Cholid Tri Tjahjono
Brawijaya Cardiovascular Research Center Department Of Cardiology And Vascular Medicine Faculty Of Medicine, Universitas Brawijaya Malang

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Kehamilan dengan Katub Jantung Prostetik Mekanik dan Penggunaan Antikoagulan Indriani, Anin; Rahardjo, Bambang; Tjahjono, Cholid Tri
Journal of Issues in Midwifery Vol 2, No 1 (2018)
Publisher : Journal of Issues in Midwifery

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.65 KB) | DOI: 10.21776/ub.JOIM.2018.002.01.2

Abstract

Wanita hamil yang menggunakan katub jantung prostetik mekanik, meningkatkan morbiditas dan mortalitas terhadap ibu dan janin. Heparin sangat aman bagi janin dibandingkan warfarin, namun memiliki efek antikoagulasi yang lebih rendah dibandingkan warfarin. Studi kasus ini melaporkan seorang wanita 39 tahun dengan katub jantung prostetik mekanik yang mengalami kehamilan setelah 2 tahun pemakaian. Selama kehamilan penderita menggunakan antikoagulan warfarin. pada usia kehamilan 5 minggu psien mengalami abortus iminens namun bisa diatasi. Pada usia kehamilan 22-24 minggu pasien mengalami serangan asma namun dapat diterapi dengan baik. Selanjutnya pasien menentukan cara persalinan perabdominam pada usia kehamilan 38 minggudilanjutkan dengan prosedur tubektomi. Hasil akhir dari tatalaksana yang digunakan, didapatkan outcome yang baik terhadap ibu maupun janin. Tidak didapatkan tanda–tanda embriopati akibat penggunaan warfarin pada trimester pertama. Dari studi kasus ini juga tampak bahwa warfarin cukup efektif untuk mencegah terjadinya tromboemboli pada ibu, dan pemakaian UFH dapat digunakan sebagai alternatif untuk persiapan persalinan.
Peran Mitokondria dalam Apoptosis Zulhaidah A, Maimun; Tjahjono, Cholid Tri
Jurnal Kedokteran Brawijaya Vol 18, No 2 (2002)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2339.228 KB)

Abstract

Apoptosis merupakan bentuk kematian fisiologis sel yang terprogram dimana secara morfologis dan biokimiawi berbeda dengan nekrosis, yang merupakan proses spontan dan tak terregulasi. Berbagai peristiwa kunci di dalam apoptosis melibatkan mitokondria dimana organela ini melepaskan protein-protein/molekul proapoptotik yang berperan di dalam mengaktifkan cascade apoptotik. Tiga mekanisme bagaimana mitokondria berperan di dalam apoptosis adalah, dengan menyebabkan gangguan transpor elektron dna metabolisme energi yang merupakan gambaran awal kematian sel; melepaskan protein-protein, antara lain sitokrom c (dilepaskan akibat adanyastimuli kematian), yang memicu aktifasi kaspase; dan dengan mengubah potensial oksidasi-reduksi seluler yang melibatkan peran anion superoksida yang banyak terdapat di dalam organella ini.
Sensitivitas Barorefleks pada Penderita Penyakit Jantung Koroner yang Menjalani Intervensi Koroner Perkutan Cholid Tri Tjahjono; Muhammad Munawar; RWM Kaligis; Idris Idham
Jurnal Kardiologi Indonesia Vol. 28, No. 6 November 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i6.207

Abstract

Background.Autonomic dysfunction contributes to incidence of ventricular arrhythmias and sudden cardiac death in patients with coronary artery disease (CAD). Revascularization, for example percutaneous coronary intervention (PCI), is intended to improve myocardial perfusion. Besides that, PCI is considered to improve autonomic dysfunction. This study is aimed at assessing baroreflex sensitivity (BRS) in patients with CAD before and after PCI.Methods. Patients with angiographically having coronary stenoses = 50% who underwent coronary angioplasty at the catheterization laboratorium of National Cardiovascular Center Harapan Kita, Jakarta, were included in this study. Baroreflex sensitivity was calculated by administering nitroglycerin 300 µg intra aortic before and after PCI.Results.Subjects comprise of 8 (42%) male and 11 (58%) female, aged 57.5 ± 9.3 year old. Most of subjects had dyslipidemia (57%), were smoker (42%), had hypertension (42%) and only 3 (16%) had diabetes mellitus. Nine (47%) of subjects had previous history of myocardial infarction. Medications suspected affecting baroreflex sensitivity, which were used by the time of study included nitrate (63%), beta-blockade (58%), and calcium antagonist (32%). Mean value of baroreflex sensitivity pre-PCI and post-PCI were 2,51+3,23 ms/mmHg and 1,96+1,61 ms/mmHg (p=0,412), subsequently. Multivariate analysis with logistic regression showed that nitrate has significant effect on decreased BRS soon after PCI (p=0,023; CI 95% 1,496-216,62;OR 18,00).Conclusion. In patients with Coronary Artery Disease, immediately after percutaneous coronary intervention, barorefelex sensitivity was decreased. Nitrate has significant effect on alteration of barorefelex sensitivity.
Comparison of Predicted Significant Coronary Lesion by Duke Treadmill Score among Coronary Heart Disease Risk Factors in Patients with Positive Ischemic Response Treadmill Test David Rubiyaktho; Cholid Tri Tjahjono
ACI (Acta Cardiologia Indonesiana) Vol 4, No 1 (2018)
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.36632

Abstract

Background: According to Framingham Study, independent risk factors for coronary heart disease (CHD) are diabetes, hypertension, smoking, dyslipidemia, family history of CHD and obesity. Previous study reported cut-off value of Duke Treadmill Score (DTS) < -0.5 represents a significant coronary lesion with positive predictive value 88.4%. Objective: To compare the incidence of predicted significant coronary lesions by DTS among various risk factors for coronary heart disease. Methods: A cross sectional study was done on 292 patients age 18 to 74 years old who had positive exercise testing for CAD screening during period of June 1st 2016 until May 30th 2017. DTS was calculated from treadmill test as: exercise time - (5 x ST deviation in mm) - (4 x exercise angina). A coronary lesion was predicted significant with DTS cut off value < -0.5. Results: Subjects mean age was 57 years old, male were 60.4%. The risk factors for CHD were found sequentially from the most frequent were hypertension 51.9%, smoking 35.3%, diabetes mellitus 23.1%, dyslipidemia 11.9%, obesity 4.2% and family history of CHD 6.3%. It was found that diabetes was significantly different from its effect on DTS value with p value = 0.021, while hypertension, obesity, dyslipidemia and family history CHD had no significant effect. Logistic regression found consistently that diabetes was significant (p=0.019). Conclusion: Predicted significant coronary lesions by DTS developed more frequent in diabetes compared to, hypertension, smoking, dyslipidemia, obesity and family history of coronary heart disease.
Increasing Age, Diabetes Mellitus and Beta Blocker Influence Heart Rate Recovery Values in Patients Undergoing Exercise Treadmill Test Adriyawan Widya Nugraha; Cholid Tri Tjahjono; Ardian Rizal
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (661.347 KB) | DOI: 10.22146/aci.44550

Abstract

Background: Heart disease is the number one cause of death globally. This disease is initiation affected by autonomic dysfunction which will cause disruption of the sympathetic-parasympathetic system. Heart Rate Recovery (HRR) is used to determineautonomic dysfunction.Objective: To determine the relationship of risk factors and cardiovascular treatment to HRR values of 1 minute and 2 minutes.Methods: Cross sectional study to measure HRR 1 and 2 minute undergoing exercise treadmill test for the screening of coronary heart disease in Saiful Anwar hospital in May 2016 until September 2017. Univariate analysis was performed to determine the frequency and proportion of HRR values classified into normal groups (HRR 1 minute > 12x / minute or HRR 2 minutes > 22x / minute) and abnormal groups (HRR 2 minutes ≤ 12x / minute or HRR 2 minutes ≤ 22x / minute).We also performed bivariate analysis using comparative test (Generalized Linear Model) and correlation test (Pearson, Spearman and Eta) and multivariate linear regression analysis.Results: This study found that age, hypertension and beta blocker were significantly associated with HRR abnormalities (p<0.05). HRR 1 and HRR 2 were significantly associated with diabetes mellitus (DM) (p=0.004 and p=0.039) and beta blocker (p=0.042 and p=0.039). Then looking at the relationship of multivariate correlations found a significant correlation between age (β=-0.133, p=0.000) and DM (β=-2.617, p=0.032) at 1 minute HRR and significant correlation with age (β=-0.165, p=0.004) and beta blockers (β=-2,947, p=0.017).Conclusion: increasing of age, diabetes mellitus and beta blockers correlate with decreasing of HRR. The most influential risk factors for HRR values of 1 minute were increasing age and DM, while for HRR values of 2 minutes were increasing age and beta blockers.
Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: Late is Better Than Not Done at All Hendrawati Hendrawati; Mohammad Saifur Rohman; Cholid Tri Tjahjono; Sasmojo Widito; Budi Satrijo; Yoga Waranugraha; Muhammad Rizki Fadlan
Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.03.5

Abstract

Background : For ST-segment elevation myocardial infarction (STEMI) patients, reperfusion through primary percutaneous coronary intervention (PCI) must be done to return the coronary arteries' blood flow. However, a large proportion of patients received late PCI. This study aimed to assess the impact of late PCI on the clinical outcomes of STEMI patients.Methods : A retrospective cohort study was conducted in Saiful Anwar General Hospital from January 2017 to April 2018. A total of 192 STEMI patients were divided into three groups: (1) on-time PCI; (2) late PCI; and (3) no PCI. The outcome measured included six months and 12 months of cardiovascular mortality and hospital readmission because of worsening heart failure and recurrent myocardial infarction (MI).Results: At six-month follow-up period, we found that hospital readmission was higher in the no PCI group (9.2% vs. 12.1% vs. 34.8%; p = 0.009). The recurrent MI (0% vs. 0% vs. 7.2%; p = 0.010) and worsening heart failure (6.2% vs. 8.6% vs. 33.3%; p < 0.001) was also higher in the no PCI group. On 12 months follow up period, the mortality (4.6% vs. 13.8% vs. 21.7%; p = 0.015) and hospital readmission (15.4% vs. 20.7% vs. 42%; p = 0.001) rate was higher in no PCI group. Hospital readmission because of worsening heart failure was also higher in no PCI group (9.2% vs. 17.2% vs. 37.7%; p = 0.015).Conclusion: Not performing revascularization was correlated with higher mortality and hospital readmission rate in STEMI patients. Late PCI was associated with better outcomes than not conducting revascularization.
Cardiomyopathy in Pregnancy: A Review Literature Ayu Asri Devi Adityawati; Anna Fuji Rahimah; Heny Martini; Cholid Tri Tjahjono
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.03

Abstract

AbstractBACKGROUND: Pregnancy is an experience that many women can achieve. Pregnancy is generally well tolerated in asymptomatic patients with cardiomyopathies but in restrictive form cardiomyopathy, pregnancy cannot be tolerated because of poor prognosis. Prior cardiac events, poor functional class (New York Heart Association class III or IV), or advanced left ventricular systolic dysfunction are present, the risk of maternal cardiac complications during pregnancy are markedly increased. Worsening of the clinical condition can occur during pregnancy, despite intensive medical treatment. Although the incident of cardiovascular disease is present 0.5-4% in developed countries, our knowledge about various of cardiomyopathy and pregnancy should be updateable.CONCLUSION: Our literature provide three types of cardiomyopathy in pregnancy with an example condition for each type that relevant during pregnancy. Peripartum cardiomyopathy is the most common form of cardiomyopathy occured in pregnancy therefore a thorough review is needed to give best outcome for pregnancy. Arryhtmia is the commonnest form in hypertrophic cardiomyopathy which need to be regularly monitored and measure should be taken if the arryhtmia is life threatening for mother and the child. Cardiac amyloidosis is the common form of restrictive cardiomyopathy in pregnancy.Keywords: Pregnancy; Cardiomyopathy; Peri Partum Cardio Myopathy (PPCM), Pregnancy, Heart Failure 
New Paradigm of Complete Revascularization in Acute Coronary Syndrome with Multivessel Coronary Artery Disease: Is it Reasonable in Clinical Practice? Adhika Prastya Wikananda; Mohammad Saifur Rohman; Novi Kurnianingsih; Cholid Tri Tjahjono
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.2

Abstract

Coronary artery disease is the leading cause of illness and death in older adults. Around 40% to 50% of patients with ST-segment elevation myocardial infarction (STEMI) have multiple coronary artery disease. Multiple vessel coronary disease has been shown to improve cardiac outcomes and survival in patients who have undergone complete revascularization (CR) versus patients who have undergone only incomplete revascularization (ICR). When coronary angiography and PCI of the source of the infarction are performed on patients with STEMI, the risk of adverse cardiac death or myocardial infarction is significantly reduced. Additional research is needed to determine the efficacy of PCI of non-critical lesions. However, following procedures such as CABG or PCI, these procedures may be impossible to perform due to a variety of personal, anatomical, technical, and logistical barriers. In this review, we discussed about benefit of complete revascularization in patient acute coronary syndrome (ACS) with multivessel disease and which patient can be performed aggressive revascularization to achieved CR in clinical practice.Keywords: complete revascularization, acute coronary syndrome, percutaneous coronary intervention
Community-based Cardiac Rehabilitation Improved Adherence to Medication, Quality of Life and Rehospitalization Among Stable Coronary Artery Patients: A Cohort Study Muchammad Dzikrul Haq Karimullah; Mohammad Saifur Rohman; Tonny Adriyanto; Cholid Tri Tjahjono; Sasmojo Widito
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (53.958 KB) | DOI: 10.21776/ub.hsj.2020.001.02.5

Abstract

Background : Community-based cardiac rehabilitation interventions have been known as an important aspect of secondary prevention. However, no data are available regarding the benefit of this program in Indonesian coronary artery disease (CAD) patients treated with optimal medication.Objectives : To assess the benefit of community-based cardiac rehabilitation on patient adherence to the drugs, quality of life (QoL) and MACE, in stable CAD.Methods : An observational prospective cohort study recruited the Malang community of cardiovascular care (MC3) members as an intervention group and Aisyah Islamic hospital patients in Malang, Indonesia, as a control, for a year follow up. Member of MC3 has regular aerobic exercise, education regarding the disease, the importance of the drugs, and its side effect in addition to standard education given in outpatient clinic setting as the control group members. A validated MMS-8, QOL (SF-36), and SAQ questionnaire were used to assess adherence to the drugs, QoL, and MACE of participants.Results: A total of 73 interventions and 73 control patients were enrolled for the study. Our findings showed that intervention patients were 2.04-fold associated with having a better physical function and 3.85-fold better compliance than control patients. The hospitalization rate also significantly lower in members of the intervention group (MC3). However, no significant difference observed among the two groups. Moreover, in the subgroup analysis, it shows that the intervention group who had participated for 2 years had the highest value of MMS-8 compared to the other groups with p < 0.005.Conclusion: Our study reveals that community based cardiac rehabilitation intervention have better adherence to medication and quality of life than patients control, and also could reduce rehospitalization in stable CAD patients.
Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction with Acute Kidney injury caused by Cardiogenic Shock, Is it Really Safe?; A Case Report Oktafin Srywati Pamuna; Mohammad Saifur Rohman; Setyasih Anjarwani; Cholid Tri Tjahjono
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.8

Abstract

BackgroundST-elevation myocardial infarction (STEMI) is a life-threatening condition. Timely treatment with Percutaneous Coronary Intervention (PCI) is a recommended management of STEMI. However, in STEMI condition accompanied by complications such as prolonged shock condition and become  Acute Kidney Injury (AKI), it is still a question of whether to be treated conservatively or invasively. If PPCI was an option, how to prevent the worsening outcome is still an issueCase IllustrationA 53 years old, woman, was referred from a private hospital with STEMI inferior Killip IV onset 5 hours with typical chest pain and azotemia with creatinine serum was 3.4 mg/dl; eGFR 15 ml/m/1.73m2. In the emergency room, she got hydration, inotropic, and planned for PPCI.  After the PPCI procedure, she was fallen into the altered mental status and then referred to our hospital. The GCS was E4V4M6; blood pressure was 118/62 mmHg (on dobutamine 10 mcg/kg BW/minutes and NE 0.3 mcg/kg BW/minutes), heart rate was 130 bpm, respiration rate was 20 times per minute, peripheral saturation was 98% on NRBM 10 liters per minute. The laboratorium result in our hospital showed a creatinine level was 1.6 mg/dl. We treated this patient for 9 days, with optimal medicamentosa and fluid therapy. There is an improvement in clinical presentation and physical examination on the last day of treatment, with urine output 1900 cc/24 hours, creatinin serum 0.8 mg/dl, and eGFR  84 ml/min/1.73m2.Conclusion Acute renal failure is a frequent complication in STEMI, leading to higher mortality, morbidity, and intrahospital complications. PPCI is a reperfusion strategy recommended by the guideline in the setting of myocardial infarction with cardiogenic shock. Proper management to prevent worsening of renal function in this condition is very important.    Keyword: acute kidney injury, cardiogenic shock, ST-elevation myocardial infarction
Co-Authors Adhika Prastya Wikananda Aditya Reza Pratama Adriyawan Widya Nugraha Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardani Galih Ardani Galih Prakosa Ardhani Galih Ardhani Galih Ardian Rizal Ardian Rizal Arif Wicaksono Aris Munandar ZI Ayu Asri Devi Adityawati Ayu Asri Devi Adityawati Bambang Rahardjo Budi Satrijo Budi Satrijo Budi Satrijo Budi Satrijo Budi Satrijo Budi Satrijo Dadang Hendrawan David Rubiyaktho Dedy Irawan Diah Ivana Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Dyah Ayu Ikeningrum Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Evit Ruspiono Evit Ruspiono Fahmy Rusnanta Fandy Hazzi Alfata Fandy Hazzy Alfata Hendrawati Hendrawati Heny Martini Heny Martini Heny Martini Heny Martini Heny Martini Hidayanti, Puji Astuti Nur Idris Idham Imelda Krisnasari Indra Prasetya Indra Prasetya Indriani, Anin Iskandar Iskandar Liemena Harold Adrian Mifetika Lukitasari Mohammad Ryan Ramadhan Mohammad Saifur Rohman Mohammad Saifur Rohman Mohammad Saifur Rohman Monika Sitio Muchammad Dzikrul Haq Karimullah Muhammad Abusari Muhammad Munawar Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Rizki Fadlan Ni Putu Frida Baskarani Novi Kurnianingsih Novi Kurnianingsih Novi Kurnianingsih Novi Kurnianingsih Novi Kurnianingsih Novi Kurniningsih Oktafin Srywati Pamuna Olivia Handayani Pawik Supriadi Puji Astuti Nur Hidayanti Ratna Pancasari RWM Kaligis Sasmojo Widito Sasmojo Widito Sasmojo Widito Sasmojo Widito Sasmojo Widito Sasmojo Widito Sasmojo Widito sawitri satwikajati Seprian Widasmara Setyasih Anjarwani Setyasih Anjarwani Setyasih Anjarwani Setyasih Anjarwani Tonny Adriyanto Tri Astiawati Valerina Yogibuana Swastika Putri Valerinna Yogibuana Swastika Putri Wira Kimahesa Anggoro Yoga Waranugraha Yordan Wicaksono Ashari Yusuf Arifin Zulhaidah A, Maimun