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Hubungan Inhibisi Agregrasi Platelet setelah Pemberian Eptifibatide dengan Kejadian Kardiovaskular Mayor pada Pasien Infark Miokard Akut Elevasi Segmen ST yang Menjalani Intervensi Koroner Perkutan Primer Elisa Feriyanti Pakpahan; Sunarya Soerianata; Nur Haryono
Jurnal Kardiologi Indonesia Vol. 35, No. 1 Januari - Maret 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i1.372

Abstract

Background: Eptifibatide, an inhibitor of glycoprotein IIb/IIIa administered as adjunctive therapy to reperfusion therapy Primary PCI in STEMI patients. Persistently high platelet reactivity was found in patients who experienced recurrent atherothrombotic events during antiplatelet therapy.Objective: To evaluate the level of platelet inhibition after eptifibatide therapy and to assess the relation between level of platelet inhibition and Major Cardiaovascular event (MACE).Methods: Platelet function test by Multiplate analyzer was performed in STEMI Patients who undergone Primary-PCI, 10 minutes after a bolus of eptifibatide. MACE were prospectively monitored during hospitalization and the incidence of MACE correlated with the measured level of platelet inhibition.Results: From 99 subjects, approximately 55% of the subjects were non-responders (high platelet reactivity). 18 patients experienced MACE, most were heart failure (8 people), malignant arrhythmias (3 people), recurrent angina (2 people), stroke (2 people) and reinfarction, infections and major bleeding each 1 person. 12 subjects experienced MACE was from the non-responder group and 8 subjects from the responder grup. The study was found that the level of platelet inhibition wasn’t an independent predictor for the risk of MACE.Conclusion: Less achieved therapeutic effects of platelet Inhibition (non-responders) was found in the majority (55%) subjects. Different level of platelet inhibition wasn’t an independent predictor for the risk of MACE.
Hubungan Kadar P-selectin dengan Fungsi Atrium Kiri pada Stenosis Mitral Rematik Prafithrie Avialita Shanti; Yoga Yuniadi; Nur Haryono
Jurnal Kardiologi Indonesia Vol. 35, No. 3 Juli - September 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i3.426

Abstract

Background. Mitral stenosis (MS) prevalence remains significant in developing countries because of the prevalence of Rheumatic Heart Disease (RHD). In moderate-severe MS patients, enormous increase in turbulent region and shear stress cause vascular endothelial dysfunction, and as the consequence, it increases the risk of thromboembolic complications. P-selectin is an adhesion molecule that play a role in the inflammation process, where it is expressed rapidly in mere minutes. Left Atrial Volume Index (LAVI) is a superior parameter compared with other two-dimensional echocardiography method to assess left atrial function.Methods. This was a cross-sectional study involving 20 MS moderate-severe patients with mitral valve area (MVA) < 1.5 cm2, to whom successful Percutaneous transvenous Balloon Mitral Valvulotomy (PBMV) was performed. Samples were taken consecutively from May-October 2013 at the National Cardiovascular Center Harapan Kita, Jakarta. Blood samples of P-selectin were collected pre and post-PBMV. The result was statistically analyzed with echocardiography data of LAVI prior PBMV to describe any association between expression of P-selectin and atrial function.Result.We found no association between LAVI and P-selectin level pre and post-PBMV in MS patients. That is described in the value of pre PBMV ?=-0.103 (95% CI -0.251-0.045) with p=0.16 and post-PBMV ?= 0.009 (95% CI -0.155-0.172) with p=0.91 We then performed linear regression test with adjusted confounding variable including sex, age, and atrial fibrillation, still we found no association between LAVI and P-selectin level, with the value of pre PBMV ?= -0.154 (95% CI -0.340-0.032) p=0.09 and post PBMV ?= -0.049 (95% CI -0.250-0.152) p=0.61.Conclusion. There is no difference in P-selectin level pre and post PBMV. There is no association between poor LAVI value and expression of P-selectin pre and post PBMV in MS.