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Dadang Hendrawan
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia.

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Do Myocardial Blush Grade Following Chronic Total Occlusion Recanalization Improve Clinical Outcome of Chronic Coronary Syndromes Patients? Ikhwan Handirosiyanto; Mohammad Saifur Rohman; Dadang Hendrawan; Djanggan Sargowo; Yoga Waranugraha; Fahmi Rusnanta; Ardhani Galih Prakoso
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.2020.001.03.6

Abstract

Background : Myocardial blush grade (MBG) is an angiographic parameter to describe the adequacy of myocardial reperfusion. The correlation between myocardial blush and the clinical outcome following chronic total occlusion (CTO) recanalization is still unclear. Our study aimed to investigate the impact of myocardial blush after CTO recanalization on the clinical outcome of CCS patients.Design : A retrospective cohort study was conducted. Patients who underwent CTO recanalization were divided into two groups based on the myocardial blush. Patients were classified as having good myocardial blush (MBG category 2 to 3 or QUBE 0 to 10.2) and poor myocardial blush (MBG category 0 to 1 or QUBE 10.2 to 36.4). The outcome measured was the improvement of angina measured using the Seattle Angina Questionnaire (SAQ) and the reduction of antianginal drug regimens.Results : The follow-up period was ranging from 2 to 24 months following the CTO recanalization procedure. The SAQ for physical limitation (83.86 ± 16.11 vs. 77.92 ± 3.44; p = 0.247), angina frequency (85.27 ± 17.44 vs. 74.76 ± 22.05; p = 0.105), and quality of life (73.24 ± 3.41 vs. 72.82 ± 3.56; p = 0.932) between the two groups was not significantly different. Good myocardial blush was not correlated with the reduction of antianginal drug regimens (10 (52.6) vs. 8 (40); p = 0.639).Conclusion : Myocardial blush post-CTO recanalization was not associated with the improvement of angina symptoms and the reduction of antianginal drug regimens among patients with CCS.
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

Abstract

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
The Role of STEMI Communication Network in Malang with Major Adverse Cardiac Event (MACE) Incidence in STEMI Patients Hospitalized in Saiful Anwar General Hospital Malang Adhika Prastya Wikananda; Lenny Kartika; Dadang Hendrawan; Heny Martini; Mohammad Saifur Rohman
Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.04.3

Abstract

Background: Patient with STEMI requires urgent reperfusion either with fibrinolytic or primary PCI. In Malang, a communication network of STEMI has been developed. It connects Saiful Anwar General Hospital with all of the PHC in Greater Malang to shorten system delay since 2015.Objective: To elucidate Malang’s communication network’s role in decreasing MACE (Major Adverse Cardiac Event) in STEMI patients.Methods : This is a retrospective cohort study. Study sample was taken from medical record. Non-network: 96 patients and 88 network patients. Statistical tests using SPSS and PLS, α value 0.05 and t-test is significant if more than 1.96.Results: Bivariate analysis shows network-group has a significantly lower MACE (p=0.001). Door-to-balloon time is also lower in network-group (p=0.026). Multivariate analysis without confounder shows that network-group has significantly shorter door-to-reperfusion time (p=0.032) and lower MACE (p=0.035) compared to non-network group. But multivariate analysis with confounder door-to-balloon and door-to-needle fails to explain lower MACE incidence. Network-group (p=0.005) and reperfusion with primary PCI (p=0.05) significantly decrease MACE incidence.Conclusion: Malang’s STEMI communication network and reperfusion with primary PCI reduce MACE in STEMI patients in Saiful Anwar General Hospital Malang.
The Effect of Add-on Garcinia mangostana L. Extract on Endothelial Dysfunction in Type 2 Diabetes Mellitus Subjects with High Risk Framingham Score: A Cohort Study Olivia Handayani; Djanggan Sargowo; Mohammad Saifur Rohman; Budi Satrijo; Cholid Tri Tjahjono; Dadang Hendrawan
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.406 KB) | DOI: 10.21776/ub.hsj.2020.001.01.5

Abstract

Background : Garcinia mangostana L. has been extensively used for years as antioxidant and anti-inflammation. However, its role in the context of endothelial disease was lacking.Objectives : To assess the effect of add-on G. mangostana L. extracts on endothelial dysfunction in type 2 diabetes subjects with high-risk Framingham score, compared to placebo.Methods : This was a prospective cohort study conducted in type 2 diabetes subjects with high-risk Framingham score. Subjects were randomized into two groups. The first group received 2,520 mg/day of G. mangostana L. extract. The second group was given a placebo for 90 days. The outcome measure of our study was the levels of endothelial progenitor cell (EPC), circulating endothelial cell (CEC), nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), Superoxide dismutase (SOD) and fasting blood glucose. Multiple linear regression was used to determine the correlation and effect estimate.Results: A total of 49 patients were included in our study. Of those, elevated levels of EPC and SOD were observed in treatment group compared to placebo. On the other hand, the level of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c was found significantly lower than placebo.Conclusion: Garcinia mangostana L. extract is associated with an increased levels of EPC and SOD, and it is also correlated with a decreased levels of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c.