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All Journal Indonesian Journal of Cardiology The Journal of Society Medicine (JSOCMED)
Akbar, Nizam Zikri
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Association of Triglyceride/High Density Lipoprotein Cholesterol Ratio and Coronary Lesion Severity in Acute Myocardial Infarction Patients at Adam Malik Hospital, Medan Sinaga, Akbar; Hasan, Refli; Reynaldo, Abdul Halim; Hasan, Harris; Akbar, Nizam Zikri; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 3 (2023): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i3.30

Abstract

Introduction: Coronary heart disease is the leading cause of worldwide death. A number of markers have been identified in terms of the atherogenic potential of the lipid profile.The TG/HDL-C ratio is an easy and economical non-invasive examination method as a predictor of coronary heart disease severity. The aim of this study is to assess the relationship of the TG/HDL ratio with the severity of coronary lesions. Method: This cross-sectional study included 53 acute myocardial infarction patients undergoing coronary angiography. Exclusion criteria include (1)AMI patients receiving fibrinolytic therapy, (2) Patients who have routinely consumed lipid lowering drug for 6 weeks,(3) Incomplete coronary angiography and medical records. The TG/HDL ratio is the result of dividing the triglyceride value by HDL. The TG/HDL ratio was divided into 2 groups, namely the TG/HDL ratio <4 group and the TG/HDL ratio >4 group. The severity of coronary lesions was described by the SYNTAX score, which was divided into two: the low SYNTAX score group (≤22) and patients with a low SYNTAX score (≤22) and medium-high SYNTAX score (≥23). Bivariate analysis was performed to find the relationship between the TG/HDL ratio and the SYNTAX score. The value of p<0.05 was considered statistically significant. Results: From 53 patients, 26 patients (49.1%) had a SYNTAX score ≥ 23 and 27 patients (50.9%) had a SYNTAX score < 23. Patients with NSTEMI, DM risk factors, and obesity were higher in the SYNTAX score group ≥23. From the results of statistical analysis, there was a significant relationship between the TG/HDL ratio with coronary lesion severity (p = 0,004). Conclusion: Enhancement of TG/HDL ratio is correlated with coronary lesion severity in acute myocardial infarction patients using the SYNTAX score.
Relationship Between P Wave Peak Time In Leads II And V1 With Left Ventricle Diastolic Function In Hypertension Patients Ihsan, Muhammad; Akbar, Nizam Zikri; Lubis, Hilfan Ade Putra
Journal of Society Medicine Vol. 2 No. 6 (2023): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i6.67

Abstract

Introduction: Left ventricular diastolic dysfunction is common in patients with hypertension. Inadequate management can cause complications such as hypertensive heart disease. Electrocardiography as a tool that is easy to find in health services is known to be able to detect left ventricular diastolic dysfunction. The purpose of this study was to examine the relationship between P wave peak time in leads II and V1 by electrocardiography with left ventricular diastolic function. Method: This study was a cross-sectional study that was conducted by collecting 111 patients with a history of hypertension at RSUP HAM from October 2021 to November 2022. The P wave peak time was measured in leads II and V1 on the ECG. Diastolic function was assessed using echocardiography. A bivariate test was performed to assess the correlation between the two variables. Furthermore, ROC analysis was performed to assess the P wave peak time as a predictor of left ventricular diastolic function. Results: : Total subjects were 111 hypertensive patients consisting of 49 (31.4%) hypertensive patients with normal diastolic function and 62 (68.6%) hypertensive patients with diastolic dysfunction. In bivariate analysis, a significant difference was found between the P wave peak time in lead II of hypertensive patients with normal diastolic function and hypertensive patients with diastolic dysfunction (65.47± 2.5 vs 68.9 ± 2.7;p = 0.001). Based on the ROC analysis, it was found that the P wave peak time could predict left ventricular diastolic dysfunction in hypertensive patients with AUC = 0.81 in lead II. Conclusion: The P wave peak time in lead II can be a predictor of diastolic dysfunction in hypertensive patients.
The Relationship between D-Dimer Levels and Coronary Lesion Severity in Patients with Acute Myocardial Infarction with ST-Segment Elevation at Haji Adam Malik Hospital Medan Rialdy, M. Isfan; Akbar, Nizam Zikri; Haykal, T. Bob; Ketaren, Andre Pasha; Andra, Cut Aryfa; Sarastri, Yuke
Journal of Society Medicine Vol. 2 No. 9 (2023): September
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.89

Abstract

Introduction: Acute coronary syndrome results from rupture or erosion of an atherosclerotic plaque. D-dimer is a direct marker of fibronolysis events and an indirect marker of hypercoagulable state associated with atherosclerotic plaque formation and acute coronary syndrome. The purpose of this study was to determine the relationship between D-dimer levels and the severity of coronary lesions in ST Elevation Myocardial Infarction patients at H. Adam Malik Hospital Medan. Method: This study was conducted with a cross-sectional method on 72 ST Elevation Myocardial Infarction patients at H. Adam Malik Medan Hospital who underwent coronary angiography from December 2022 to May 2023. Definition of ST Elevation Myocardial Infarction followed the definition of Universal Definition of Myocardial Infarction and the severity of coronary lesions was calculated based on syntax score. Data were analyzed univariately and bivariately using SPSS to assess the association of D-dimer levels with syntax score with p<0.05 considered statistically significant. Results: The total study subjects were 72 people with an average age of 56,5410,84years. Most of the study samples were male 56 people (77.8%). The median D-dimer level was 605 and mean syntax score 22.027 + 14.61. There is a significant relationship between D-dimer levels and the severity of coronary lesions based on the syntax score (p: <0.001). Conclusion: There is a significant relationship between D-dimer and severity of coronary lesions in patients with acute myocardial infarction with ST segment elevation at H. Adam Malik General Hospital, Medan.
The Relationship between Myocardial Strain Using 2D Speckle Tracking Echocardiography and Coronary Lesion Severity Measured by Syntax Score in Patients with Chronic Coronary Syndrome at Haji Adam Malik Hospital Purba, Antonius Leonardo; Akbar, Nizam Zikri; Sarastri, Yuke
Journal of Society Medicine Vol. 3 No. 4 (2024): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i4.137

Abstract

Introduction: Coronary heart disease continues to be the leading cause of morbidity and death worldwide. The cardiac dysfunction known as chronic coronary syndrome is caused by atherosclerosis-related obstruction or constriction of coronary arteries. Currently, One interesting non-invasive technique is GLS assessment, which has shown to be useful in predicting coronary lesions in chronic coronary syndrome patients. This study aims to evaluated the correlation between myocardial strain based on 2-D Speckle-Tracking Echocardiography and the severity of coronary lesions in chronic coronary syndrome patients at Haji Adam Malik Hospital Medan Method: This research is an analytical observational study with a cross sectional design on patients who diagnosed with chronic coronary syndrome and treated at H Adam Malik General Hospital Medan which met the inclusion and exclusion criteria. Sampling was carried out starting in January to December 2023. In bivariate analysis, the Fisher Exact test is used if the data is not normally distributed, and the chi square test is used if the data is normally distributed. P values less than 0.05 indicate statistical significance in data analysis using computer statistical methods. Results: Myocardial global longitudinal strain (GLS) based on 2-D Speckle-Tracking Echocardiography was significantly associated with the severity of coronary lesions as measured by syntax score in chronic coronary syndrome patients (p value  0.0001, OR 2.732, 95% CI 1, 81-4,11). As a predictor of coronary lesions severity based on the Syntax score in patients with chronic coronary syndrome, the global longitudinal strain (GLS) cut-off value of -17.37 demonstrates a sensitivity of 92.9% and a specificity of 83.6%. Conclusion: Myocardial global longitudinal strain (GLS) with a cut-off value of -17.37 can be used as a predictor coronary lesions severity in chronic coronary syndrome patients with a sensitivity of 92.9% and a specificity of 83.6%.
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.
Validasi Skor PEACH sebagai Prediktor Mortalitas Selama Rawatan Paska Operasi Penyakit Jantung Bawaan Pada Dewasa di Rumah Sakit Umum Pusat Haji Adam Malik Medan Zebua, Juang Idaman; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Hasan, Harris; Akbar, Nizam Zikri
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.1546

Abstract

Introduction: Congenital heart disease (CHD) is an abnormality in the structure and function of the heart that is acquired while still intrauterine where the incidence of CHD worldwide is estimated at around 8 cases per 1,000 live births. Even though the development of the medical science is currently advanced, there are still CHD patients who are lately diagnosed and found when the patient is an adult so it requires surgical interventions. The PEACH score is a score that can predict postoperative in-hospital mortality in adults CHD patients. This study aims to validate the PEACH score. Methods: This is a retrospective cohort study of 52 adult patients with CHD who underwent surgery at Haji Adam Malik General Hospital from January 2019 to April 2023. Validation was analyzed using a calibration and discrimination test to the PEACH score in predicting postoperative in-hospital mortality. Result: The incidence of in-hospital mortality was 8 (15.4%) patients. There is a relationship between the PEACH score group and the incidence of mortality (p=0.006). The results of the calibration test using the Hosmer and Lameshow analysis and the discrimination test using the Receiver Operating Characteristic analysis showed good validation (p=0.85; AUC=0.83). Conclusion: The PEACH score is valid for predicting postoperative in-hospital mortality in adult congenital heart disease at Haji Adam Malik General Hospital.
Co-Authors Andra, Cut Aryfa Ardini, Tengku Winda Hasan, Harris Hasan, Refli Haykal, T. Bob Ketaren, Andre Pasha Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Muhammad Ihsan Mukhtar, Zulfikri Nasution, Ali Nafiah Purba, Antonius Leonardo Reynaldo, Abdul Halim Rialdy, M. Isfan Ryanti, Dina Sarastri, Yuke Sinaga, Akbar Zebua, Juang Idaman