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Suwanto, Denny
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Health Professions Medicine & Pharmacology Public Health

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Peran Hiperhomosisteinemia dalam Atherosklerosis Suwanto, Denny
Cermin Dunia Kedokteran Vol 44, No 9 (2017): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (500.016 KB) | DOI: 10.55175/cdk.v44i9.728

Abstract

Hiperhomosistenemia adalah peningkatan kadar homosistein dalam darah di atas 15 μmol/L. Di dalam siklus daur homosistein terdapat beberapa enzim yang memerlukan vitamin B12 dan asam folat sebagai kofaktor. Hiperhomosisteinemia dapat disebabkan defek genetik bawaan seperti defisiensi enzim Metilentetrahidrofolat reduktase, Metionin sintase, dan Sistationin β sintase, atau oleh faktor didapat seperti gagal ginjal, kanker, psoriasis, diabetes, paparan asap rokok, alkohol, kopi, usia tua, menopause, serta obat-obatan. Berbagai studi menunjukkan hiperhomosisteinemia berhubungan dengan disfungsi endotel, aktivasi platelet, dan pembentukan thrombus yang dapat berujung pada aterosklerosis dan penyakit jantung koroner.Hyperhomocysteinemia is defined as plasma homocystein level above 15 μmol/L. Several enzymes involved in homocysteine metabolism require vitamin B and folic acid as cofactor. Hyperhomocysteinemia could be caused by inherited genetic disease such as deficiency of Methylentetrahydrofolate reductase and Methionin synthase, or by acquired factors such as kidney failure, cancer, psoriasis, diabetes, smoking, alcohol, caffeine, elderly, menopause, and drugs. Prospective studies has shown that hyperhomocysteinaemia is associated with endothelial injury and dysfunction, promoting platelet activation and thrombus formation, which could result in atherosclerosis and coronary artery disease.
Hiperkoagulabilitas pada Kehamilan dengan COVID-19 Marpaung, Richardo; Chandra, Evelyne; Suwanto, Denny
Cermin Dunia Kedokteran Vol 47, No 11 (2020): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.561 KB) | DOI: 10.55175/cdk.v47i11.1203

Abstract

Pandemi coronavirus disease 2019 (COVID-19) akibat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) menginfeksi lebih dari 7 juta jiwa di seluruh dunia dengan angka kematian lebih dari 400.000 jiwa. Koagulopati adalah salah satu sekuele paling berat dari COVID-19. Hipotesis terkait koagulopati ini melibatkan peningkatan signifikan respon inflamasi yang mengakibatkan trombo-inflamasi melalui mekanisme seperti badai sitokin, aktivasi komplemen, dan endotelitis. Dalam kehamilan, terdapat beberapa perubahan fisiologis yang memengaruhi koagulasi dan sistem fibrinolisis mengakibatkan kondisi hiperkoagulabilitas dan meningkatkan risiko kejadian tromboemboli. Tulisan ini memaparkan mekanisme hiperkoagulasi dalam COVID-19 dan kehamilan, manifestasi klinis, pemeriksaan laboratorium yang diperlukan, serta rekomendasi terapi.Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects more than 7 million people worldwide with a death toll of more than 400,000. Coagulopathy is one of the most severe sequelae of COVID-19. This coagulopathy-related hypothesis involves a significant increase in the inflammatory response that causes thrombo-inflammation , through several mechanism such as cytokine storms, complement activation, and endothelitis. In pregnancy, several physiological changes affect coagulation and fibrinolysis system which results in hypercoagulability and increases the risk of thromboembolic events. This article describes the mechanism of hypercoagulation in COVID-19 and pregnancy, clinical manifestations, necessary laboratory tests, and recommendations for therapy. 
Deteksi Dini untuk Mencegah Kematian Mendadak Akibat Aritmia Chandra, Evelyne; Suwanto, Denny
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (278.435 KB) | DOI: 10.55175/cdk.v48i6.1429

Abstract

Penyakit kardiovaskuler merupakan penyebab 30% kematian di dunia ( 17 juta jiwa) dan 25% nya ( 4 juta jiwa) merupakan kematian jantung mendadak. Kematian jantung mendadak menggambarkan kematian alami yang tidak diduga dengan penyebab jantung dalam periode singkat, umumnya ≤1 jam sejak timbulnya gejala, pada seseorang yang tidak memiliki keluhan sebelumnya. Salah satu etiologi kematian jantung mendadak adalah aritmia jantung, yang umumnya dapat dicegah dengan implantable cardioverter defibrillator (ICD). Skrining dan asesmen risiko dapat mencegah kematian jantung mendadak pada berbagai populasi individu dengan atau tanpa penyakit jantung. Artikel ini membahas deteksi dini potensi kematian jantung mendadak untuk pencegahan primer.Cardiovascular diseases are responsible for 30% of global mortality rate annually, approximately 25% of which caused by sudden cardiac deaths. Sudden cardiac death is defined as unpredictable death, with cardiovascular cause as the presumed etiology, within 1 hour from the onset of symptoms in previously asymptomatic individual. Arrhythmia is one of the most prevalent cause, potentially preventable with implantable cardioverter defibrillator (ICD). Sudden cardiac death may be preventable by risk screening and severity assessment. This article sought to elaborate early detection as a part of primary prevention continuum in sudden cardiac death.
Co-Authors Chandra, Evelyne Marpaung, Richardo