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All Journal Jurnal Kedokteran Brawijaya JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Journal of Issues in Midwifery Heart Science Journal CRJIM (Clinical and Research Journal in Internal Medicine) Journal of Nursing Science Update Journal of Community Health and Preventive Medicine (JOCHAPM)

Cholid Tri Tjahjono

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

Author-ID : 3606196

Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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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

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

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

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

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

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

Endovascular Stenting for Critical Limb Ischemia Patient with Superficial Femoral Artery Occlusive Disease: A Case Report Mohammad Ryan Ramadhan; Novi Kurnianingsih; Djanggan Sargowo; Cholid Tri Tjahjono
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

BACKGROUND: Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease (PAD), in the absence of intervention, may lead to lower extremity amputation or death. In cases where medical management is not effective or severe cases of PAD, endovascular and surgical interventions are indicated.2 Endovascular interventions become a first-line approach of CLI management and have advanced considerably within the past decade.1,3CASE DESCRIPTION: A 73-year old female with complain of left leg pain, accompanied with necrotic wound since 6 months ago. Duplex ultrasound showed no-flow from proximal to distal left superficial femoral artery (SFA). From CT-Angiography showed total occlusion from proximal left SFA to proximal poplitea artery about 7,2cm with collateral vessels. She was diagnosed with CLI left inferior extremity Fontaine IV Rutherford III. Angiography inferior extrimities was performed with total occlusion from proximal to distal left SFA with collateral vessels run to distal. We deployed a self-expanding stent with size 6mmx100mmx120cm at proximal-mid SFA. The patient showed improvement and was discharged after 5-days observationDISCUSSION: Patients with CLI have high risk of limb-loss without revascularization and high short term risk of cardiovascular events. Endovascular revascularization of femoro-popliteal occlusive offers lower initial risks than open surgery, with grade IIB-recommendation for lesion less than 25cm. Clinical success of endovascular stenting on CLI usually synonymous to limb salvageCONCLUSION:Favorable results can be achieved with endovascular stenting approach in patients with CLI, where close follow-up treatment afterwards can save limb loss.

Right-Sided Heart Failure Presentation in Severe Valvular Aortic Stenosis: How to Deal with Diuretic Use? Fahmy Rusnanta; Cholid Tri Tjahjono; Anna Fuji Rahimah; Heny Martini
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.2021.002.01.07

BACKGROUND: Patients with right-sided heart failure and severe aortic stenosis (AS) have many clinical challenges to overcome fluid retention. Typical diuretic therapeutic approach can be recommended for the guidance of removing fluid overload in severe AS with right ventricular (RV) failure. The aim of this case review is to understand how to assess and manage RHF and severe AS. CASE SUMMARY: A 65-year-old female with worsening bilateral leg swelling and she aware of shortness of breath for 3 months. Physical examination revealed a grade 3/6 ejection systolic murmur at the aortic area radiating to the neck, a grade 2/6 diastolic murmur at the pulmonic area, and a grade 3/6 systolic murmur at the apex radiating to the axilla, increased jugular venous pressure, prominent bilateral leg swelling, and minimal rhonci at the base of the lungs. The chest X-ray showed worsening cardiomegaly in the last 3 months. Echocardiography revealed high gradient severe valvular AS, decreased systolic RV function, and other valvular dysfunctions including moderate mitral regurgitation, moderate pulmonary regurgitation, and mild tricuspid regurgitation. She was introduced high dose furosemide infusion. The average urine output production was 5 L/day and negative fluid balance was 3 L/day. Furosemide dose was adjusted daily according to urine output production and she was discharged after 6 days hospitalization. DISCUSSION: This case report provides an example of RV failure in severe AS patient. Hemodynamic monitoring and typical approach of diuretic therapies should be needed in the management of fluid overload in severe AS. KEYWORDS: right-sided heart failure, severe aortic stenosis, diuretic.

Community-Based Cardiac Rehabilitation To Improves Medication Adherence in Stable Coronary Artery Disease Tonny Adriyanto; Cholid Tri Tjahjono; Mohammad Saifur Rohman; Sasmojo Widito; Ardian Rizal
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Cardiovascular disease contributes to 48% of deaths in the world. A cohort study at the Harapan Kita National Heart Center and 5 Indonesia hospitals in 2006 showed that the death rate due to heart disease in hospitals was around 6-12%. Rehospitalization rate reached 29% and the all-out expense of INA-CBG claimed for inpatient was Rp 42.4 trillion. The major problem causing rehospitalization was poor compliance to medication in coronary artery disease (CAD) patients. Education to improve compliance has been known not only reduced rehospitalization rate but also improve quality of life. In these review the author discussed the efficacy of community based cardiac rehabilitation for rehospitalisation reduction dan quality of life improvement.

Is There A Role of Glycated Hemoglobin for Predicting Major Ad- verse Cardiac Event in ST-Elevation Myocardial Infarction? Muhammad Abusari; Cholid Tri Tjahjono; Dadang Hendrawan; Yoga Waranugraha; Ayu Asri Devi Adityawati; Ratna Pancasari
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.2020.001.03.4

Background : Coronary Artery Disease (CAD) especially ST-Elevation Myocardial Infarction (STEMI) is the leading cause of mortality worldwide. Hyperglycemia and diabetes mellitus are both prevalent among patients with STEMI admitted to the hospital. Glycated hemoglobin (HbA1c) is a marker of glucose control.Objectives : We aimed to investigate the role of HbA1c as the predictor of major adverse cardiovascular events in STEMI patients.Methods : This was a retrospective cohort study. STEMI patients visiting Saiful Anwar General Hospital were registered. Patients were divided into three groups based on the HbA1c level <6.5%; 6.5-8.4% and ≥8.5%; respectively. The primary endpoint was in-hospital Major Adverse Cardiovascular Events (MACE), including cardiac death, recurrent myocardial infarction (MI), recurrent revascularization, acute pulmonary edema, cardiogenic shock, malignant arrhythmia, and stroke.Results: A total of 118 STEMI patients were included in this study, with distribution of 61 patients with HbA1c <6.5%, 25 patients with HbA1c 6.5-8.4%, and 31 patients with HbA1c ≥8.5%; respectively. The HbA1C level was associated with the history of diabetes mellitus (3.2% vs 36% vs 71%; p =0.000) and random blood glucose level at hospital admission (140.71 ± 39.67 mg/dL vs 172.96 ± 53.43 mg/dL vs 366.61 ± 169.67 mg/dL; p = 0.000). The MACE among three groups was not significantly different (17.7% vs 20% vs 35.5%; p=0,149). Conclusion: Our study reveals that the HbA1c level at hospital admission is associated with the history of diabetes mellitus and random blood glucose at hospital admission. However, HbA1c could not predict MACE in STEMI patients

When to Return for Usual Activity After ACS The Benefit of Cardiac Rehabilitation Cholid Tri Tjahjono
Heart Science Journal Vol 1, No 4 (2020): Acute Coronary Syndrome in Daily Practice : Diagnosis, Complication, and Managem
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.04.01

Cardiac rehabilitation (CR) can be managed as global long-term care and comprehensive risk reduction of cardiac patients based on preventive care through a professional multi-disciplinary integrated process approach.11 Multidisciplinary CR elements include: patient evaluations, physical activity counselling, exercise training, diet/nutritional counseling, psychosocial management, lipid management, smoking avoidance, management of weight, and regulation of blood pressure. Exercise training if begun at the post-ACS acute phase, would achieve its greatest beneficial effect on the process of LV remodeling in the dysfunctional LV and cardiopulmonary rehabilitation in patients after acute coronary syndrome. Cardiac rehabilitation (CR) can be managed as global long-term care and comprehensive risk reduction of cardiac patients based on preventive care through a professional multi-disciplinary integrated process approach

Co-Authors Adhika Prastya Wikananda Aditya Reza Pratama Adriyawan Widya Nugraha Anjarwani, Setyasih Anna Fuji Rahimah 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 Arif Wicaksono Aris Munandar ZI Ayu Asri Devi Adityawati Ayu Asri Devi Adityawati Bambang Rahardjo Budi Satrijo Budi Satrijo Budi Satrijo Dadang Hendrawan David Rubiyaktho Dedy Irawan Diah Ivana Djanggan Sargowo 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 Hidayanti, Puji Astuti Nur Idris Idham Imelda Krisnasari Indra Prasetya Indra Prasetya Indriani, Anin Iskandar Iskandar Liemena Harold Adrian Maimun Zulhaidah Arthamin Mifetika Lukitasari Mohammad Ryan Ramadhan 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 Kurniningsih Oktafin Srywati Pamuna Olivia Handayani Pawik Supriadi Puji Astuti Nur Hidayanti Ratna Pancasari RWM Kaligis Sasmojo Widito Sasmojo Widito Sasmojo Widito Sawitri Satwikajati sawitri satwikajati Seprian Widasmara Setyasih Anjarwani Setyasih Anjarwani Teguh Aryanugraha Titin Andri Wihastuti Titin Andri Wihastuti Tonny Adriyanto Tri Astiawati Valerina Yogibuana Swastika Putri Valerina Yogibuana Swastikaputri Valerinna Yogibuana Swastika Putri Wira Kimahesa Anggoro Yoga Waranugraha Yordan Wicaksono Ashari Yusuf Arifin Zainal Fathurohim Zulhaidah A, Maimun

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