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OVERVIEW CHARACTERISTICS AND P2Y12 REACTIVITY UNIT (PRU) VALUES OF ACUTE CORONARY SYNDROME AGE PRODUCTIVE PATIENTS WITH CLOPIDOGREL THERAPY ., Rahmatini; Aliska, Gestina; Syafri, Masrul
Jurnal Ilmu Kesehatan dan Kesehatan Vol 1 No 1 (2017): FEBRUARY
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/mhsj.v1i1.612

ABSTRACTBackground: Ischemic heart disease is the leading cause of death and disability in the world with a fairlyhigh portion coming from countries Low- and Middle-Income (LMICs). In Pakistan, 54% patients acutecoronary syndrome (ACS) was resistant to clopidogrel, and no data on clopidogrel resistance on ethnicMinang. This study aims to look at the characteristics and P2Y12 Reactivity Unit (PRU) from ACS patientsin Dr. M. Djamil Hospital, Padang. Methods: This research is a cross sectional study. The effectiveness ofclopidogrel on platelet reactivity identified through examination of PRU value using VerifyNow® with a cutoff point is 208. From the PRU values, it can be classified whether patients resistant or responsive. The studywas conducted in September 2016. Result: From 14 patients with ACS who received clopidogrel, 11 patients(78.57%) are male with 3 female patients (21.43). The mean of age was 53.78 years old. Patients mostlycame from West Sumatra provinces (92,85%) and 7,15% from others. From all of patients head risk factorsof coronary arterial disease. Hipertension was the greatest risk factor. Conclusion: It can be concluded thatmost of the patients were male. From PRU data, 7 patients (50%) were resistant and 7 patients (50%) wereresponse to clopidogrel. Further research is needed with larger numbers of patients and investigatepharmacogenetic profile of CYP2C19 as caused of resistance.

OVERVIEW CHARACTERISTICS AND P2Y12 REACTIVITY UNIT (PRU) VALUES OF ACUTE CORONARY SYNDROME AGE PRODUCTIVE PATIENTS WITH CLOPIDOGREL THERAPY Rahmatini .; Gestina Aliska; Masrul Syafri
Jurnal Ilmu Kesehatan dan Kesehatan Vol 1 No 1 (2017): FEBRUARY
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/mhsj.v1i1.612

ABSTRACTBackground: Ischemic heart disease is the leading cause of death and disability in the world with a fairlyhigh portion coming from countries Low- and Middle-Income (LMICs). In Pakistan, 54% patients acutecoronary syndrome (ACS) was resistant to clopidogrel, and no data on clopidogrel resistance on ethnicMinang. This study aims to look at the characteristics and P2Y12 Reactivity Unit (PRU) from ACS patientsin Dr. M. Djamil Hospital, Padang. Methods: This research is a cross sectional study. The effectiveness ofclopidogrel on platelet reactivity identified through examination of PRU value using VerifyNow® with a cutoff point is 208. From the PRU values, it can be classified whether patients resistant or responsive. The studywas conducted in September 2016. Result: From 14 patients with ACS who received clopidogrel, 11 patients(78.57%) are male with 3 female patients (21.43). The mean of age was 53.78 years old. Patients mostlycame from West Sumatra provinces (92,85%) and 7,15% from others. From all of patients head risk factorsof coronary arterial disease. Hipertension was the greatest risk factor. Conclusion: It can be concluded thatmost of the patients were male. From PRU data, 7 patients (50%) were resistant and 7 patients (50%) wereresponse to clopidogrel. Further research is needed with larger numbers of patients and investigatepharmacogenetic profile of CYP2C19 as caused of resistance.

Gambaran Tekanan Darah pada Pasien Sindrom Koroner Akut di RS Khusus Jantung Sumatera Barat Tahun 2011-2012 Meidiza Ariandiny; Afriwardi Afriwardi; Masrul Syafri
Jurnal Kesehatan Andalas Vol 3, No 2 (2014)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v3i2.85

AbstrakPenyakit jantung koroner merupakan penyakit degeneratif dengan permasalahan yang serius karena prevalensinya yang terus meningkat. Keadaan yang mengkhawatirkan dari penyakit jantung koroner adalah pada fase akut atau disebut dengan sindrom koroner akut. Salah satu faktor yang menyebabkan terjadinya sindrom koroner akut adalah tekanan darah yang tinggi yang mengakibatkan pecahnya plak aterosklerotik. Penelitian bertujuan untuk mengetahui gambaran tekanan darah pada pasien sindrom koroner akut di RS Khusus Jantung, Sumatera Barat dan mengetahui jenis hipertensi yang terjadi. Penelitian dilakukan dengan mengambil data sekunder yaitu data tekanan darah awal masuk rumah sakit pada pasien sindrom koroner akut di RS Khusus Jantung, Sumatera Barat pada bulan Maret-April 2013. Penelitian ini merupakan studi deskriptif observasional dengan total sampling. Analisis data yang dilakukan adalah analisis univariat. Hasil penelitian dari 145 data ditemukan bahwa hipertensi (tekanan darah tinggi) sebanyak 88 pasien (61%), prehipertensi sebanyak 33 pasien (23%), dan normotensi sebanyak 24 pasien (16%), dengan jenis hipertensi yaitu hipertensi kombinasi sebanyak 53 pasien (60%), hipertensi sistolik sebanyak 20 pasien (23%) dan hipertensi diastolik sebanyak 15 pasien (17%). Kelompok usia yang terbanyak yaitu usia 46-55 tahun (30%) diikuti kelompok usia 66-75 tahun (25%), 56-65 tahun (24%), >76 tahun (10%), 36-45 tahun (0,8%), dan < 35 tahun (0,2%) dengan jenis kelamin laki-laki sebesar 74% dan perempuan sebesar 26%. Kesimpulan dari hasil penelitian adalah gambaran tekanan darah pada pasien sindrom koroner akut yang terbanyak yaitu hipertensi dengan jenis hipertensi kombinasi. Kelompok usia terbanyak yaitu usia 46-55 tahun dengan jenis kelamin laki-laki.Kata kunci: tekanan darah, hipertensi, sindrom koroner akutAbstractCoronary heart disease is a degenerative disease. It becomes serious because the prevalence continues increase. The worst condition is the acute phase which is called acute coronary syndrome. The high blood pressure is one of the risk factors of acute coronary syndrome because it lead atherosclerotic plaques ruptured. This research aims is to describe the blood pressure and the type of hypertension in patients with acute coronary syndromes in The Heart Hospital, West Sumatera. This research took the secondary data of admission blood pressure in patients hospitalized with acute coronary syndrome in The Heart Hospital, West Sumatera, March - April 2013. This research is an observational descriptive study with a total sampling. Data analysis was performed univariate analysis. The results of 145 data were 88 patients (61%) had hypertension (high blood pressure), 33 patients (23%) were prehypertension, and 24 were normotensive (16%). The type of hypertension were 53 patients with combination hypertension (60%), 20 patients with systolic hypertension (23%) and 15 patients with diastolic hypertension (17%). Based on the age classification of hypertension, found that 46-55 years were 30%, 66-75 years were 25%, 56-65 years were 24%, > 76 years were 10%, 36-45 years were 0.8%, and < 35 years were 0.2%. based on gender classification of hypertension found that male gender were 74% and women were 26%. The conclusion of this research find that the largest blood pressure in patients with acute coronary syndromes is hypertension, the largest type of hypertension is combination hypertension, the largest age classification is 46-55 years, and the largest gender classification is male.Keywords:blood pressure, hypertension, acute coronary syndrome

Gambaran Profil Lipid pada Pasien Sindrom Koroner Akut di Rumah Sakit Khusus Jantung Sumatera Barat Tahun 2011-2012 Fitri Zahara; Masrul Syafri; Eti Yerizel
Jurnal Kesehatan Andalas Vol 3, No 2 (2014)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v3i2.74

AbstrakPenyakit kardiovaskuler merupakan penyebab kematian nomor satu secara global. Salah satu penyakit kardiovaskuler itu adalah Sindrom Koroner Akut (SKA) yang merupakan keadaan gawat darurat dari Penyakit Jantung Koroner (PJK). Salah satu faktor risiko SKA adalah perubahan dari kadar fraksi lipid yaitu kolesterol total, kolesterol LDL, kolesterol HDL, dan trigliserida yang dikaitkan dengan pembentukan plak aterosklerosis. Penelitian ini bertujuan untuk mengetahui gambaran profil lipid pada pasien SKA di rumah sakit khusus jantung Sumatera Barat tahun 2011-2012. Telah dilakukan penelitian deskriptif dengan bentuk cross sectional study dan pendekatan retrospective menggunakan data rekam medik mengenai hasil pemeriksaan profil lipid (kolesterol total, HDL, LDL, dan trigliserida) di rumah sakit khusus jantung Sumatera Barat untuk mengetahui gambaran profil lipid pada pasien SKA tahun 2011-2012. Hasil penelitian ini menemukan 98 kasus SKA. hasil ini menunjukkan bahwa pasien SKA dengan kadar kolesterol total tinggi adalah 44 orang (44,9%) dan normal sebanyak 54 orang (55,1%), pasien SKA dengan kadar kolesterol HDL rendah adalah 63 orang (64,3%) dan normal sebanyak 35 orang (35,6%), pasien SKA dengan kadar kolesterol LDL tinggi adalah 44 orang (44,9%) dan normal sebanyak 54 orang (55,1%), dan pasien SKA dengan kadar trigliserida tinggi adalah 21 orang (21,4%) dan normal sebanyak 77 orang (78,6%). Kejadian SKA terbanyak adalah STEMI sebanyak 51 kasus (52%), kemudian NSTEMI sebanyak 24 kasus (24,5%) dan yang paling sedikit adalah angina pektoris tak stabil sebanyak 23 kasus (23,5%) frekuensi umur terbanyak dari pasien SKA adalah 40-59 tahun, jenis kelamin terbanyak dari pasien SKA adalah laki-laki sekitar 74,5%. Penelitian menunjukkan jumlah bahwa pasien SKA yang memiliki kadar kolesterol total yang tinggi lebih sedikit daripada yang normal, kadar kolesterol HDL yang rendah lebih banyak daripada yang normal, kadar kolesterol LDL yang tinggi lebih sedikit daripada yang normal, kadar trigliserida yang tinggi lebih sedikit daripada yang normal, kasus SKA terbanyaKata kunci: Sindrom Koroner Akut, kolesterol total, kolesterol LDL, kolesterol HDL, trigliseridaAbstractCardiovascular diseases are the number one cause of death globally. One of the cardiovascular disease is Acute Coronary Syndrome (ACS) which is a state of emergency from Coronary Heart Disease (CHD). One of the risk factors for ACS is a change in the levels of lipid fractions such as total cholesterol, LDL Cholesterol, HDL Cholesterol and triglycerides which are associated with the formation of atherosclerotic plaque. This study aims to determine description of lipid profile in patients with acute coronary syndrome at the heart hospital of west sumatera 2011-2012. Descriptive research has been conducted with a a cross-sectional study and a retrospective approach using medical record about the result of lipid profile test (total cholesterol, HDL, LDL, and triglycerides) at the heart hospital of West Sumatera to describe the lipid profile in patients with ACS in 2011-2012. The results of this study found 98 cases of ACS. It showed that ACS patients with high total cholesterol levels are 44 people (44,9%) and normal are 54 people (55,1%), acute coronary syndrome patients with low levels of HDL cholesterol are 63 people (64,3%) and normal are 35 people (35,6%), acute coronary syndrome patients with high levels of LDL cholesterol are 44 people (44,9%) and normal are 54 people (55,1%), acute coronary syndrome patients with high levels of triglyceride are 21 people (21,4%) and normal are 77 people (78,6%), the highest incidence of SKA is STEMI with 51 cases (52%), then NSTEMI with 24 cases (24,5%) and the lowest incidence is unstable angina pectoris with 23 cases (23,5%), most age of the patients of ACS are 40-59 years old, the most gender of ACS are male about 74,5%. Research shows that the number of ACS patients who have a high level of total cholesterol are less than normal, low levels of HDL cholesterol are more than normal, high level of LDL cholesterol are less than normal, high level of triglyceride are less than normal, most incidens of ACS is STEMI then NSTEMI and the lowest is unstable angina pectoris, most age of ACS patients are 40-59 years, and most of gender are men.Keywords:acute myocardial infarction, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride

Hubungan Kadar Gula Darah saat Masuk Rumah Sakit dengan Jenis Sindroma Koroner Akut di RS Dr. M. Djamil Padang Willy Valerian; Masrul Syafri; Zelly Dia Rofinda
Jurnal Kesehatan Andalas Vol 4, No 2 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i2.267

AbstrakSindrom Koroner Akut (SKA) merupakan spektrum dari penyakit arteri koroner yang tidak stabil, mulai dari angina pektoris tidak stabil sampai infark miokardium. SKA terbagi atas Unstable Angina Pectoris (UAP), ST elevation myocardial infarction (STEMI), Non-ST elevation myocardial infarction (NSTEMI). Tujuan penelitian ini adalah untuk menentukan hubungan antara kadar gula darah saat masuk rumah sakit dan jenis SKA. Metode penelitian yang digunakan adalah cross sectional. Penelitian dilakukan di Instalasi Rekam Medik RS Dr. M. Djamil Padang dengan mengambil data pasien SKA dari Januari 2012 sampai Desember 2012. Hasil penelitian ini didapatkan jenis SKA dengan gula darah yang tidak normal dari 60 sampel, yaitu: UAP 25%, NSTEMI 35%, STEMI 40%. Hasil pengolahan data dapat dilihat bahwa nilai p = 0,592 yang artinya tidak terdapat hubungan yang bermakna antara kadar gula darah saat masuk rumah sakit dengan jenis SKA. Hal ini terjadi mungkin karena terlalu sedikitnya sampel dan banyak sampel kriteria ekslusi dalam pencarian data. Sebaiknya dalam penelitian yang akan datang dapat memperbanyak sampel.Kata kunci: sindrom koroner akut, kadar gula darah, hubungan kadar gula darah dengan SKA AbstractAcute Coronary Syndrome (ACS) is a spectrum of coronary artery disease that is not stable, ranging from unstable angina to myocardial infarction. Acute Coronary Syndrome is divided into Unstable Angina Pectoris (UAP), ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI). The objective of this study was to determine the relationship between blood sugar levels when admitted to hospital and Acute Coronary Syndrome type by using cross sectional study. The study was conducted at the Medical Records RS Dr. M. Djamil Padang. The ACS data collected from January 2012 until December 2012. The results of this study was found the SKA with abnormal blood sugar of 60 samples, i.e. UAP25%, NSTEMI35%, 40% STEMI. On the results of data processing can be seen that the value of p=0.592, which means there is no significant correlation between blood sugar levels upon hospital admission and the type of SKA. No relationship because of little samples and exclusion criteria. The further study has to used more samples.Keywords: acute coronary syndrome, blood sugar levels, blood sugar relationship with acute coronary syndrome

Hubungan antara Kadar Troponin T dengan Luas Infark Miokard yang Diukur dengan Menggunakan Metode Skoring QRS Selvester pada Pasien Infark Miokard Akut Muhammad Lingga Primananda; Masrul Syafri; Malinda Meinapuri
Jurnal Kesehatan Andalas Vol 5, No 3 (2016)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v5i3.562

AbstrakDalam kriteria diagnosis IMA oleh WHO salah satunya apabila ditemukan peningkatan kadar enzim jantung. Troponin T merupakan salah satu enzim jantung yang akan meningkat apabila terjadi kerusakan sel miokardium. Tujuan penelitian ini adalah menentukan hubungan antara kadar Troponin T dan luas infark miokard yang diukur dengan metode skoring QRS Selvester. Ini merupakan penelitian analitik dengan desain cross sectional yang dilaksanakan dari Oktober 2013 sampai September 2014 di Subbagian Rekam Medis RS Khusus Jantung YJI Cabang Utama Sumatera Barat. Analisis data menggunakan uji Kolmogorov-Smirnov dengan p ≤ 0,05 jika bermakna. Sampel penelitian adalah data rekam medis semua pasien dengan diagnosis IMA di RS Khusus Jantung YJI Cabang Utama Sumatera Barat periode Juli 2013 – Juni 2014 yang diambil dengan teknik total sampling. Penyeleksian data menghasilkan 81 data pasien dengan diagnosis IMA dan 37 data yang memiliki hasil pemeriksaan troponin T dan EKG. EKG digunakan untuk menentukan luas infark dengan menggunakan metode skoring QRS Selvester dengan hasil luas infark rendah, sedang, dan tinggi. Hasil penelitian menunjukkan tidak terdapat hubungan yang signifikan antara kadar Troponin T dengan luas infark pada pasien IMA dengan nilai p = 0,097 (p > 0,05). Kesimpulan penelitian ini adalah tidak terdapat hubungan antara kadar Troponin T dan luas infark miokard.Kata kunci: troponin T, luas infark miokard, infark miokard akut, skoring QRS Selvester AbstractThe one of WHO criteria for the diagnosis of AMI is the elevated levels of cardiac enzymes. Troponin T is one of cardiac enzyme that will increase if there is a myocardial cells damage. The objective of this study was to determine the correlation between troponin T level and myocardial infarction size that measured by using Selvester QRS scoring method. This research was an analytic research with cross sectional design that conducted in October 2013 to September 2014 in the sub-section of Medical Record of Khusus Jantung YJI Cabang Utama Sumatera Barat hospital. Analysis of the data was using the Kolmogorov-Smirnov test to determine the correlation with p ≤ 0.05 was significant. Samples of the research were medical record data of all patients with diagnosis of AMI in the Khusus Jantung YJI Cabang Utama Sumatera Barat hospital period July 2013 - June 2014 that were selected with a total sampling technique. The result of data selection was 81 patients with diagnosis of AMI and 37 data with the results of Troponin T and ECG Examination. ECG results were used to determine infarction size by using Selvester QRS scoring method with results low, medium, and high of infarction size. The results shown that there was no significant correlation between Troponin T level and myocardial infarction size with p value was 0.097 (p> 0.05). The conclusion of this research is there is no correlation between Troponin T level and myocardial infarction size.Keywords: troponin T, myocardial infarction size, acute myocardial infarction, Selvester QRS scoring

Gambaran Kadar Troponin T dan Creatinin Kinase Myocardial Band pada Infark Miokard Akut Rendi Dwi Prasetyo; Masrul Syafri; Efrida Efrida
Jurnal Kesehatan Andalas Vol 3, No 3 (2014)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v3i3.171

AbstrakInfark Miokard Akut (IMA) adalah kematian sel miokardium akibat terlepasnya plak aterosklerotik dari salah satu arteri koroner yang mencetuskan terjadinya agregasi trombosit, pembentukan trombus, dan spasme koroner. Diagnosis IMA dapat dilakukan dengan cara: anamnesis, abnormalitas Elektrokardiogram (EKG), peningkatan Creatinin Kinase Myocardial Band (CKMB), dan cardiac specific troponin (cTn)T. Diagnosis IMA dapat ditegakkan jika terdapat minimal dua dari tiga kriteria yang harus dipenuhi, yaitu: anamnesis, abnormalitas EKG, dan peningkatan aktivitas enzim jantung. Tujuan penelitian ini adalah untuk mengetahui gambaran kadar troponin T dan CKMB pada pasien IMA di RS. Dr. M. Djamil Padang periode 1 Januari 2012 - 31 Desember 2012. Penelitian dilakukan secara retrospektif deskriptif terhadap 54 sampel rekam medik pasien IMA yang dirawat inap di bagian penyakit dalam dan jantung RS. Dr. M. Djamil Padang periode 1 Januari 2012 - 31 Desember 2012. Kadar troponin T diperiksa dengan metode chemiluminescent dan CKMB diperiksa dengan metode enzymatic immunoassay with serum start. Hasil penelitian ini menunjukkan umur terbanyak pasien IMA adalah 40-60 tahun berjumlah 30 orang (55,56%). Jenis kelamin terbanyak pasien IMA adalah laki-laki berjumlah 39 orang (72,22%). Pasien IMA yang memiliki kadar CKMB ≥24 U/L berjumlah 35 orang (64,82%). Pasien IMA yang memiliki kadar troponin T ≥0,1 ng/mL berjumlah 44 orang (81,48%). Didapatkan peningkatan kadar troponin T dan CKMB pada pasien IMA.Kata kunci: infark miokard akut, troponin t, CKMBAbstractAcute Myocardial Infarction (AMI) is a muscle necrosis of the heart caused by rupture atherosclerotic plaque from one of coronary artery that cause platelet aggregation, thrombus formation, and coronary spasm. Diagnosis of AMI can be made by some way : anamnesis, electrocardiogram (ECG) abnormalities, increase levels of creatinine kinase myocardial band (CKMB) and cardiac specific troponin (cTn)T. Diagnosis of AMI can be established if obtained at least two of three criteria : anamnesis, ECG abnormalities and increase of levels cardiac enzymes. The objective of this study was to determine the troponin T levels and CKMB in AMI at RS. Dr. M. Djamil Padang period January 1st, 2012 - December 31th, 2012. The study was conducted with retrospective descriptive with 54 medical records sample of treated patients AMI at internal medicine and cardiology department of RS. Dr. M. Djamil Padang from January 1st, 2012 - December 31th 2012. Troponin T level checked with chemiluminescent method and CKMB checked with enzymatic immunoassay with serum start method. The results of this study indicate that the most age of the patients of AMI are 40-60 years old, 30 people (55,56%). The most gender of AMI are male, 39 people (72,22%). Patients AMI with CKMB levels ≥24 U/L are 35 people (64,82). Patients AMI with troponin T levels ≥0,1 ng/mL are 44 people (81,48%). There are increased in troponin T levels and CKMB in patients of AMI.Keywords: acute myocardial infarction, troponin t, ckmb

Padang Skoring Elektrokardiografi untuk Memprediksi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Kronik Wiza Erlanda; Hauda El Rasyid; Masrul Syafri; Ricvan Dana Nindrea
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.858

ABSTRAK Latar Belakang: Gagal Jantung dibagi menjadi 3 kelompok yaitu gagal jantung fraksi ejeksi menurun (HfrEF <40%), rentang tengah (HFmrEF 40-49%), dan terpelihara (HfpEF â‰¥50%). Ekokardiografi masih menjadi pemeriksaan standar saat ini, sayangnya pemeriksaan tersebut masih terbatas dibeberapa pusat kesehatan. Perlu pemeriksaan awal yang lebih sederhana salah satunya elektrokardiografi (EKG) yang mudah digunakan. Penentuan skoring dari EKG diharapkan dapat memudahkan memprediksi fraksi ejeksi dan memberikan terapi yang tepat. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Diambil data rekam medis pasien gagal jantung kronik (GJK) di poliklinik Jantung RSUP Dr. M.Djamil Padang bulan Januari-Agustus 2017. Dilakukan analisis bivariat pada varibel EKG terhadap fraksi ejeksi dengan metode chi-square. Analisis multivariate dengan uji regresi binari logistik untuk mendapatkan variabel pada kalkulasi skor dengan uji Hosmer-Lameshow (p<0,25). Skoring dilakukan uji sensitivitas, spesifisitas dan analisis receiver operating curve (ROC). Hasil Penelitian : 283 subjek GJK dibagi menjadi tiga kelompok. Variabel yang memenuhi persyaratan untuk dilakukan kalkulasi skor adalah pembesaran atrium kiri (LAE) (OR=6,36; p= 0.000) dengan skor 2, QRS lebar (OR=13,06; p= 0.000) dengan skor 3, interval QTc memanjang (OR=2,18; p= 0.065) dengan skor 1 dan perubahan gelombang ST-T (OR=5,05; p= 0.000) dengan skor 2. Subjek dengan HFpEF mempunyai skor <3, HFmrEF mempunyai skor 3-4, dan HFrEF mempunyai skor >4. Sistem skoring EKG memiliki sensitivitas 71,4% dan spesifisitas 88,6% dengan AUC 87,9% Kesimpulan : Sistem skoring EKG pada penelitian ini dapat digunakan sebagai pedoman awal dalam menentukan fraksi ejeksi ventrikel kiri pada pasien GJK Kata kunci : elektrokardiografi, gagal jantung kronik, fraksi ejeksi ventrikel kiri Background: Heart failure (HF) are divided into HF reduced ejection fraction (HFrEF<40%), mid range (HFmrEF 40-49%), and preserved (HFpEF â‰¥50%). Nowadays echocardiography is used as gold standard examination, but it is limited only in several health centers. For this reason, a preliminary examination tools is needed. Electrocardiographic (ECG) examinations tool that available almost at every health center and easy to be used. Calculating the scores from ECG variables to determine the EF will make clinicianâ€™s earlier to give initial terapi Method: An observational approach with cross sectional study design. The data was taken from patientâ€™s medical record with chronic heart failure (CHF) who went to the Tepartement of Cardiology at Dr. M. Djamil Padang Hospital in January-August 2017. Bivariate analysis was performed on each ECG variable then correlated with LVEF by chi-square method. Multivariate analysis with logistic binary regression test was conducted to obtain variables that would go into the score calculation stage with the Hosmer-Lameshow test (p <0.25). The sensitivity, specificity test and receiver operating curve (ROC) analysis were performed. Result: 283 subjects of CHF who had been divided into three groups. Obtained variables that met the requirements for calculating scores were left atrial enlargement (LAE) (OR = 6.36; p = 0.000) score was 2, wide QRS (OR = 13.06; p = 0,000) score was 3 , prolonged QTc interval (OR = 2,18; p = 0,065) score was 1 and ST-T change (OR = 5.05; p = 0.000) score was 2. Subjects with HFpEF if the scored were <3, HFmrEF if the scored were 3-4, and HFrEF if the scored were >4. It has sensitivity 71,4%, specificity 88,6% with AUC 87,9%. Conclusion: Electrocardiography scoring system in this study can be used as an initial tools to determining LVEF in patients with CHF. Keywords: electrocardiography, chronic heart failure, left ventricular ejection fraction

Relationship Between of Lactate Clearance with Major Cardiovascular Events in Patients with Acute Decompensated Heart Failure David Ramli; Masrul Syafri; Muhammad Fadil; Ricvan Nandra Nindrea
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.860

ABSTRACT Background: Acute decompensated heart failure (ADHF) still a major health problem with high morbidity and mortality. The risk stratification of ADHF patients is an important factor to determine the initial management. Examination of lactic acid levels is an inexpensive tool and mostly available at primary care centers. Lactate clearance, derivation of lactic acid level, is one of the modalities that can be used to assess risk stratification. The association between lactate clearance and in-hospital major cardiovascular events (MACE) of ADHF patients has not been studied yet. Method: Observational approach with cross-sectional design. Data obtained from observations during treatment in ADHF patients at Dr. RSUP M. Djamil Padang in April-July 2018. Bivariate analysis between variables lactate clearance and KKM was carried out during the treatment using the chi-square method and the Odds ratio was obtained. Result: From 44 subjects, 22 of subjects experienced MACE. From the results were found significant differences in lactate clearance in both of groups, -11,72 Â± 4,25 %, vs 26,09 Â± 9,36 % (p=0,000). The association between lactate clearance and in-hospital major cardiovascular events of ADHF patients in this study obtained OR 1,16 with 95% CI 1,12 - 4,102 (p = 0.000). Conclusion: Lactate clearance is a valuable modality that can be used to make a risk stratification in ADHF patients. Keywords: Lactate clearance, ADHF, risk stratification ABSTRAK Latar Belakang: Gagal jantung dekompensata akut (ADHF) masih merupakan masalah kesehatan dengan morbiditas dan mortalitas tinggi. Stratifikasi risiko pasien ADHF merupakan faktor penting untuk menentukan managemen awal. Pemeriksaan kadar asam laktat merupakan alat yang murah dan tersedia di pusat pelayanan primer, lactate clearance merupakan salah satu modalitas untuk menilai stratifikasi risiko. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF belum diteliti. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Data diperoleh dari pengamatan selama perawatan pada pasien ADHF di RSUP Dr. M. Djamil Padang bulan April-Juli 2018. Dilakukan analisis bivariat antara varibel lactate clearance dengan KKM selama perawatan dengan menggunakan metode chi-square dan didapatkan nilai Odds ratio. Hasil Penelitian : Dari 44 subyek penelitian, 22 subjek dengan ADHF tidak mengalami KKM dan 22 subjek mengalami KKM. Hasil penelitian menemukan adanya perbedaan yang bermakna variabel lactate clerance pada kedua kelompok, yakni -11,72 Â± 4,25 % vs 26,09 Â± 9,36 %, dengan nilai p=0,000. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF pada penelitian ini didapatkan nilai OR 1,16 dengan 95% CI 1,12 - 4,102 (nilai p=0,000). Kesimpulan : Lactate clearance dapat digunakan sebagai stratifikasi risiko pada pasien ADHF. Kata kunci : Lactate clearance, ADHF, stratifikasi risiko

Diagnostic Value Of Qtc Dispersion And And Qt Dispersion Ratio Changes On Stress Test In Detecting Significance Of Coroner Lesion In Stable Angina Pectoris Patients putri yeantesa; Hauda El Rasyid; Masrul Syafri; Ricvan Dana Nindrea
Jurnal Kardiologi Indonesia Vol 40 No 2 (2019): Indonesian Journal of Cardiology: April-June 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i2.921

Background : Treadmill exercise test remains an important method and often used in the initial evaluation of patients with chest pain and can be a filter for more expensive invasive diagnostic. Increased QT dispersion (QTD) occurs because of the heterogeneity of ventricular repolarization because transient ischaemia during a treadmill stress test can be a marker of coronary artery disease (CAD) and can improve the accuracy of exercise tests to diagnose CAD, but this parameter is still controversial. Method : This is an analytic observational approach with a cross sectional study. Data was taken retrospectively at the Heart Center Installation at RSUP Dr. M. Djamil Padang, from March to April 2019, stable angina pectoris patient with a positive treadmill stress test who underwent coronary angiography as the subject. Bivariate analysis was performed on changes in QTcD (âˆ†QTcD) and QTdR (âˆ†QTdR) variables on the significance of coronary lesions by the chi-square method, after which a diagnostic test was based on receiver operating curve (ROC) analysis. Study Result : There were 122 subjects and found that older age, male and smoking were more common in groups with significant coronary lesions. Cut off point for âˆ†QTcD is â‰¥13 ms with a sensitivity of 87,1% and specificity 85,2% and AUC 95,1%, while âˆ†QTdR â‰¥5.5% with sensitivity 85,7% and specificity 81,9% and AUC 90,5% are related to significancy of coronary lesion. Obtained subjects with significant lesions generally had a value of âˆ†QTcD â‰¥ 13 ms (p <0.001) and âˆ†QTdR â‰¥ 5.5% (p <0.001). Conclusion : The use of âˆ†QTdR dan âˆ†QTdR parameters as ECG variables, which are easily obtained in evaluating stress tests, can improve the diagnostic accuracy of exercise tests. In addition, evaluation of âˆ†QTdR dan âˆ†QTdR can provide information about the incidence of CAD. Keywords : âˆ†QTcD, âˆ†QTdR, Treadmill Exercise Test, Coronary Lession Significancy

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