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Raymond Pranata
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Editorial Office: Heart House, Jalan Katalia Raya No. 5, Kota Bambu Utara West Jakarta, 11430 - Indonesia Telephone: +62 21 5681149, Fax: +62 21 5684220 Email: ijc@inaheart.org
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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 794 Documents
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SYNTAX Score 2020 Risk Estimates Between PCI and CABG in Coronary Artery Disease : A Descriptive Study Alysa Masytha Masyhudi; Sanggap Indra Sitompul; Karina Yesika Manalu; Refiansyah Tri Anggoro; Yusuf Galenta
Jurnal Kardiologi Indonesia Vol 47 No 3 (2026): July - September, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2050

Abstract

Background: The SYNTAX Score 2020 is a validated tool that combines anatomical and clinical parameters to estimate long-term outcomes in CAD and guide revascularization decisions between PCI and CABG. Although its components are well defined, further studies are needed to clarify how clinical variables influence risk predictions in diverse populations, including Indonesia. Methods: This cross-sectional study enrolled 115 patients with angiographically confirmed CAD at dr. Doris Sylvanus Regional General Hospital, Palangka Raya, Indonesia, between January and June 2025. The SYNTAX Score 2020 and anatomical SYNTAX Score I were calculated using the official application. Statistical analyses included bivariate non-parametric tests, Spearman correlations, and multivariate linear regression to identify independent clinical determinants of the SYNTAX Score 2020–predicted 10-year mortality and 5-year MACE following PCI and CABG. Results: PVD and DM were strongly associated with a higher SYNTAX Score 2020–predicted 5-year MACE and 10-year mortality after both PCI and CABG, with a stepwise increase in risk from no DM to insulin-treated DM. LMCAD was associated with a higher CABG-predicted risk than 3VD, whereas smoking was not associated with predicted outcomes. Age and SYNTAX Score I were positively correlated with all risk estimates, whereas CrCl and LVEF were inversely correlated. In the multivariate models, age, PVD, DM, and lower LVEF remained independent predictors for both strategies; SYNTAX Score I remained significant only for PCI, and CrCl was no longer independently associated with risk. Conclusion: Age was the main independent predictor of a higher SYNTAX Score 2020 that predicted long-term risk, followed by PVD and diabetes (highest in insulin-treated DM). Higher LVEF was protective, and left main disease carried a higher predicted risk than three-vessel disease.
Predischarge Lung Ultrasound B-Lines as a Robust Predictor of 90-Day Rehospitalization in Heart Failure with Reduced Ejection Fraction (HFrEF): Evidence from Clinical and Classification and Regression Tree (CART)-Based Risk Stratification Akhtar Fajar Muzakkir; Yogi Andrew Taruk Padang; Peter Kabo; Ali Aspar Mappahya; Andi Alfian Zainuddin
Jurnal Kardiologi Indonesia Vol 47 No 3 (2026): July - September, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2051

Abstract

Background: Heart failure is a major global health burden, with high morbidity, mortality, and substantial rehospitalization rates. Residual pulmonary congestion at discharge is a key determinant of early readmission but is often underestimated using clinical assessment alone. Lung Ultrasound (LUS) offers an objective, bedside tool for detecting pulmonary congestion through B-line quantification. This study aimed to evaluate whether predischarge B-line measurements predict 90-day rehospitalization due to all cardiovascular causes in patients with Heart Failure with reduced Ejection Fraction (HFrEF). Methods: This retrospective cohort study included 107 adults hospitalized with HFrEF at Wahidin Sudirohusodo Hospital from March to July 2023. LUS was performed prior to discharge using an eight-zone protocol, and total B-line counts were recorded. Clinical, laboratory, and echocardiographic variables were obtained from the Heart Failure Registry and electronic medical records. Patients were followed for 90 days to identify heart failure–related rehospitalization. Statistical analyses included independent t-test, Mann–Whitney U tests, chi-square test, ROC curves, multivariate logistic regression, and a Classification and Regression Tree (CART) model to identify the strongest predictors of rehospitalization. Results: Among 107 patients (mean age 58.52 ± 12.16 years; 74.77% male), 48 (44.86%) experienced 90-day rehospitalization due to all cardiovascular causes. Rehospitalized patients had significantly higher predischarge B-line counts (25.98 ± 8.23 vs. 17.63 ± 8.03, p <0.0001). A B-line cutoff of ?20 predicted rehospitalization with 75.7% accuracy, 77.08% sensitivity, 74.58% specificity, and an AUC of 0.754. Renal dysfunction (eGFR 58.72 ± 29.32 vs. 75.43 ± 27.49 mL/min/1.73 m², p = 0.003; creatinine 1.86 ± 2.01 vs. 1.21 ± 0.76 mg/dL, p = 0.021), lower EF (31.6 ± 8.15% vs. 36.64 ± 9.05%, p = 0.004), and higher filling pressures (PCWP, E/e?) were also significantly associated with rehospitalization. The CART model identified B-line ?20 as the strongest primary classifier, with additional risk contributed by renal impairment and reduced EF, yielding an accuracy of 90.65% and an AUC of 0.966. Conclusion: Predischarge B-line quantification is a strong predictor of 90-day rehospitalization in HFrEF. Integration of B-line assessment with renal function and cardiac parameters substantially improves risk stratification. LUS provides a practical, noninvasive tool for optimizing predischarge evaluation and may guide interventions to reduce early rehospitalization.
Coronary Vulnerable and High-Risk Plaque: Current Concepts, Selective Preventive PCI, and an ISIC Position Statement Muhammad Munawar; Aninka Saboe; Achmad Fauzi Yahya; Teguh Santoso; Abdul Hakim Alkatiri; Sunanto Ng; Sunarya Soerianata; Sodiqur Rifqi; Yudi Her Oktaviono; Nahar Taufiq; Janry Pangemanan; Sasmojo Widito; Muhammad Saifur Rohman; Muhammad Syukri; Doni Firman
Jurnal Kardiologi Indonesia Vol 47 No 3 (2026): July - September, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2316

Abstract

The concept of coronary vulnerable plaque has evolved from a histopathological concept into a potential therapeutic target for precision cardiovascular prevention. Recent evidence has expanded this paradigm beyond the traditional vulnerable-plaque construct towards the broader concept of high-risk plaque, encompassing rupture-prone plaques, erosion-prone plaques, calcified nodules, plaque burden, inflammatory activity, healing capacity, and patient-level susceptibility to thrombosis.Advances in Coronary Computed Tomography Angiography (CCTA), Intravascular Ultrasound (IVUS), Optical Coherence Tomography (OCT), Near-Infrared Spectroscopy (NIRS), molecular imaging, and Artificial Intelligence (AI) have substantially improved the detection and characterization of high-risk plaque. Circulating lipid, inflammatory, metabolic, and renal biomarkers provide complementary information regarding patient vulnerability. Concurrently, contemporary pharmacological therapy has substantially improved the natural history of coronary atherosclerosis by promoting plaque stabilization, fibrous cap thickening, lipid core regression, and attenuation of vascular inflammation.The emergence of preventive Percutaneous Coronary Intervention (PCI) for non-flow-limiting vulnerable plaques, particularly following the PREVENT trial, has reignited interest in focal treatment before clinical destabilization. Nevertheless, important uncertainties remain regarding patient selection, diagnostic thresholds, imaging strategies, device selection, long-term durability, cost-effectiveness, and applicability in resource-limited healthcare systems. Drug-Eluting Stents (DES) remain the most established device platform, whereas next-generation bioresorbable scaffolds and Drug-Coated Balloons (DCB) may offer future approaches to local plaque treatment without permanent metallic implantation. Although Coronary Artery Bypass Grafting (CABG) does not directly treat vulnerable plaques, it may indirectly protect selected patients with diffuse multivessel disease by bypassing plaque-bearing coronary segments.For Indonesia and other resource-constrained healthcare systems, future implementation should emphasize pragmatic implementation rather than widespread adoption of advanced technologies. Emphasis should remain on aggressive Optimal Medical Therapy (OMT), selective use of advanced imaging, careful identification of patients at the highest absolute cardiovascular risk, structured operator training, national registries, and rigorous evaluation of cost-effectiveness. The ultimate objective is not simply to detect more vulnerable plaques but to prevent more myocardial infarctions and cardiovascular deaths through efficient use of healthcare resources.The Indonesian Society of Interventional Cardiology (ISIC) recommends that aggressive systemic prevention, centered on OMT, should remain the foundation of care. Advanced plaque imaging and preventive PCI should be reserved for carefully selected patients with converging high-risk plaque characteristics, high patient-level risk, and a favorable benefit–risk profile.
Optimizing Revascularization Outcomes in Chronic Coronary Syndromes Aninka Saboe
Jurnal Kardiologi Indonesia Vol 47 No 3 (2026): July - September, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2430

Abstract

The value of coronary revascularization in Chronic Coronary Syndromes (CCS) depends on whether it delivers the benefit that justifies intervention. Anatomical, physiological, and plaque assessment inform patient selection, but each answers a different clinical question. Applying evolving trial evidence requires attention to the populations studied, outcomes measured, and durability of treatment. Procedural optimization and complete revascularization require the same clinical judgment, with imaging and devices serving defined treatment goals. Medical therapy remains essential regardless of the revascularization strategy. Follow-up connects the procedure to sustained prevention, rehabilitation, and assessment of symptoms and clinical events. Reviewing these outcomes against the original indication, together with the patient’s priorities, provides a practical basis for improving care.

Page 80 of 80 | Total Record : 794

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