Indra Prasetya
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.

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Neutrophil-Lymphocyte Ratio value as a predictor of Troponin Elevation in patients with Non-ST Segment Elevation Acute Coronary Syndrome Lutfi hafiz zunardi; Setyasih Anjarwani; Indra Prasetya; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.2

Abstract

Acute coronary syndrome (ACS) is a prominent contributor to mortality and morbidity on a global scale, consistently ranking within the top five primary causes. Inflammation is one of the many elements that have a role in the pathophysiology of the development and destabilization of plaque atherosclerosis in ACS. Troponin is a component of a biomarker that signals damage to the heart muscle in ACS patients; however, at the present time, not all medical facilities are able to perform troponin testing. An acute myocardial infarction begins with an initial inflammatory process that generates proinflammatory cytokines at the cellular level. This can be evaluated by the NLR through peripheral blood tests. The NLR as an indication of systemic inflammation has been demonstrated to be associated with poor clinical outcomes, an increased risk of complications, and mortality in ACS patients. In addition, several studies showed that the NLR has prognostic value in patients with ACS. The NLR is a mix of inflammatory markers, which can be a predictor of increased troponin in cases of non-ST segment elevation acute coronary syndrome (NSTEACS) in an emergency room.
Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room Lutfi Hafiz Zunardi; Setyasih Anjarwani; Indra Prasetya; Budi Satrijo; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.7

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. 
Diagnostic Test for Estimation of Plasma Volume on Assessment of Congestive Status in Acute Heart Failure Patients at Saiful Anwar General Hospital Oktafin Srywati Pamuna; Indra Prasetya; Tri Astiawati; Mohammad Saifur Rohman; Novi Kurnianingsih
Heart Science Journal Vol 4, No 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac C
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.3

Abstract

BackgroundHeart failure is a severe health issue with high death and morbidity rates globally, including in Indonesia. Congestion is the main symptom of acute heart failure. B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-pro BNP) are well-known markers to confirm the condition. Plasma volume estimation (ePVS)is one of the procedures currently being developed to assess a patient's congestive status at a lower cost. MethodsThis is descriptive observational research with a cross-sectional study method that included all patients with acute heart failure between May 2019-February 2022. Baseline characteristics, medication history, and echocardiography were also included in the statistical analysis. We used univariate and multivariate analysis to assess the effect of each variable on the patient's congestive condition. A diagnostic test of plasma volume estimation was carried out using Receiver Operating Characteristics (ROC) Analysis compared to NT pro-BNP as the gold standard.   Results A total of 506 subjects were diagnosed with acute heart failure at Dr. Saiful Anwar Malang Hospital, who met the inclusion and exclusion criteria. The mean age was older in congestive patients with 62.5% being male. Patients with congestive conditions have a lower ejection fraction with a higher estimated right atrial pressure from echocardiography. The estimation plasma volume status was also higher in congestive conditions (6,90 vs 3,5). The ePVS from ROC analysis has a good diagnostic value with a sensitivity of 91, 7% and specificity of 92,6%. ConclusionThe estimation of plasma volume status has a good sensitivity and specificity value to assess congestive status in patients with acute heart failure who are fluid-overloaded.