickly tackle the problem. Although HFrEF medications were developing vastly, the outcome of HF in real world still varies. This indicates another approach is still needed to manage HFrEF/HFmrEF comprehensively. This paper is aimed to give an overview of HFrEF and HFmrEF epidemiological data, based on CORE-HF real world data. Methods : The CORE-HF is a single-center, prospective-cohort registry, which enrolls all patients with chronic HF, that were recruited consecutively from the outpatient Sebelas Maret HF Clinic. Both enrollment and follow-up have been performed since January 2018 until December 2022. Variables recorded consists of baseline characteristics, risk factors, subjective indicators, objective diagnostic assessments, therapies, and outcomes (readmission and mortality). Results : The population of this registry was younger (58.7 ± 12.14) compared to other HF registries, with more multi comorbidities. The number of HFrEF patient was higher than HFmrEF (77.7% vs 22.3%), with clinically higher mortality rate (7.2% in the 1st year and 18.2% in the next year). Although triple therapy initiation and uptitration were excellent in number, the mortality rate during second year of follow-up was higher than other registries. We found non-compliant behavior to be responsible for those results. Conclusion : Based on CORE-HF sub-analysis of the HFrEF and HFmrEF groups, adherence to HF guidelines is the main but not the only key leading to lower mortality and rehospitalization. Our data provide satisfying low hard outcomes, but solving the non-compliance behavior and optimizing the non-pharmacological approach should be done comprehensively by the HF team.This article has a related Erratum.

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