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All Journal Heart Science Journal
Dea Arie Kurniawan
Brawijaya University
Health Professions Immunology & microbiology Medicine & Pharmacology

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Premature Coronary Artery Disease in Young Male Patient with Strong Family History Dea Arie Kurniawan; Mohammad Saifur Rohman; Anna Fuji Rahimah; Budi Satrijo
Heart Science Journal Vol 3, No 1 (2022): Assesment and Outcome of Coronary Artery Disease in the Reperfusion Era
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.01.8

Abstract

BACKGROUND: Coronary artery disease (CAD) occurring in less than 45 years of age is termed as premature CAD (PCAD). Recent studies showed a prevalence of 4-10 % of PCAD. PCAD is associated with unfavorable outcomes for the patients and had a greater impact on the quality of life. Family History is the best method to explained complex interaction between shared risk factor.CASE ILLUSTRATION: A 37-years old male admitted to Saiful Anwar Hospital for further evaluation of anginal pain. The patient complains of recurrent chest pain since 5 months ago but still relieved by rest. The electrocardiogram showed Wellens Type B which is specific for critical stenosis of the left anterior descending artery (LAD). Then the patient undergoing DCA Ad Hoc. The implantation of a 46 mm DES at proximal until distal LAD was performed. The patient discharged after a day observation.DISCUSSION: The challenging point, in this case, was it happen at a young age with strong family history. There was positive family history of PCAD in 1st degree relative on her brother and mother, despite several risk factors were identified in this case consist of smoking, and dyslipidemia, which make CAD risk higher. Despite adequate control of risk factors, family screening is important to reveal subclinical atherosclerosis.CONCLUSION: Approach to a patient with PCAD comprises of management of traditional risk factors and careful investigation of Family History. Individual with positive family history of PCAD should be treated more cautiously
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.
Acute Decompensated Heart Failure: Current Role of Diuretics and Ultrafiltration Dea Arie Kurniawan; Indra Prasetya; Sasmojo Widito; Heny Martini
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.2023.004.01.2

Abstract

Acute decompensated heart failure (ADHF) continues to be the leading cause of hospitalization and has a poor prognosis. Loop diuretic had been long used as cornerstone therapy for congestion and volume overload. However, several factors including diuretic resistance and declining renal function reduced the loop diuretic's effectiveness, necessitating a different treatment strategy. In ADHF, ultrafiltration (UF) could be a promising method to volume management. UF appears to be more effective at removing fluid than diuretics, according to several studies, with better quality of life and lower rehospitalization. This review highlights the current state of knowledge regarding the use of diuretics and UF in ADHF patients, as well as the challenges and questions raised associated with each approach.
Co-Authors Anna Fuji Rahimah Ardian Rizal Budi Satrijo Budi Satrijo Heny Martini Indra Prasetya Mohammad Saifur Rohman Sasmojo Widito Setyasih Anjarwani Valerinna Yogibuana