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All Journal Heart Science Journal
Setyasih Anjarwani
Brawijaya University
Health Professions Immunology & microbiology Medicine & Pharmacology

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Acute Hemodynamic Index as a Predictor of In-Hospital Mortality in Mechanical Ventilated Acute Decompensated Heart Failure Patients Dea Arie Kurniawan; Setyasih Anjarwani; Ardian Rizal; Budi Satrijo; Valerinna Yogibuana
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.4

Abstract

Background: The likelihood of a poor clinical outcome is significantly increased in patients with acute decompensated heart failure. Mechanical ventilation was necessary for 23% of ADHF patients receiving treatment. The simple parameters of blood pressure and heart rate have good accuracy and repeatability. The development of the Acute Hemodynamic Index allowed for the calculation of pulse pressure and heart rate to be used as a basis for predicting intrahospital mortality.Methods: The medical records of patients who received care at CVCU RSSA were used in this retrospective, single-center study. ROC analysis and multivariate regression analysis were used to evaluate the prognostic performance of AHI. Statistical significance was determined by the P value of 0.05 or lower.Results: 252 patients with heart failure and low ejection fraction had their data analyzed. Hospital mortality is 82 percent. The cut-off was 4.19 mmHg/bpm, which was the AHI value. 68.8% of patients with fatal illnesses had low AHIs ( 4.19 mmHgbpm). AHI > 4.19 mmHgbpm patients have a 9-fold increased risk of dying in the hospital than patients with low AHI. AUC: 0.825 [0.743-0.907]; sensitivity: 0.814; specificity: 0.689; AUC: 0.825 [0.743-0.907; p = 0.000]; demonstrate the high predictive power of AHI.Conclusion: AHI has a strong degree of association with the likelihood of dying in the hospital from acute decompensated heart failure.
Early Management of Shock Condition in STEMI Patient Yudha Tria Nugraha; Setyasih Anjarwani; Budi Satrijo; Mohammad Saifur Rohman
Heart Science Journal Vol 4, No 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascula
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.9

Abstract

Background: Acute myocardial infarction is one of the emerging cardiovascular events worldwide. Infarcts of the inferior wall were present between one-third and half of the patients with RV involvement. The worse outcome was strongly associated with cardiogenic shock, and 7% of cases were caused by RV failure.Objective: This study aimed to describe the diagnosis and management of cardiogenic shock in STEMICase presentation: A male in his 40s was brought to our hospital 12 hours after the onset of persistent epigastric pain. He had a history of hypertension and a family history of diabetes Mellitus. Diagnostic procedures included blood tests, ECG, X-rays, coronary angiogram, and echocardiography. He underwent PCI to implant DES in his proximal RCA, which had 100% occlusion. The patient was admitted to the intensive cardiovascular care unit for 30 hours and died due to various complications.Conclusion: Current case was very complicated and seriously life-threatening. After acute myocardial infarction, Important problems kept coming up one after the other, and they all affected each other. Patients with cardiogenic shock must be found quickly and treated quickly and aggressively.
Neutrophil-Lymphocyte Ratio value as a predictor of Troponin Elevation in patients with Non-ST Segment Elevation Acute Coronary Syndrome Lutfi hafiz zunardi; Setyasih Anjarwani; Indra Prasetya; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.2

Abstract

Acute coronary syndrome (ACS) is a prominent contributor to mortality and morbidity on a global scale, consistently ranking within the top five primary causes. Inflammation is one of the many elements that have a role in the pathophysiology of the development and destabilization of plaque atherosclerosis in ACS. Troponin is a component of a biomarker that signals damage to the heart muscle in ACS patients; however, at the present time, not all medical facilities are able to perform troponin testing. An acute myocardial infarction begins with an initial inflammatory process that generates proinflammatory cytokines at the cellular level. This can be evaluated by the NLR through peripheral blood tests. The NLR as an indication of systemic inflammation has been demonstrated to be associated with poor clinical outcomes, an increased risk of complications, and mortality in ACS patients. In addition, several studies showed that the NLR has prognostic value in patients with ACS. The NLR is a mix of inflammatory markers, which can be a predictor of increased troponin in cases of non-ST segment elevation acute coronary syndrome (NSTEACS) in an emergency room.
The Relationship Between Cha2ds2-Vasc Scores And The Degree of TIMI Flow in Patients With Acute St-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention at Dr. Saiful Anwar Malang Bayu Aji; Sasmojo Widito; Setyasih Anjarwani; Novi Kurnianingsih; Evit Ruspiono
Heart Science Journal Vol 5, No 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.10

Abstract

Background: Suboptimal reperfusion of the compromised myocardium in the area of the culprit coronary arteries is one of the main problems associated with primary PCI that need reliable risk stratification methods to accurately predict the occurrence of decreased TIMI flow given its complex pathophysiology. Some parameters are included CHA2DS2-VASc score.Objective: To understand the relationship between CHA2DS2-VASc and the decreased TIMI flow in STE-ACS patients who had underwent primary PCI at RSUD dr. Saiful Anwar Malang.Material and Methods: The study was cohort retrospective with the inclusion criteria being all STE-ACS patients who underwent primary PCI in RSUD Dr. Saiful Anwar Malang from January 2018 – August 2023. Patients were assigned to TIMI flow grade <3 group (N =169) and TIMI flow grade 3 (N = 677) according to TIMI Flow degree after primary PCI. All the patient’s angiogram were evaluated for TIMI score and CHA2DS2-VASc score is based on a guideline. We concluded data in SPSS program and used the Spearman test and p value of .05 was considered as significant.Result: From a total sample of 846 patients, the correlation between STE-ACS onset and TIMI flow indicates that a higher number of patients with STE-ACS onset <12 hours was found in the TIMI flow <3 and 3 groups (p=0.000). The cutoff CHA2DS2 VASC score's sensitivity and specificity values were ascertained using ROC analysis with cut off value 2.5. The incidence of decreased TIMI flow rate was more significant in the CHA2DS2-VASc ≥3 group with DM (+) and age ≥64 (OR value 0.156, p=0.000) than in the CHA2DS2-VASc ≥3 group without DM and age < 64. With an OR value of 2.94 (p=0.000), Killip class > 2 is another powerful predictor of lower TIMI flow.Conclusion: The only variables in the CHA2DS2-VASc score component that are most strongly associated with the risk of reducing the degree of TIMI flow are DM, age, and Killip class.
Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room Lutfi Hafiz Zunardi; Setyasih Anjarwani; Indra Prasetya; Budi Satrijo; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.7

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. 
Effects of the Low-Dose Colchicine Regimen on Left Ventricular Adverse Remodeling and Systolic Function in Acute Myocardial Infarction Patients With Anterior ST Segment Elevation Undergoing Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial Fahreza Caesario; Indra Prasetya; Mohammad Saifur Rohman; Budi satrijo; Setyasih Anjarwani
Heart Science Journal Vol 5, No 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.9

Abstract

Background: Inflammation in reperfusion injury results in adverse ventricular remodeling and reduced systolic function. The anti-inflammatory effects of colchicine have shown beneficial effects in cardiovascular disease.Objective: To determine the effects of low-dose colchicine on left ventricular (LV) adverse remodeling and systolic function in acute myocardial infarction with anterior ST-segment elevation (anterior STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).Material and Methods: This prospective, randomized, double-blinded study randomly assigned anterior STEMI patients who underwent PPCI to receive either low-dose colchicine (1mg loading dose followed by 0.5mg daily) or a matching placebo for 30 days in addition to standard therapy. Outcomes included adverse LV remodeling and systolic function, determined by transthoracic echocardiography (TTE) in the first and third month.Result: Enrollment comprised 196 patients, with 92 patients in the colchicine group and 104 patients in the placebo group. Adverse LV remodeling and a decrease in systolic function were observed in both groups. No significant differences in LV remodeling were observed between the colchicine and placebo groups, as indicated by the change in LV end-systolic volume index (LVESVI) at the first month (16.5% vs. 18.25% [p=0.091]) and third month (19.5% vs. 21.5% [p=0.124]). Similar results were found in LV systolic function between the colchicine and placebo groups, with a reduction in LV ejection fraction (LVEF) observed in the first month (6.3% vs. 8.95% [p=0.083]) and third month (9.5% vs. 11.5% [p=0.163]). Diarrhea was the only reported side effect, occurring in 6.5% of patients in the colchicine group.Conclusion: Low-dose colchicine administration in anterior STEMI patients undergoing PPCI did not reduce LV adverse remodeling or systolic function.
Validation of Self-Assessment-Based Chest Pain Algorithm (DETAK) as An Early Identification Tool for Acute Coronary Syndrome Krishna Ari Nugraha; Mohammad Saifur Rohman; Anna Fuji Rahimah; Setyasih Anjarwani; Ardian Rizal; Tri Astiawati; Andi Wahjono Adi; Lina Haryati
Heart Science Journal Vol 4, No 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac C
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.5

Abstract

BackgroundThe most common reason of prehospital delay in ACS patients is inability to pay attention to symptoms in order to act fast and effectively. Patient oriented machine learning algorithms has the opportunity to reduce the total ischemic time, that determines the clinical outcome of ACS patients.AimAssessing the accuracy of the chest pain self-assessment algorithm (DETAK) in identifying ACS.MethodThis study included seven hospitals, five PCI capable hospitals and two of non-PCI capable hospitals. The study was conducted from August 2021 to June 2022. The study included all patients with chest pain who visited the hospital and used the DETAK algorithm. Patients were interviewed after being confirmed hemodynamically stable. Patients with UAP, as well as those who died or declined to participate in this study were excluded. The area under the curve receiver operating characteristic (AUROC) was used to verify DETAK's performance in identifying SKA. We compare the DETAK algorithm's diagnosis with the definitive diagnostic based on ECG and/or troponin results.ResultsA total of 539 patients (mean age 58 years) with a higher proportion of male patients (n=424). An AUC value of 0.854 was obtained, where the cut of point accuracy of DETAK in identifying ACS for the entire sample had a sensitivity of 89.5% and a specificity of 81.2%. The algorithm's specificity decreased in certain subgroups, including type 2 diabetes (79.4%), women (77.3%), and hypertensive patients (80.9%). Algorithm reliability test obtained moderate to strong level of agreement values.ConclusionDETAK's self-assessment-based chest pain algorithm offers an excellent diagnostic performance in early identification of ACS.
Co-Authors Andi Wahjono Adi Anita Surya Santoso Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardian Rizal Ardian Rizal Ayu Asri Devi Adityawati Bayu Aji Budi satrijo Budi Satrijo Budi Satrijo Budi Satrijo Cholid Tri Tjahjono Dea Arie Kurniawan Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Evit Ruspiono Fahmy Rusnanta Fahreza Caesario Heny Martini Imelda Krisnasari Indra Prasetya Indra Prasetya Indra Prasetya Indra Prasetya Iskandar Iskandar Krishna Ari Nugraha Krishna Ari Nugraha Lina Haryati Lutfi Hafiz Zunardi Lutfi hafiz zunardi Mohammad Saifur Rohman Mohammad Saifur Rohman Muhammad Rizki Fadlan Muhammad Rizki Fadlan Novi Kurnianingsih Oktafin Srywati Pamuna Olivia Handayani Putri Annisa Kamila Salvatore Di Somma Sasmojo Widito Tri Astiawati Valerinna Yogibuana Valerinna Yogibuana Swastika Putri Yoga Waranugraha Yoseph Budi Utomo Yudha Tria Nugraha