ACI (Acta Cardiologia Indonesiana)
ACI (Acta Cardiologia Indonesiana) is published twice a year (biannually) by the Department of Cardiology and Vascular Medicine Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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Risk Stratification for Sudden Cardiac Death in Heart Failure
Hendry Purnasidha Bagaswoto
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47673
Heart failure (HF) is a complex clinical syndrome in which structural / functional myocardial abnormalities result in symptoms and signs of hypoperfusion and/or pulmonary or systemic congestion at rest or during exercise. More than 80% of deaths in patients with HF recognize a cardiovascular cause, with most being either sudden cardiac death (SCD) or death caused by progressive pump failure. Risk stratification of SCD in patients with HF represents a clinical challenge. This review will give an update of current strategies for SCD risk stratification in HF.
Predicting and Preventing Sudden Cardiac Death in the Young
Erika Maharani
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47674
Sudden cardiac death (SCD) is an unexpected death condition and occurs with unknown causes or cardiac condition. The SCD incidence at young age is a rare condition but when this condition happens it become traumatic event for both family and community. Incidence rate of death on 1-35 years old is around 0.8-2.8/100.000 each year. This number also varies according to age and sex. Death incidence on 1-4 years old is more common than on 5-10 years old group. This number is increasing after 15 years old, where age of 31-35 years has 10 fold risk of SCD compared to 1-10 years old group. Ratio of SCD in men and woman are 2: 1. Early detection of underlying heart disease is the most important action of preventio. If young people are known to have a risk of SCD, the lifestyle changing and appropriate medical therapy, including implantation of implantable cardioverter defibrillator, according to risk stratification must be done.
Dealing with Sudden Cardiac Death: Who Deserves Device Implantation
Dicky Armein Hanafy
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47675
Sudden cardiac death is one of the leading causes of death in the western industrial nations. Most people are affected by coronary heart disease (coronary heart disease, CHD) or heart muscle (cardiomyopathy). These can lead to life-threatening cardiac arrhythmias. If the heartbeat is too slow due to impulse or conduction disturbances, cardiac pacemakers will be implanted. High-frequency and life-threatening arrhythmias of the ventricles (ventricular tachycardia, flutter or fibrillation) cannot be treated with a pacemaker. In such cases, an implantable cardioverter-defibrillator (ICD) is used, which additionally also provides all functions of a pacemaker. The implantation of a defibrillator is appropriate if a high risk of malignant arrhythmias has been established (primary prevention). If these life-threatening cardiac arrhythmias have occurred before and are not caused by a treatable (reversible) cause, ICD implantation will be used for secondary prevention. The device can stop these life-threatening cardiac arrhythmias by delivering a shock or rapid impulse delivery (antitachycardic pacing) to prevent sudden cardiac death. Another area of application for ICD therapy is advanced heart failure (heart failure), in which both main chambers and / or different wall sections of the left ventricle no longer work synchronously. This form of cardiac insufficiency can be treated by electrical stimulation (cardiac resynchronization therapy, CRT). Since the affected patients are also at increased risk for sudden cardiac death, combination devices are usually implanted, which combine heart failure treatment by resynchronization therapy and the prevention of sudden cardiac death by life-threatening arrhythmia of the heart chambers (CRT-D device). An ICD is implanted subcutaneously or under the pectoral muscle in the area of the left collarbone. Like pacemaker implantation, ICD implantation is a routine, low-complication procedure today.
Role of Non-Vitamin K Oral Anticoagulants for Prevention of Stroke in Renal Impaired Atrial Fibrillation Patients
Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47677
Atrial fibrillation (AF) and chronic kidney disease (CKD) are highly prevalent, particularly with increasing of age and associated comorbidities, such as hypertension, diabetes, heart failure, and vascular disease. The relationship between AF and CKD seems to be bidirectional. CKD predisposes to AF while onset of AF seems to lead to progression of CKD. Stroke prevention is the cornerstone of AF management, and AF patients with CKD are at higher risk of stroke, mortality, cardiac events, and bleeding. Stroke prevention requires use of oral anticoagulants, which are either vitamin K antagonists (e.g. warfarin), or the non-vitamin K antagonist oral anticoagulants (NOAC). While NOAC have been shown to be effective in mild-to-moderate renal dysfunction, there are a paucity of data regarding NOAC in severe and end-stage renal dysfunction. The followingwill discuss the evidence for NOAC in CKD, and summarize the current knowledge regarding the efficacy and safety of NOAC to prevent AF-related stroke and systemic embolism in severe and end-stage renal disease.
Sympathetic Overdrive in Hypertension, The Role of Beta Blocker, Focus on Bisoprolol
Lucia Kris Dinarti
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47678
Sympathetic neural factors played an important role in homeostatic blood pressure control. Dysregulation in sympathetic function may favor the development and progression of the hypertensive state. Beta-blocker, as one of antihypertensive drugs, provides several positive effects to hinder overactivity of sympathetic nerve in patients with hypertension.
Newest Update in Heart Failure Guidelines Recommendation
Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47679
Heart failure remains a global burden despite important progress that has been made in the management of heart failure. Guidelines from ESC and AHA are still widely used as a guidance for diagnosis and management of heart failure. We will discuss the new recommendation from ESC and AHA guideline for heart failure.
Navigating Your Acute Heart Failure Patient in Emergency and Pre-Discharge Phase
Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47680
Heart failure (HF) leads to frequent hospitalizations. The presence of re-hospitalization risk among patientshospitalized for heart failure is important, especially hemodynamic instability and neurohormonal over activation. ARNI is needed to restore the balance of neurohormonal system in HF. PARADIGM-HF study provide insight on long term benefit of ARNI (i.e. sacubitril/valsartan) in ambulatory setting. How is the evidence of ARNI use for in hospitalization phase of HF? PIONEER and TRANSITION showed that initiation of sacubitril/valsartan shortly after an ADHF event is feasible and well tolerated. In-hospital initiation of sacubitril/valsartan is associated with early and sustained improvements in biomarkers of cardiac wall stress and myocardial injury, indicating pathophysiological benefits in a wide range of HFrEF patients.
Is Plaque Rupture Always Responsible in Acute Coronary Syndrome?
Putrika Prastuti Ratna Gharini
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47681
The majority cause of myocardial infarction is the atherothrombotic event, mainly cause by plaque rupture. Since the 20th century, it was found that the plaque rupture was not the solely condition responsible for the acute coronary syndrome. With the invention of more sensitive myocardial biomarker, a series of guideline was written as guideline for the definition of myocardial infarction. This review discuss about the consensus in the Universal Definition of Myocardial Infarction.
Applicability of Recent Dyslipidemia Guidelines in Clinical Practice
Erwinanto Erwinanto
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47682
Atherosclerotic plaque rupture is closely related to acute coronary syndromes.Stabilization of atherosclerotic plaque which slashes plaque rupture is as importantas regression ofplaque size for reducing cardiovascular events. Dyslipidemia therapy targeting to decrease LDL cholesterol reduces cardiovascular events such as acute myocard infarct, stroke, and death which are suggested to be the result of plaque stabilization. Dyslipidemia therapy also regress atherosclerotic plaque into a smaller volume. Plaque regression improves coronary flow responsible for the reduction of myocardial infarction incidence in patients with coronary heart disease (CHD).This paper consists of two parts. The first part discusses the evidence of cardiovascular event reduction with statin. The second part describes dyslipidemia management based on the 2017 Indonesian Heart Association (PERKI) Guideline on the Management of Dyslipidemia
Distinct Mechanism between Arterial and Venous Thrombosis: Impact for Clinical Manifestations
M. Taufik Ismail
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
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DOI: 10.22146/aci.47683
Hemostasis is a complex physiological process aiming to keep the integrity of a closed circulatory system after an occurrence of vessel wall injury. Hemostasis involving the role of circulating platelets and coagulation cascade.1 There are two major pathways that act independently to activate the platelet. The first pathway is mediated by collagen and the other by tissue factor. After intimal layer injury, platelets are recruited through the interaction between platelet’s surface glycoprotein (GPVI and GPIb/V/IX) with collagen and von Willebrand factor. This process results in adhesion of platelets in the site of injury. Further recruitment of platelets is achieved by secretion of aggregatory mediators such as thromboxane A2 and adenosine diphosphate.