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All Journal Acta Interna : The Journal of Internal Medicine ACI (Acta Cardiologia Indonesiana) JK Unila (Jurnal Kedokteran Universitas Lampung) Indonesian Journal of Pharmacology and Therapy
Anggoro Budi Hartopo
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital Setianto, Budi Yuli; Sari, Julia; Hartopo, Anggoro Budi; Gharini, Putrika Prastuti Ra
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

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Abstract

ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently.Several studies reported that young patients have distinct clinical characteristics as compare with olderpatients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronarysyndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensivecardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admittedwith acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS(age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrumsfrom both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was consideredsignifi cantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Mostyoung ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not differentfrom that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50%vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did notdiffer from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. Theyoung ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15%vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65).Thirty percent of young ACS patients presented with Killip class II or higher, however there were nosignifi cant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinicalpresentation and spectrums between young ACS and older ACS patients. The need for preventionprogram in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.
Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital Setianto, Budi Yuli; Sari, Julia; Hartopo, Anggoro Budi; Ra Gharini, Putrika Prastuti
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.819 KB)

Abstract

ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.
Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital Budi Yuli Setianto; Julia Sari; Anggoro Budi Hartopo; Putrika Prastuti Ra Gharini
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.819 KB) | DOI: 10.22146/acta interna.5728

Abstract

ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.
The Prevalence and Impact of Body Mass Index Category in Patients with Acute Myocardial Infarction Anggoro Budi Hartopo; Vina Yanti Susanti; Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.22604

Abstract

Background: Body mass index is widely recognized as a tool to classify obesity and adiposity. In Asian population, body mass index category can be divided as underweight, normal, overweight and obese. The prevalence of this categorisation is varied among patients with acute myocardial infarction. Furthermore, there is a J and U curve relationship between body mass index category with outcome in acute myocardial infarction. This research aims to investigate the prevalence of body mass index category and its impact on patients with acute myocardial infarction.Methods: The research design is a cross sectional study. The subjects of this research are patients hospitalised with acute myocardial infarction. Subjects are categorised as underweight, normal, overweight and obese, based on Asian body mass index categorisation. The demography, clinical and laboratory data is compared among categories and statistically analysed. The major adverse cardiac events occuring during hospitalisation are recorded and its incidence is compared among group. A p value < 0.05 is statistics limit for significance.Results: We analyse 375 subjects hospitalised with acute myocardial infarction. The most prevalence BMI category is overweight (47.7 %), the second most common category is normal (33.1 %), followed by obese (15.5 %) and the least common category is underweight (3.7 %). No significant difference is observed in respect of gender and cardiovascular risk factors. The underweight subject is significantly older as compared to other categories. The glucose level and atherogenic lipid tend to be higher in underweight subject as compared with normal subject. There is no difference in the incidence of major adverse cardiac events among body mass index categorisation.Conclusion: The overweight is the most common body mass index category in acute myocardial infarction. The underweight subject is significantly older and tend to have worse biochemical parameters as compared to other categories. The incidence of MACE is not associated with the body mass index category.Keywords: body mass index; overweight; underweight; acute myocardial infarction 
The Dynamic Electrocardiogram Pattern of T Wave Inversion Following ST Segment Elevation in Acute Coronary Syndrome with Non Significant Coronary Artery Disease Anggoro Budi Hartopo; Hariadi Hariawan; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.22608

Abstract

ST segment elevation acute myocardial infarction (STEMI) is sometime indicated by typical electrocardiogram pattern, and rarely by atypical pattern. The definite diagnosis of STEMI is important to be determined rapidly and timely and becoming the key management success. The 12 lead electrocardiogram is the main diagnostic tool which should be completed and interpreted as soon as possible on patient admission. In the case, a female patient with anginal chest pain and initial ST segment elevation in electrocardiogram with non significant coronary artery disease. The subsequent electrocardiogram shows T wave inversion evolution pattern.Keywords: STEMI; T wave inversion; variant angina; evolution
Safety monitoring of chloroquine and hydroxychloroquine in COVID-19 patients in Indonesia on QT prolongation: hospital based monitoring study Jarir At Thobari; Togi Junice Hutadjulu; Tri Asti Isnariani; Umi Sa'adatun Nikmah; Lukman Ade Chandra; Pompini Agustina Sitompul; Anggoro Budi Hartopo; Rizki Amalia Gumilang; Luhur Pribadi; Deva Bachtiar; Anwar Santoso
Indonesian Journal of Pharmacology and Therapy Vol 4 No 1 (2023)
Publisher : Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFI) and Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.561 KB) | DOI: 10.22146/ijpther.7148

Abstract

Chloroquine (CQ) and Hydroxychloroquine (HCQ) are the challenging drugs used for COVID-19. Several studies show its beneficial, however, both medications can prolong the QTc interval and increase the risk of patients for torsades de pointes and death. The Tisdale score is identified to have successfully predicted the at-risk population of side effects of these drugs. This study aim to evaluate the QT prolongation caused by the administration of chloroquine and hydroxychloroquine in COVID-19 patients and the association with the treatment outcomes based on their Tisdale score. We conducted an observational study on 213 hospitalized patients with confirmed or suspect COVID-19 in 6 referral hospitals in Indonesia. All baseline demographic such as age and gender, RT-PCR test result, severity of disease, history of cardiovascular disease (myocardial infarction, heart failure, hypertension), serum kalium level at baseline, and the use of medication associated with risk QTc interval prolongation were collected. The Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation. Out of 213 patients who were treated with CQ/HCQ, there were 60 (28.2%) patients had QTc interval prolongation, included 43 patients (20.2%) who had normal QTc interval at baseline and at the end of treatment had prolong interval; or 17 patients (8.0%) who had QTc interval more than 470 msec at baseline and QTc interval prolongation was worsen at the end of treatment. Several factors, including age more than 50 years, COVID-19 confirm PCR, and had comorbidity heart failure, were statistically significant associated with QTc interval prolongation. The high-risk score of Tisdale score have increased risk significantly on QTc interval prolongation (RR: 2.15, 95%CI 1.07-4.32) and associated with risk of death (RR: 3.50, 95%CI 1.34-9.13) compared to low-risk score. Our findings showed that the treatment of CQ/HCQ in COVID-19 patients is associated with QTc prolongation. The Tisdale score can be used as a valuable tool to predict the COVID-19 patients’ outcome after treatment of these QTc-prolonging drugs.
Manajemen Pasien Infark Miokardium Akut Dengan Elevasi Segmen ST (IMA-EST) Anterior Onset Lebih dari 48 Jam Tanpa Tindakan Reperfusi di Bangsal Perawatan Jantung Iswandi Darwis; Anggoro Budi Hartopo; Muhammad Gahan Sarwiko
Jurnal Kedokteran Universitas Lampung Vol 7, No 1 (2023): JURNAL KEDOKTERAN UNIVERSITAS LAMPUNG
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jkunila7125-36

Abstract

Latar Belakang. Sindrom koroner akut merupakan penyakit utama penyebab kematian di dunia. Infark miokardium akut dengan elevasi segmen ST merupakan salah satu SKA yang banyak menimbulkan kematian. Tatalaksana reperfusidengan IKP primer sesuai dengan onset nyeri dada menjadi tatalaksana utama untuk menurunkan morbiditas danmortalitas. Kasus. Pasien laki-laki 62 tahun dengan diagnosis IMA-EST anterior onset lebih dari 48 jam berdasarkan keluhan nyeri dada khas angina dan sesak nafas. Pada pemeriksaan EKG didapatkan irama sinus, frekuensi 120 x/menit, dengan aksisnormal, terdapat elevasi segmen ST pada lead V1-V4 dan Q patologis pada lead V1-V3 serta terdapat peningkatan enzim hs-Troponin I. Pasien didapatkan kondisi infeksi paru dan terjadi perbaikan selama perawatan di bangsal. Pasien tidakdilakukan reperfusi karena menurut rekomendasi pada pasien IMA-EST onset lebih dari 48 jam rekomendasi III untuk dilakukan reperfusi. Pasien diterapi dengan pemberian vasodilator, penyekat beta, statin, heparinisasi dan kontrolkomorbid infeksi pada pasien merupakan tatalaksana lanjutan pada pasien di bangsal perawatan jantung. Pasien dirawat selama 7 hari di RS dan didapatkan perbaikan klinis. Pasien dilakukan 6MWT sebagai dasar penilaian untukaktivitas fisik pasien di rumah. Aktivitas fisik pasca SKA sangat diperlukan untuk memperbaiki luaran klinis, menurunkan angka mortalitas dan rehospitalisasi dan mencegah kejadian reinfark pada pasien di kemudian hari. Tes viabilitasjantung diperlukan untuk mengetahui apakah didapatkan perbaikan fungsi mikardium bila dilakukan reperfusi. Pada pasien direncanakan untuk tes viabilitas dengan menggunakan DSE.Kesimpulan.  Pasien dengan diagnosis IMA-EST onset lebih dari 48 jam tanpa ada keluhan nyeri dada, hemodinamik stabil dan tidak ada kelainan irama jantung yang mengancam jiwa tidak direkomendasikan untuk dilakukan reperfusi. Kata kunci: Infark miokardium akut dengan elevasi segmen ST, onset 48 jam, Repefusi
Co-Authors Abdul S Wahab, Abdul S Anwar Santoso Budi Yuli Setianto Deva Bachtiar Gumilang, Rizki Amalia Hariadi Hariawan Irsad Andi Arso, Irsad Andi Iswandi Darwis Jarir At Thobari Julia Sari Lucida Kris Dinarti, Lucida Kris Luhur Pribadi Lukman Ade Chandra Muhammad Gahan Sarwiko Nahar Taufiq Pompini Agustina Sitompul Putrika Prastuti Ra Gharini Putrika Prastuti Ra Gharini Togi Junice Hutadjulu Tri Asti Isnariani Umi Sa'adatun Nikmah Vina Yanti Susanti