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Liemena Harold Adrian
Department of Cardiology and Vascular Medicine Medical Faculty of Universitas Brawijaya dr. Saiful Anwar General Hospital Malang, Indonesia

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Validation of Saiful Anwar Clinical Congestion Score in Comparison with NT-proBNP for Prediction of Short-term Outcome in Acute Heart Failure with Reduced Ejection Fraction Liemena Harold Adrian; Mohammad Saifur Rohman; Muhammad Rizki Fadlan; Cholid Tri Tjahjono; Anna Fuji Rahimah; Novi Kurnianingsih
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.2020.001.04.06

Abstract

Background : Risk stratification of acute heart failure (AHF) patient during hospital admission utilizing clinical scores emerges as an alternative to standart natriuretic peptide measurement. Development of Saiful Anwar clinical congestion score (SACS) as multivariable predictive model for prediction of short-term outcome in AHF with reduced ejection fraction (AHF-rEF) requires validation in comparison to NT-proBNP.Objective : To validate prognostic value of SACS compare with NT-proBNP in AHF-rEFMethod : This single-center, prospective cohort study was held in dr. Saiful Anwar General Hospital during January 2019 to June 2020. From total 89 AHF-rEF patients who admitted to emergency department, were assigned to SACS prospective questionnaire fulfillment and NT-proBNP measurement during first 12-hours since admission. Patients were divided into two groups based on SACS score and NT-proBNP value during admission. 90-days follow up was performed after index hospitalization with outcome of interest i.e all-cause mortality (ACM) and HF-related rehospitalization (HFR).Results : ACM and HFR rate in this study were 16.8% and 22.5%, respectively. SACS ≥6 demonstrated higher ACM and HFR rate during 90-days follow-up compared to SACS <6 (p=0.000; p=0.000, respectively). Performance of SACS ≥6 on admission showed good discriminative power for predicting 90-days ACM and HFR (AUC 0.841, p=0.000; AUC 0.788, p=0.000, respectively) compared to NT-proBNP ≥5000pg/mL (AUC 0.812, p=0.000; AUC 0.819, p=0.000, respectively). Additive value of NT-proBNP ≥5000pg/mL on top of SACS ≥6 increases discriminative power for predicting 90-days ACM and HFR after index hospitalization (AUC 0.836, p=0.000; AUC 0.90, p=0.000, respectively).Comclusion : SACS has demonstrated prognostic value compared to NT-proBNP for prediction of 90-days ACM and HFR after index hospitalization in AHF-rEF patients.
The Role of Colchicine in Acute Coronary Syndrome Liemena Harold Adrian; Budi Satrijo; Djanggan Sargowo; Indra Prasetya
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.2020.001.04.02

Abstract

Background: Despite the advances of current optimal treatment of atherosclerotic disease, the incidence of events after acute coronary syndrome (ACS) remains high. Colchicine, with its well-established pleiotropic anti-inflam- matory effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation. NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitated by cholesterol crystals that are present in all atherosclerosis stages. ???????????????????????????????????????? ???????????????????????????????????????? ???????? ???????????????????????????????????????????????????????????????? ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? cytokines are the crucial inflammatory pathway mediators that promote the formation of plaque and instability in the inflammatory cascade.Objective: This review will elaborate on the function of immune cells in atherosclerosis, explain the mechanisms of NLRP3 inflammasome activation in the context of AAI, and address the possible role of colchicine specifically targeting NLRP3 inflammasome and its concomitant downstream mediators in ACS, and provide an overview of current or ongoing studies produced in this area.Discussion : NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitat- ed by cholesterol crystals that are present in all atherosclerosis stages. Subsequent activation of pro-inflammatory ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? ???????????????????????????????????? ???????????? ???????????? ???????????????????????????? ???????????????????????????????????????????????? pathway mediators that promote the formation of plaque and instability in the inflammatory cascade. A potential advantage of a medication acting through an inflammatory milieu found in atherosclerotic lesions has recently become the need for novel therapeutic options. Colchicine, with its well-established pleiotropic anti-inflammato- ry effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation.Conclusion: Colchicine is a safe and reliable medication for ACS patients, alongside reveal various benefit in reducing inflammation through inhibition of NLRP3 Inflammasome`