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All Journal Sumatera Medical Journal Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED)
Sitepu, Andika
Unknown Affiliation
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Adherence to European Society of Cardiology Heart Failure Treatment Guideline in Haji Adam Malik General Hospital Medan Wirtanto, Ardy Putra; Sitepu, Andika
Sumatera Medical Journal Vol. 3 No. 1 (2020): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v3i1.3382

Abstract

Background. Heart failure is a public health problem and the main cause of morbidity and mortality in the world. The goal of the therapy is to reduce symptoms, prevents rehospitalization and increases survivability. Objective. To evaluate the adherence to the European Society of Cardiology for heart failure treatment at H. Adam Malik Medan hospital. Methods. The study was descriptive observational cross sectional design with medical record data of heart failure at H. Adam Malik Hospital, using consecutive sampling method. The adherence of guidelines was assessed by: (1) drug prescribing (“yes” or “no”), and (2) guideline adherence indicator (GAI), both GAI-3 or GAI-5, by calculating the proportion as the number of drugs prescribed by number of drugs indicated to the ESC guidelines. Results. From research, the predominant GAI-3 and GAI-5 were High, which were 54.9% and 59.5%, respectively. The recommended drug used based on indications were ACE-i / ARB (89.1%), beta-blockers (83.4%), MRA (73.6%), diuretics (93.7%), and digitalis (20,8%). Conclusion. The predominant category in adherence to the ESC heart failure treatment guidelines based on GAI-3 and GAI-5 is High.
The Relationship between Transient Ischemic Dilation (TID) and Severity of Coronary Artery Disease (CAD) in Patients with Chronic Coronary Syndrome (CCS) in Haji Adam Malik Medan, Indonesia Tamba, Ratna Mariana; Lubis, Hilfan Ade Putra; Mukhtar, Zulfikri; Sitepu, Andika; Habib, Faisal; Andra, Cut Aryfa; Haykal, T. Bob
Journal of Society Medicine Vol. 2 No. 9 (2023): September
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.88

Abstract

Introduction: TID ratio derived from ratio of LV volume in stress and rest phase of MPS. It is said that this phenomenon has been a useful marker of severe CAD, that can be present with atypical angina. This occurs due to global myocardial hypoperfusion caused by severe and extensive CAD. Method: This study was an analytic observational study with a retrospective cohort design in CCS patients who underwent Myocardial Perfusion SPECT at Haji Adam Malik General Hospital from January 2022 to April 2023.  All participants underwent MPS with Tc99m sestamibi with pharmacology Adenosine stress test and coronary angiography. The MPS could be performed before or after coronary angiography without any revascularization procedure between the two examination preocedures. An unpaired t-test analysis was performed to find the mean difference in TID values in the mild CAD and moderate-severe CAD groups. Results: The study subjects totaled 93 people with an average age of 55.87±7.44. It was found that the TID value was significantly different between the two groups of mild and moderate-severe CAD based on Syntax score, 0.906±0.13 vs 1.03±0.11 in the mild vs moderate-severe CAD group (p<0.001). Bivariate analysis showed that in this study, the ratio of TID was only associate with LV ESV and LV EDV in stress phase of MPS (p = 0.001). Conclusion: There is a relationship between TID and CAD severity based on Syntax score with higher TID values in patients with moderate-severe CAD compared to patients with mild CAD. TID ratio was only depends on severity od CAD and directly proportional to the volume of LV in the stress phase, suitable to the theory that said TID ratio comes from ratio of LV volume in stress and rest phase of MPS.
Association between Systemic Inflammatory Immunity Index and Intracoronary Thrombus Burden in Acute Myocardial Infarction with ST Segment Elevation (IMA EST) Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Hospital Dhilion, Har Rawishwar Singh; Nasution, Ali Nafiah; Sitepu, Andika
Journal of Society Medicine Vol. 3 No. 2 (2024): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i2.122

Abstract

Introduction: Acute coronary syndrome (ACS) account for 30% of deaths worldwide. High peri-procedural intracoronary thrombus burden is a strong predictor of poor outcome. Inflammation plays an important role in the pathogenesis of intracoronary thrombus formation. The systemic inflammatory immunity index represents the immune responses to inflammation, which consist of neutrophilia, thrombosis and decreased lymphocytes. The previous study showed that systemic inflammatory immunity index predicted high intracoronary thrombus burden in STEMI patients. This study aimed to evaluate systemic inflammatory immunity index in predicting the incidence of high intracoronary thrombus burden in STEMI patients. Method: This research is a retrospective analytical observational study on 95 patients diagnosed with ACS in the period 1 January 2022-31 March 2023 at H. Adam Malik General Hospital, Medan. All patients involved had undergone primary percutaneous coronary intervention. Patient characteristics, risk factors, laboratory results and coronary angiography were recorded from the patient's medical record. Results: There was a significant relationship between the systemic inflammatory immunity index value and the incidence of high intracoronary thrombus burden in STEMI patients (P < 0.001). The systemic inflammatory immunity index cut off point value > 1108 has a sensitivity of 89.4% and a specificity of 89.7% which has a better accuracy in predicting high intracoronary thrombus burden in STEMI patients. Conclusion: Systemic inflammatory immunity index has a good accuracy to predict high intracoronary thrombus burden in STEMI patients.
Comparison of Syntax II Score And Grace Score As Predictors of Major Cardiovascular Events 30 Days after Treatment in STEMI Undergoing PPCI Abimanyu, Roni; Sitepu, Andika; Nasution, Ali Nafiah
Journal of Society Medicine Vol. 3 No. 6 (2024): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i6.150

Abstract

Introduction: IMA-EST is still the main cause of morbidity and mortality in Coronary Artery Disease (CAD) and PPCI is still the main treatment method for IMA-EST patients. Even though PPCI has been undergone, patients are reported to still experience mortality and morbidity both in hospital and after discharged. The SYNTAX II score uses clinical, laboratory and anatomical parameters that are believed to be better than the GRACE score to predict mortality and morbidity. Method: This study is an observational analytic with a retrospective cohort design in STEMI patients who underwent PPCI at HAM General Hospital from January 2023 to June 2023. Patients who were diagnosed with STEMI and underwent with PPCI had their GRACE score and SYNTAX II score calculated and followed for 30 days. SYNTAX-II Score’s cut-off point, sensitivity and specificity as well as predictive possibilities in predicting adverse outcomes were determined. Then bivariate analysis was carried out on each SYNTAX-II Score and GRACE score. Results: The study subjects totaled 73 people with an average age of 56.05 ± 10.07 years. The incidence of MACE 30 days after treatment in our sample was 23.3%. It was found that the SYNTAX II score could well predict occurrence of MACE 30 days after treatment (cut off 33,75, AUC 0.861; 0.773 – 0.949; sensitivity 94.1%; specificity 69.6%, PPV 94.1% and NPV 67.6). The result of the bivariate analysis of the SYNTAX-II Score were: P < 0,0001; OR: 18,353; 95%; CI: 2,566 – 131,241and the results of the GRACE Score were: P < 0,006; OR 5,854; 95%; CI: 1,442 – 23,764. Conclusion: The SYNTAX II score is better to predict occurrence of MACE 30 days after treatment in STEMI patients who  undergoing PPCI compared to the GRACE score.
The Relationship between Red Blood Cell Distribution Width and Coronary Artery Lesion Severity In Acute Myocardial Infarction Patients with Non-Elevation of ST-Segment (IMA-NEST) at Haji Adam Malik Hospital Alfuadi, T. Rifki Mirza; Mukhtar, Zulfikri; Sitepu, Andika
Journal of Society Medicine Vol. 3 No. 7 (2024): July
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i7.157

Abstract

Introduction: Red cell distribution width (RDW), a measure of erythrocyte size variability, is associated with acute inflammation. Elevated RDW predicts adverse outcomes in cardiovascular diseases like acute myocardial infarction. This study investigated the relationship between RDW and coronary lesion severity, assessed by the SYNTAX Score, in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) undergoing coronary angiography. Methods: This retrospective analytical study included NSTE-ACS patients who underwent coronary angiography at H. Adam Malik General Hospital Medan. Baseline characteristics, laboratory parameters (including RDW), and angiography results were collected. The association between RDW and SYNTAX Score was analyzed. ROC/AUC curve analysis assessed RDW's predictive ability for coronary lesion severity, determining sensitivity and specificity. Results: In 160 patients, RDW was significantly associated with SYNTAX Score (p<0.001). TIMI score, GRACE score, and number of involved arteries also correlated with lesion severity. Conclusion: RDW is a promising predictor of coronary lesion severity in NSTE-ACS patients undergoing coronary angiography.
Prevalence of Valvular Heart Disease and Pulmonary Hypertension in Children in Rantau-Prapat City, North Sumatra, Indonesia Haykal, Teuku Bob; Sitepu, Andika; Ilyas, Kamal Kharrazi
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 4 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i4.14333

Abstract

Background: Valvular heart disease and pulmonary hypertension (PH) are two distinct but often interconnected cardiac conditions that can affect children and encompass abnormalities of the heart's valves such as the aortic, mitral, tricuspid, and pulmonary valves, and can present with symptoms such as chest pain, fatigue, and dyspnea. In contrast, PH refers to elevated blood pressure in the pulmonary arteries. Routine screening for these conditions is needed for prompt diagnosis and management. This study was conducted to obtain data on children with valvular heart disease or PH who participated in the Community Service Program of the Department of Cardiology and Vascular Disease, Universitas Sumatera Utara. Method: This study was a descriptive study conducted through a cross-sectional study design. Data was collected from interviews and on-the-spot examination with validated measurement tools. Data was analyzed using SPSS version 26. Categorical variables were presented using frequency (n) and percentage (%), and numerical variables with normally distributed data were presented with mean and standard deviation (SD). In non-normally distributed data, numerical variables were presented using the median and interquartile range. Results: There were 157 children included in this study. Most subjects were female (n=94, 59.9%) in the age range 12 to 16 years old. Most subjects (n=152, 96.8%) had normal mitral valves, three subjects had anterior mitral valve prolapse (1.9%), one subject (0.6%) had anterior mitral valve thickening and one subject (0.6%) had mild mitral regurgitation. 10 subjects (5.7%) had pulmonary regurgitation. Two subjects had tricuspid regurgitation (1.2%). No subjects had any aortic abnormalities. No subjects had a PH. Conclusion: In the children population in Rantau-Prapat City, most subjects with valve abnormalities had mitral and pulmonary valve abnormalities. No subjects had aortic valve abnormalities or PH.
Co-Authors Abimanyu, Roni Alfuadi, T. Rifki Mirza Andra, Cut Aryfa Dhilion, Har Rawishwar Singh Habib, Faisal Haykal, T. Bob Haykal, Teuku Bob Ilyas, Kamal Kharrazi Lubis, Hilfan Ade Putra Mukhtar, Zulfikri Nasution, Ali Nafiah Tamba, Ratna Mariana Wirtanto, Ardy Putra