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All Journal Indonesian Journal of Cardiology
Kamardi, Stanly
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Health Professions Medicine & Pharmacology

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Evaluation of Cardiometabolic Factors Affecting Chronotropic Incompetence: A Cross-Sectional Retrospective Study in Sanglah General Hospital, Bali Prana Jagannatha, Gusti Ngurah; Yasmin, AA Ayu Dwi Adelia; Surya Pradnyana, I Wayan Agus; Kamardi, Stanly; Wiryawan, I Nyoman; Wita, I Wayan
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1189

Abstract

Background: Recent studies have identified that chronotropic incompetence is correlated with poor cardiometabolic health and systemic inflammation that results in exercise intolerance, impaired quality of life and death due to cardiovascular disease (CVD). Unfortunately, there’s still paucity of data regarding cardiometabolic factors associated with chronotropic incompetence. The purpose of this study was to identify the cardiometabolic factors associated with chronotropic incompetence. Methods: This study was a cross-sectional retrospective study using cardiac treadmill stress test data at Sanglah General Hospital from May 2018 - May 2020 and 136 patients were enrolled. Data analysis used SPSS version 21. Pearson chi-square test was used to compare categorical variables based on cardiometabolic risk factors in chronotropic incompetence. Results: Patients were divided based on the characteristics of age, gender, smoking status, body mass index, coronary artery disease, heart failure, hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), the levels of HbA1C, total cholesterol, LDL, HDL, and triglyceride. In this study, it was found that T2DM (PR 2.29; 95%CI 1.16–3.37), HbA1C (PR 3.13; 95%CI 2.31-4.22), dyslipidemia (PR 1.773; 95%CI 1.170–2.687), high total cholesterol (PR 2.396; 95%CI 1.650-3;481), and high LDL level (PR 1.853, 95%CI 1.229-2.794) were significantly associated with chronotropic incompetence (all p-value <0.05), while other factors were not significantly related. Conclusion: Chronotropic incompetence can impair quality of life and contribute to cardiovascular mortality. However, T2DM, high HbA1C, dyslipidemia, high total cholesterol and LDL levels were found to be associated with chronotropic incompetence. This may contribute to higher cardiovascular risk attributed to those factors.
Ratio C-Reactive Protein Terhadap Albumin Dalam Memprediksi Lauren Rumah Sakit Dan Jangka Panjang Pasien STEMI Dengan Infeksi SARS-CoV2 Yang Menjalani Terapi Fibrinolitik Prana Jagannatha, Gusti Ngurah; Rina Artha, I Made Junior; Surya Pradnyana, I Wayan Agus; Kamardi, Stanly
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1305

Abstract

Background: The choice of reperfusion therapy in STEMI patients with COVID-19 is unclear. CRP to Albumin ratio (CAR) found to be a predictor of thrombus burden. This study was to determine the relationship and predictive value of CAR to in-hospital and long-term outcome of STEMI patients with COVID-19 treated with fibrinolytic. Methods: 297 COVID-19 patients with STEMI underwent fibrinolytic were enrolled. In-hospital outcomes were in-hospital mortality due to cardiovascular death which was divided into mortality <48 hours and >48 hours, fibrinolytic failure, and cardiogenic shock. The presence of reinfarction post fibrinolytic and mortality after the patient discharged was assessed as the long-term outcome. Results: During follow-up, 19.8% experienced in-hospital mortality and 16.1% had reinfarction. In the in-hospital outcome, patients with in-hospital death, failed fibrinolytic and cardiogenic shock had higher CAR (6.7+2.4 vs 4.7+1.9; 6.3+1.9 vs 2.1+1.6; 5.5+2.1vs1.8+1.5) with all p-value <0.05. CAR with an optimal cut-off >4.46 can be a predictor of fibrinolytic failure with sensitivity of 86.7% and specificity of 93.6% (PR19.82; 95%CI 10.32-38.06) and predictor of in-hospital death <48 hours with sensitivity of 84.6% and specificity of 82.7% (PR5.02; 95%CI 3.20-7.90). In the long-term outcome, patients who experienced reinfarction and out-hospital death had higher CAR (5.1+1.2vs2.5+2.4; 5.2+1.3vs2.6+2.4) than those who did not experience the event respectively with all p-value <0.05. CAR with an optimal cut-off >3.67 can be predictor of reinfarction with sensitivity of 87.5% and specificity of 73.5% (PR12.250; 95%CI 5.38-27.87). The Cox regression model showing CAR >3.67 was also associated with higher reinfarction event (p=0.001). Conclusion: CAR has the potential to be a predictor of in-hospital and long-term outcomes for STEMI patients with COVID-19 which can help determine which patients need more invasive strategy to prevent mortality and morbidity.
Co-Authors Anak Agung Ayu Dwi Adelia Yasmin I Wayan Wita Prana Jagannatha, Gusti Ngurah Rina Artha, I Made Junior Surya Pradnyana, I Wayan Agus Wiryawan, I Nyoman