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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 717 Documents
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EFFECT OF STATINS ON ENDOTHELIAL PROGENITOR CELL (EPC) MIGRATION FROM PERIPHERAL BLOOD OF STABLE CORONARY ARTERY DISEASE PATIENT tyagita rani savitri; Yudi Her Oktaviono; Djoko Soemantri
Jurnal Kardiologi Indonesia Vol 40 No 1 (2019): Indonesian Journal of Cardiology: January-March 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i1.840

Abstract

Penelitian Klinis ABSTRAK Efek Pemberian Statin Terhadap Migrasi Endothelial Progenitor Cell (EPC) Pada Darah Tepi Penderita Penyakit Jantung Koroner Stabil Tyagita Verdena Rani Savitri, Yudi Her Oktaviono, Djoko Soemantri Latar Belakang: Endothlelial progenitor cell (EPC) berpartisipasi dalam perbaikan endotel dan pertumbuhan pembuluh darah baru. Farmakoterapi kardiovaskular telah dibuktikan dapat memperbaiki jumlah dan fungsi EPC pada penderita dengan risiko kardiovaskular. Banyak studi melaporkan bahwa statin memiliki efek yang menguntungkan terhadap EPC dengan meningkatkan jumlah dan fungsi EPC, termasuk didalamnya adalah fungsi migrasi. Oleh karena itu, kami melakukan penelitian untuk menganalisis efek tiga statin yang berbeda terhadap migasi EPC. Tujuan: Untuk menganalisis efek pemberian statin terhadap migrasi EPC pada darah tepi penderita penyakit jantung koroner stabil. Metode: Penelitian ini kami lakukan secara in vitro true experimental post-test only control group design. Sel mononuklear diisolasi dari darah tepi penderita penyakit jantung koroner stabil dan dilakukan kultur dalam medium Stemline II Hematopoietic Stemcell Expansion Medium selama 3 hari. Kemudian sampel dibagi menjadi empat kelompok yaitu kelompok simvastatin 0.5 µmol/L,, atorvastatin 0.5 µmol/L, rosuvastatin 0.5 µmol/L dan kelompok kontrol kemudian diinkubasi selama 48 jam. Metode imunositokimia dilakukan untuk identifikasi EPC dengan mengevaluasi ekspresi CD34+. Pada hari ke-5 kultur, sel di pindahkan ke bagian atas transwell system sebanyak 5x105 sel per sumur perlakuan , kemudian di inkubasi selama 1 hari. Sel yang berpindah pada sumur transwell system bagian bawah dihitung dengan automatic cell counter dengan pewarnaan typhan blue. Data dianalisis dengan independent t test dan ANOVA. Hasil: Hasil independent t test terhadap hasil migrasi pada transwell system menunjukkan peningkatan bermakna terhadap migrasi EPC pada kelompok simvastatin, atorvastatin, dan rosuvastatin dibandingkan dengn kelompok kontrol (234000 ± 1290. 994, 265000 ± 1290. 994, 203000 ± 1290. 994 vs 174071.43 ± 1426. 785, p<0.05). Migrasi EPC juga berbeda antar kelompok statin, dimana efek tertinggi didapatkan pada kelompok atorvastatin. Migrasi EPC pada kelompok atorvastatin lebih tinggi daripada kelompok simvastatin (265000 ± 1290. 994 vs 234000 ± 1290. 994, p<0.05), dan simvastatin lebih tinggi daripada kelompok rosuvastatin (234000 ± 1290. 994 vs 203000 ± 1290. 994, p<0.05). Pemeriksaan imunositokimia menunjukkan ekspresi positif terhadap CD34+. Kesimpulan: Statin meningkatkan migrasi EPC pada darah tepi penderita penyakit jantung koroner stabil. Efek tertinggi tampak pada kelompok atorvastatin, diikuti kelompok simvastatin, dan rosuvastatin. Kata kunci: Migrasi EPC, simvastatin, atorvastatin, rosuvastatin Clinical Research ABSTRACT Effect of Statins on Endothelial Progenitor Cell (EPC) Migration from Peripheral Blood of Stable Coronary Artery Disease Patient Tyagita Verdena Rani Savitri Yudi Her Oktaviono Djoko Soemantri Background: Endothelial progenitor cell (EPC) participates in endothelial repair and new blood vessel growth. Cardiovascular pharmacotherapy has been shown to improve the amount and function of EPC in patients with cardiovascular risk. Many studies report that statins have a beneficial effect on EPC by increasing the number and function of EPC, including the migration function. Therefore, we conducted a study to analyze the effects of three different statins on EPC migration. Objective: To analyze the effect of statins on EPC migration from peripheral blood of stable coronary artery disease (SCAD) patient. Methods: This was an in vitro true experimental post-test only control group design. The MNCs were isolated from peripheral blood of SCAD patient and were cultured in Stemline II Hematopoietic Stemcell Expansion Medium in 3 days. Then samples were put into four groups, simvastatin 0.5 µmol/L, atorvastatin 0.5 µmol/L, rosuvastatin 0.5 µmol/L and control, then incubated for 48 hours. Immunocytochemical examination was performed to evaluate expression of CD34+. On the 5th day of culture, 5x105 cells per group were transferred to the upper chamber of the transwell system, then incubated for 1 day. Cells that migrated to the lower chamber of transwell system were calculated by automatic cell counter with typhan blue coloring. Data were analyzed by independent T-test and ANOVA. Results: The results of independent T-tests showed a significant increase in EPC migration in the simvastatin, atorvastatin, and rosuvastatin groups compared with the control group (234000 ± 1290.994, 265000 ± 1290.994, 203000 ± 1290. 994 vs 174071.43 ± 1426 785, p <0.05). EPC migration also differed between statin groups, where the highest effect was found in the atorvastatin group. EPC migration in the atorvastatin group was higher than the simvastatin group (265,000 ± 1290,994 vs 234,000 ± 1290,994, p <0.05), and simvastatin was higher than the rosuvastatin (234,000 ± 1290,994 vs 203000 ± 1290. 994, p < 0.05). Immunocytochemical examination showed a positive expression on CD34+. Conclusion: Statins increase EPC migration from peripheral blood of SCAD patient. Atorvastatin showed the highest EPC migration, followed by simvastatin, and rosuvastatin. Keywords: EPC migration, simvastatin, atorvastatin, rosuvastatin
Effect of Sweet Purple Potato (Ipomoea batatas L.) Extract and Vitamin C on Endothelial Progenitor Cell Migration in Stable Coronary Disease Patient Febryanti Hartono; Yudi Her Oktaviono; Djoko Soemantri
Jurnal Kardiologi Indonesia Vol 40 No 4 (2019): Indonesian Journal of Cardiology: October-December 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i4.843

Abstract

Background: Number and function of Endothelial Progenitor Cells (EPC) are reduced incoronary artery disease (CAD) patient. EPC as progenitor of mature endothelial cell has important role for angiogenesis and neovasculogenesis. Dysfunctional EPC partly because of oxidative stress. Decreasing oxidative stress with antioxidant especially with sweet purple potato extract and vitamin as easily found in Indonesia, may improve EPC migration to ischemic organ in stable CAD patient. Purpose : To analyze effect of sweet purple potato (Ipomoea batatas L.) extract and vitamin C on Endhotelial Progenitor Cell in Stable Coronary Disease patient. Method: This is experimental post-test control group study. Mononuclear cells (MNC) are isolated from peripheral blood of sample, and cultivated in medium for 3 days, immunofluorescence assay with CD34 as a marker for EPC. EPCs divided into sweet purple potato extract group (1 and 25 mcg/mL), vitamin C group (10 and 250 mcg/mL) and control, incubated for 2 days. 5x105 cell taken from each group and place in upper chamber of Transwell system. EPC migration was assessed in lower chamber of Transwell system after 24 hours using automated cell counters. Statistic testing using ANOVA. Results: EPC migration was increased significantly in sweet purple potato extract and vitamin C compared with control (3.03 ± 0.01, 2.15 ± 0.03 vs control 1.21 ± 0.04, p<0.01). Increased dose of sweet purple potato extract and vitamin C shows significantly increased of EPC migration (1.81 ± 0.02 vs1.47 ± 0.04 and 3.03 ± 0.01 vs 2.15 ± 0.03, p<0.01). There is significantly diferentiation between sweet potato purple extract and vitamin C (3.03 ± 0.01 vs 2.15 ± 0.03, p<0.01). Conclusion: Sweet purple potato extract and vitamin C increased EPC migration dose-dependently. Sweet purple potatao extract induces EPC migration better than vitamin C. Keywords: EPC migration, Stable CAD, sweet purple potato extract, vitamin C, antioxidant
Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction Jaya Suganti; Anggia Chairuddin Lubis; Abdullah Afif Siregar; Andika Sitepu; Cut Aryfa Andra; Ali Nafiah Nasution; Harris Hasan
Jurnal Kardiologi Indonesia Vol 40 No 4 (2019): Indonesian Journal of Cardiology: October-December 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i4.849

Abstract

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction Jaya Suganti, Anggia Chairuddin Lubis, Abdullah Afif Siregar, Andika Sitepu, Cut Aryfa Andra, Ali Nafiah Nasution, Harris Hasan Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia Background: Whether a precordial ST segment depression (PSTD) is merely a benign electrical phenomena or a sign of multivessel coronary artery disease (MVCAD) in inferior myocardial infarction (MI) remains unclear. The objective of this study is to analyze the complexity of coronary artery disease (CAD) in inferior MI patients with PSTD and to investigate whether PSTD can be used as a predictor of MVCAD in inferior MI. Methods: Patients with inferior MI were divided into two groups based on the presence of PSTD on admission ECG and were compared based on the patient’s coronary artery complexities. Results: A total of 215 patients with inferior MI were found in this study period, with 102 patients meet the inclusion and exclusion criteria. Patients with PSTD had a higher incidence of MVCAD and SYNTAX score. Further analyzes showed PSTD on admission ECG was an independent predictor of MVCAD in inferior MI [45 (66%) vs 23 (34%); OR 4.097; 95% CI 1.638-10.247; p=0.003). Conclusion: In daily clinical practice, PSTD on admission ECG may serve as a simple noninvasive tool for predicting MVCAD or a more complex CAD in inferior MI. Keywords: Precordial ST Segment depression, inferior myocardial infarction, SYNTAX score
EFFECT OF PLATELET RICH PLASMA ON PROLIFERATION OF ENDOTHELIAL PROGENITOR CELL (EPC) OF STABLE CORONARY ARTERY DISEASE PATIENT Ronald Rendy Hehanusa; Andrianto Andrianto; Budi S Pikir
Jurnal Kardiologi Indonesia Vol 40 No 2 (2019): Indonesian Journal of Cardiology: April-June 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i2.851

Abstract

ABSTRACT Effect of Platelet Rich Plasma (PRP) on Proliferation of Endothelial Progenitor Cell (EPC) of Stable Coronary Artery Disease Patient Ronald R Hehanusa, Andrianto, Budi S Pikir Background : Endothelial Progenitor Cell (EPC) is the progenitor of endothelial cell which has important role in regulation of vascular wall integrity and homeostasis, to protect vessels from inflamation and thrombosis, that leads into pathogenesis of coronary artery disease. Growth factors proven has important role to stimulate transduction signal in the process of proliferation of EPC. Platelet Rich Plasma (PRP) contains variety of growth factors, wellknown role in homeostasis and wound healing process. Therefore, this study was conducted to analyze the effect of PRP on proliferation of EPC of Stable Coronary Artery Disease (SCAD) patient. Objective : To analyze the effect of Platelet Rich Plasma (PRP) on the proliferation of Endothelial Progenitor Cell (EPC) from peripheral blood of patient with SCAD Methods : This is an in vitro, true experimental, post-test only control group design. The mononuclear cells were isolated from peripheral blood of SCAD patient and cultured in M-199 medium. EPC divided into 3 groups, which received Platelet Rich Plasma (PRP), Platelet Poor Plasma (PPP), and control. After 14 days of incubation, immunocytochemical examination was performed, EPC which marked with CD34, FITC labeled,was counted using immunofluoroscence microscope. Data analysis using ANOVA test. Result : Cell counting showed significant increase of EPC proliferation in PRP group compared to PPP group (1.052 ± 0.16 vs 0.762 ± 0.19, p = 0.003), and control group as well (1.052 ± 0.16 vs 0.068 ± 0.05, p = 0.000). EPC proliferation in PPP group also increase significantly compared to control group (0.762 ± 0.19 vs 0.068 ± 0.05, p = 0.000). Conclusion : Platelet Rich Plasma (PRP) increase EPC proliferation significantly from peripheral blood of SCAD patient. Keywords : EPC proliferation, PRP, SCAD
Original Articles ISICAM ISICAM
Jurnal Kardiologi Indonesia Vol 39 No Suppl_B (2018): Indonesian Journal of Cardiology Supplement_B
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39iSuppl_B.854

Abstract

Original Articles; Abstracts of the 10th Indonesian Society of Interventional Cardiology Annual Meeting Jakarta, 23-25 November 2018
Case Reports ISICAM ISICAM
Jurnal Kardiologi Indonesia Vol 39 No Suppl_B (2018): Indonesian Journal of Cardiology Supplement_B
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39iSuppl_B.855

Abstract

Case Reports; Abstracts of the 10th Indonesian Society of Interventional Cardiology Annual Meeting Jakarta, 23-25 November 2018
Systematic Reviews and Meta-Analyses ISICAM ISICAM; Mahdi BA; Purnamasari Y; Fajar JK; Raymond Pranata; Emir Yonas
Jurnal Kardiologi Indonesia Vol 39 No Suppl_B (2018): Indonesian Journal of Cardiology Supplement_B
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39iSuppl_B.856

Abstract

Systematic Reviews and Meta-Analyses; Abstracts of the 10th Indonesian Society of Interventional Cardiology Annual Meeting Jakarta, 23-25 November 2018
Padang Skoring Elektrokardiografi untuk Memprediksi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Kronik Wiza Erlanda; Hauda El Rasyid; Masrul Syafri; Ricvan Dana Nindrea
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.858

Abstract

ABSTRAK Latar Belakang: Gagal Jantung dibagi menjadi 3 kelompok yaitu gagal jantung fraksi ejeksi menurun (HfrEF <40%), rentang tengah (HFmrEF 40-49%), dan terpelihara (HfpEF ≥50%). Ekokardiografi masih menjadi pemeriksaan standar saat ini, sayangnya pemeriksaan tersebut masih terbatas dibeberapa pusat kesehatan. Perlu pemeriksaan awal yang lebih sederhana salah satunya elektrokardiografi (EKG) yang mudah digunakan. Penentuan skoring dari EKG diharapkan dapat memudahkan memprediksi fraksi ejeksi dan memberikan terapi yang tepat. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Diambil data rekam medis pasien gagal jantung kronik (GJK) di poliklinik Jantung RSUP Dr. M.Djamil Padang bulan Januari-Agustus 2017. Dilakukan analisis bivariat pada varibel EKG terhadap fraksi ejeksi dengan metode chi-square. Analisis multivariate dengan uji regresi binari logistik untuk mendapatkan variabel pada kalkulasi skor dengan uji Hosmer-Lameshow (p<0,25). Skoring dilakukan uji sensitivitas, spesifisitas dan analisis receiver operating curve (ROC). Hasil Penelitian : 283 subjek GJK dibagi menjadi tiga kelompok. Variabel yang memenuhi persyaratan untuk dilakukan kalkulasi skor adalah pembesaran atrium kiri (LAE) (OR=6,36; p= 0.000) dengan skor 2, QRS lebar (OR=13,06; p= 0.000) dengan skor 3, interval QTc memanjang (OR=2,18; p= 0.065) dengan skor 1 dan perubahan gelombang ST-T (OR=5,05; p= 0.000) dengan skor 2. Subjek dengan HFpEF mempunyai skor <3, HFmrEF mempunyai skor 3-4, dan HFrEF mempunyai skor >4. Sistem skoring EKG memiliki sensitivitas 71,4% dan spesifisitas 88,6% dengan AUC 87,9% Kesimpulan : Sistem skoring EKG pada penelitian ini dapat digunakan sebagai pedoman awal dalam menentukan fraksi ejeksi ventrikel kiri pada pasien GJK Kata kunci : elektrokardiografi, gagal jantung kronik, fraksi ejeksi ventrikel kiri Background: Heart failure (HF) are divided into HF reduced ejection fraction (HFrEF<40%), mid range (HFmrEF 40-49%), and preserved (HFpEF ≥50%). Nowadays echocardiography is used as gold standard examination, but it is limited only in several health centers. For this reason, a preliminary examination tools is needed. Electrocardiographic (ECG) examinations tool that available almost at every health center and easy to be used. Calculating the scores from ECG variables to determine the EF will make clinician’s earlier to give initial terapi Method: An observational approach with cross sectional study design. The data was taken from patient’s medical record with chronic heart failure (CHF) who went to the Tepartement of Cardiology at Dr. M. Djamil Padang Hospital in January-August 2017. Bivariate analysis was performed on each ECG variable then correlated with LVEF by chi-square method. Multivariate analysis with logistic binary regression test was conducted to obtain variables that would go into the score calculation stage with the Hosmer-Lameshow test (p <0.25). The sensitivity, specificity test and receiver operating curve (ROC) analysis were performed. Result: 283 subjects of CHF who had been divided into three groups. Obtained variables that met the requirements for calculating scores were left atrial enlargement (LAE) (OR = 6.36; p = 0.000) score was 2, wide QRS (OR = 13.06; p = 0,000) score was 3 , prolonged QTc interval (OR = 2,18; p = 0,065) score was 1 and ST-T change (OR = 5.05; p = 0.000) score was 2. Subjects with HFpEF if the scored were <3, HFmrEF if the scored were 3-4, and HFrEF if the scored were >4. It has sensitivity 71,4%, specificity 88,6% with AUC 87,9%. Conclusion: Electrocardiography scoring system in this study can be used as an initial tools to determining LVEF in patients with CHF. Keywords: electrocardiography, chronic heart failure, left ventricular ejection fraction
Relationship Between of Lactate Clearance with Major Cardiovascular Events in Patients with Acute Decompensated Heart Failure David Ramli; Masrul Syafri; Muhammad Fadil; Ricvan Nandra Nindrea
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.860

Abstract

ABSTRACT Background: Acute decompensated heart failure (ADHF) still a major health problem with high morbidity and mortality. The risk stratification of ADHF patients is an important factor to determine the initial management. Examination of lactic acid levels is an inexpensive tool and mostly available at primary care centers. Lactate clearance, derivation of lactic acid level, is one of the modalities that can be used to assess risk stratification. The association between lactate clearance and in-hospital major cardiovascular events (MACE) of ADHF patients has not been studied yet. Method: Observational approach with cross-sectional design. Data obtained from observations during treatment in ADHF patients at Dr. RSUP M. Djamil Padang in April-July 2018. Bivariate analysis between variables lactate clearance and KKM was carried out during the treatment using the chi-square method and the Odds ratio was obtained. Result: From 44 subjects, 22 of subjects experienced MACE. From the results were found significant differences in lactate clearance in both of groups, -11,72 ± 4,25 %, vs 26,09 ± 9,36 % (p=0,000). The association between lactate clearance and in-hospital major cardiovascular events of ADHF patients in this study obtained OR 1,16 with 95% CI 1,12 - 4,102 (p = 0.000). Conclusion: Lactate clearance is a valuable modality that can be used to make a risk stratification in ADHF patients. Keywords: Lactate clearance, ADHF, risk stratification ABSTRAK Latar Belakang: Gagal jantung dekompensata akut (ADHF) masih merupakan masalah kesehatan dengan morbiditas dan mortalitas tinggi. Stratifikasi risiko pasien ADHF merupakan faktor penting untuk menentukan managemen awal. Pemeriksaan kadar asam laktat merupakan alat yang murah dan tersedia di pusat pelayanan primer, lactate clearance merupakan salah satu modalitas untuk menilai stratifikasi risiko. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF belum diteliti. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Data diperoleh dari pengamatan selama perawatan pada pasien ADHF di RSUP Dr. M. Djamil Padang bulan April-Juli 2018. Dilakukan analisis bivariat antara varibel lactate clearance dengan KKM selama perawatan dengan menggunakan metode chi-square dan didapatkan nilai Odds ratio. Hasil Penelitian : Dari 44 subyek penelitian, 22 subjek dengan ADHF tidak mengalami KKM dan 22 subjek mengalami KKM. Hasil penelitian menemukan adanya perbedaan yang bermakna variabel lactate clerance pada kedua kelompok, yakni -11,72 ± 4,25 % vs 26,09 ± 9,36 %, dengan nilai p=0,000. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF pada penelitian ini didapatkan nilai OR 1,16 dengan 95% CI 1,12 - 4,102 (nilai p=0,000). Kesimpulan : Lactate clearance dapat digunakan sebagai stratifikasi risiko pada pasien ADHF. Kata kunci : Lactate clearance, ADHF, stratifikasi risiko
Left Atrial Thrombus Resolution Using Unfractionated Heparin and Warfarin in a Patient with Mitral Stenosis Zainuddin Zainuddin; Endang Ratnaningsiah; Andika Rizki Lubis; Sebastian Andi Manurung; Tike Hari Pratikto; Amiliana Mardiani Soesanto
Jurnal Kardiologi Indonesia Vol 40 No 3 (2019): Indonesian Journal of Cardiology: July-September 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i3.870

Abstract

Abstract Background: Though the use of Low Molecular Weight Heparin (LMWH) in general is preferred due to its convenient and eliminates the need for activated Partial Thromboplastin Time ( aPTT) monitoring but Unfractionated Heparin (UFH) is still widely used in clinical setting due to its availability and low price. Besides UFH, the use of oral anticoagulant therapy with warfarin, has been the standard therapy for the prevention of thromboembolism in patients with AF. Our aim is to report a case of the resolution of left atrial thrombus in a patient with mitral stenosis. Case Illustration: A Case report of a female patient aged 54 years who admitted with a sudden neurological deficits and mitral stenosis with atrial fibrillation. Transthoracal Echocardiography (TTE) showed mobile thrombus which moved and obstructed the mitral valve during diastolic phase. Unfractionated heparin (UFH) was administered 3000 unit bolus intravenously and maintained with 600 unit per hour with the combination of warfarin 2 mg for five days. TTE evaluation showed the resolution of LA thrombus. Conclusion : The administration of the combination of UFH and warfarin had successfully caused resolution of the LA thrombus and prevented the patient from surgical intervention. This case report indicated that Unfractionated Heparin and Warfarin were still the treatments option in LA thrombus patients with mitral stenosis and atrial fibrillation. Key words :Left atrial thrombus, unfractionated heparin, thrombus resolution

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