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All Journal Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana)
Nahar Taufiq
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Health Professions Medicine & Pharmacology

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Wire Crossing Time Correlate with Left Ventricular End-Diastolic Pressure in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention Indra Widya Nugraha; Anggoro Budi Hartopo; Nahar Taufiq
Jurnal Kardiologi Indonesia Vol 41 No 3 (2020): Indonesian Journal of Cardiology: July - September 2020
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.936

Abstract

Backgrounds: Mortality and morbidity in acute myocardial infarction depend on the extent of the infarct area. Rapid recovery of coronary artery blood flow with primary percutaneous coronary intervention (pPCI) can limit the extent of infarction and improve left ventricular function. Acute myocardial infarction reduce diastolic function, which in the early stage of diastolic dysfunction, there is an increase in left ventricular end-diastolic pressure (LVEDP). The non-invasive marker of E/e’ ratio is an accurate parameter of increased LVEDP.Methods: This was a cross-sectional study enrolled consecutive patients with ST Segment Elevation Myocardial Infarction (STEMI) who underwent pPCI at Dr. Sardjito Hospital. The wire crossing time was calculated from the onset of chest pain until the guidewire crossed the infarct-related artery during the pPCI procedure. The E/e’ ratio was determined by transthoracic echocardiography which performed within 48 hours after the primary PCI. Correlation between the wire crossing time and the E/e’ ratio was assessed by the Pearson correlation test. The value of p <0.05 was considered statistically significant.Results: A total of 40 patients were enrolled in this study. The mean wire crossing time was 12.73±5.22 hours. The median value of the E/e’ ratio was 8.36 (range: 4.71-22.00). There was a moderate strength and significant correlation between the wire crossing time and the E/e’ ratio (r = 0.572; p <0.001). Patients with E/e’ ratio >15 had significantly longer wire crossing time than in patient with E/e’ ratio ≤15 (20.21±2.5 hours vs. 11.41±4.39 hours; p <0.001; respectively). The wire crossing time was independently associated the E/e’ ratio (r = 0.463; p = 0.003).Conclusion: There was a moderate strength and significant positive correlation between the wire crossing time and increased LVEDP, an earlier marker of diastolic dysfunction, measured by E/e’ ratio using TTE in patients with STEMI underwent pPCI.
ST Elevation Myocardial Infarction in Young Women Caused by a Coronary Embolism Generated from Mitral Valve Disease: a Case Report Budi Yuli Setianto; Nahar Taufiq; Muhamad Taufik Ismail
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
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.17793

Abstract

Coronary emboli causing ST elevation myocardial infarction (STEMI) is a rare condition. Intracardiac thrombus generated by valvular disease is the most common source of intracoronary embolism and mitral stenosis is frequently affected by intraatrial thrombus. Therapeutic strategy of coronary embolism is challenging because there were still no recommendation regarding coronary embolism published to day. We reported A 25 years old woman was admitted to the emergency department because of STEMI with complication of acute pulmonary edema and cardiogenic shock, and recurrent cardiac arrest. Angiographically showed total occlusion of left main artery with thrombotic lesions. Unfortunately after unfractionated heparin (UFH) was given and performed catheter cannulation, thrombus run to distal part of left coconary artery. Procedure is stopped and then patient transferred to cardiac care unit, but death shortly after arrival. Transthroracic echocardiography revealed mild to mild-modertae mitral stenosis with severe regurgitation due to mitral valve prolaps, aortic regurgitation, and left atrial and ventricular dilatation with no thrombus or spontaneous echo contrast, and failed to fi nd thrombus with in atrium. The presence af atrial dilatation and aortic regurgitation increased risk of thrombosis, meanwhile mitral regurgitation were reported as protective factor of atrial thrombosis. The pathophysiology of arterial thrombus or whitethrombus involving platelet activation leads to double antiplatelets and GbIIb/IIIa inhibitior to be more cruciale in coronary embolism. Double antiplatelet dan UFH administration did not improve survival in these patients. So that further research was needed to make a consensus of therapy. Careful assessment of intracardiac thrombus and risk of thromboembolism were important to prevent systemic embolization.Keywords: STEMI, coronary embolism, mitral valve disease.
NSTEMI Presenting with Acute Pulmonary Edema with Culprit Lession Total Occluced Left Circumflex: a case report Budi Yuli Setianto; Nahar Taufiq; Heri Hernawan
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
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.17794

Abstract

Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the ECG to dichotomize patients into having ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI)/ Unstable Angina (UA) in order to rapidly triagepatients to receive reperfusion therapy. Left circumfl ex artery occlusion is often categorized as NSTEMI because of the absence of signifi cant ST elevation on the 12 standard ECG leads. ST elevation is the condition ‘sine qua non’ for diagnosing acute total coronary occlusion causing transmural infarction. However, ST elevation when there is circumfl ex artery occlusion is seen onthe 12 standard ECG leads in fewer than 50% of patients. We reported a 77 years old women who diagnosed with NSTEMI. Twelve lead ECG showed ST depressed in V2-V5. On angiography we found a totaly ocluded of left circumfl ex as culprit lession.Keywords: NSTEMI; culprit lession; total occlusion; left circumflex artery
Association Between Coronary Artery Lesion Severity and Erectile Dysfunction in Stable Coronary Heart Disease Patients Arif Bowo Kurniawan; Irsad Andi Arso; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 2, No 1 (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.17816

Abstract

Background: Atherosclerosis is the underlying process of coronary heart disease. Atherosclerosis is preceded by endothelial dysfunction caused by systemic mechanical and chemical stressors that may occur throughout the blood vessels. Recent studies have found the link incidence of atherosclerosis in the coronary arteries and other arteries as well. Erectile dysfunction (ED) is a clinical manifestation might be caused by atherosclerosis in iliac or pudendal artery. Previous studies have established the relationship between coronary artery involvement and the incidence of ED, but the odds of risk has not been well established. Methods: This was an age matched-paired case-control study. Erectile dysfunction in CHD patients who had undergone coronary angiography was checked by IIEF - 5 questionnaire. The severity of coronary artery lesion was assessed with a Syntax score from coronary angiography results. Moreover these results were assessed by a single experienced observer, blind method and were shown consistency test. Then, the risk of coronary artery lesion severity of the ED was analyzed by chi square test using SPSS version 20. Result: There were 86 subjects consist of 57 subjects in the case group and 29 subjects in thecontrol group. Stable CHD patients with high Syntax scores had 2.75 times risk for development of ED compare with low Syntax scores patients (OR : 2.75, 95 % CI : 1.08 to 6.95, p = 0.03). The severity of coronary artery lesions assessed with Syntax scores were not statistically signifi cant as an independent factor as the incidence of ED. Conclusion: Stable CHD patients with higher severity of lesions in coronary artery have a higher risk of erectile dysfunction than patients with lower severity of the lesion but was not statistically significant as an independent factor on the incidence of ED.Keywords: Severity of coronary artery lesions, erectile dysfunction, stable coronary heart disease
Right Heart Catheterization on Sinus Venosus Type of Atrial Septal Defect with Partial Anomalous Pulmonary Vein Drainage Pamrayogi Hutomo; Lucia Krisdinarti; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 2, No 1 (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.17820

Abstract

Atrial septal defect (ASD) is a non-cyanotic congenital heart disease characterized by the presence of defects on atrium septal wall. ASD is 10% of congenital heart disease. This defect is the third most common congenital heart disorder with an estimated incidence of 56 out of 100,000 live births. With the improved echocardiographic technique that can diagnose a defect in asymptomatic abnormalities, the estimated incidence is increased to 100 out of 100,000 live births. The disorder is more common in women than men with a ratio of male: female 1: 2.
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
Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry Dafsah Arifa Juzar; Akhtar Fajar Muzakkir; Yose Ramda Ilhami; Nahar Taufiq; Tri Astiawati; I Made Junior R A; Miftah Pramudyo; Andria Priyana; Afdhalun Hakim; Setyasih Anjarwani; Jusup Endang; Bambang Widyantoro
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1406

Abstract

Background Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. Methods IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. Results Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients. Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). Conclusion Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy.
Co-Authors Afdhalun Hakim Akhtar Fajar Muzakkir Andria Priyana Anggoro Budi Hartopo Anggoro Budi Hartopo Arif Bowo Kurniawan Bambang Widyantoro Budi Yuli Setianto Dafsah Arifa Juzar Hariadi Hariawan Heri Hernawan I Made Junior R A Indra Widya Nugraha Irsad Andi Arso Jusup Endang Lucia Krisdinarti Miftah Pramudyo Muhamad Taufik Ismail Pamrayogi Hutomo Setyasih Anjarwani Tri Astiawati Yose Ramda Ilhami