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All Journal Indonesian Journal of Cardiology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Wicaksono, Sony Hilal
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Factors Influencing Mortality of Thoracic Aortic Surgery in The Third World Country Diansari, Rienna; Aligheri, Dicky; Herlambang, Bagus; Wicaksono, Sony Hilal; Medel, Brian; Yaniarti, Dian; Alkatiri, Amir Aziz; Andriantoro, Hananto; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1494

Abstract

Abstract Background: A prominent increase of overall global death rate of aortic disease is seen on developing country, with South-east Asia having the highest increase of 41%. Lack of identification and prompt management of the diseases in conjunction with lack of facilities in third world countries that could perform aortic surgery made the procedure more complex when the patients admitted to tertiary hospitals Methods: The data was obtained through medical record of patients underwent thoracic aortic surgery from 2018 to 2021 in National Cardiovascular Center Harapan Kita (NCCHK). One-year and 3-year survival analysis was obtained through phone calls and digital messages. Statistical analysis was done to investigate the impact of surgical complexity as the main predictor and other variables on primary (in-hospital mortality) and secondary (mid-term survival) outcome. Results: A total of 208 patients were included in the analysis; 157 (75,5%) underwent complex surgery, and 51 (24,5%) underwent non-complex surgery. In-hospital mortality was similar across 2 groups (23,6% vs 13,7%; p = 0,1240). On multivariable analysis, malperfusion syndrome (OR 3,560; p = 0,002), CPB duration > 180 minutes (OR 4,331; p = 0,001), and surgical priority (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) were identified as independent predictor of in-hospital mortality. Cox regression identified diabetes (HR 4,539; p = 0,025) and emergency procedure (HR 9,561; p = 0,015) as independent predictors for 1-year mortality, and diabetes (HR 3,609; p = 0,004), aortic dissection (HR 2,795; p = 0,029), and maximum aortic diameter (HR 1,034; p = 0,003) for 3-year mortality. Surgical complexity was not associated with early and mid-term mortality. Conclusions: In patients undergoing thoracic aortic surgery, surgical complexity was not associated with early and mid-term survival. Early and mid-term survival was largely determined by patient comorbidities and intra-surgery factors.
Consensus Statements on the Use of High-Sensitivity Troponin I as the Assessment of Cardiac Risk in Apparently Healthy Population in Indonesia Ambari, Ade Meidian; Ng, Sunanto; Rejeki, Vidya Gilang; Rina Artha, I Made Junior; Raynaldo, Abdul Halim; Alsagaff, Mochamad Yusuf; Wicaksono, Sony Hilal; Dwiputra, Bambang; Desandri, Dwita Rian
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1544

Abstract

Cardiovascular disease (CVD) is a growing burden in Indonesia, making primary prevention of utmost importance. High sensitivity cardiac troponin I (hsTnI) has been known as one of the biomarkers of choice for diagnosing acute myocardial infarction. Nonetheless, recent studies indicate that hsTnI assay has potential as a predictor of cardiac risk in asymptomatic individuals. An advisory board consisting of renowned cardiologists from the Indonesian Heart Association was convened in Jakarta in March 2023. The meeting aimed to explore the appropriate use of hsTnI for cardiovascular (CV) risk stratification in apparently healthy adults in Indonesia. The board reviewed relevant literature and developed key consensus statements, including hsTnI cut-off for identifying high-risk asymptomatic patients, the proposed algorithm, and monitoring after aggressive risk factor control. This article presents the resulting consensus statements to provide clinicians with a practical tool for planning primary prevention strategies. Furthermore, it is expected to raise awareness and advocacy among stakeholders in the healthcare infrastructure regarding the use of hsTnI as a guide for assessing CV risk in Indonesia.
Laporan Kasus Langka Sarkoidosis Jantung dengan Hipertensi Pulmonal Purnomo, Nathania; Damay, Vito Anggarino; Wicaksono, Sony Hilal
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-1019

Abstract

Introduction: Cardiac sarcoidosis (CS) is a rare granulomatous disorder in which white blood cells form clusters on the myocardium. The clinical presentations of CS are varied, as is its etiology. Multiple diagnostic approaches to determine the cause of persistent dyspnea may fail, as cardiac sarcoidosis can mimic many other diseases.Case Report: A 47-year-old woman presented with a sudden onset of dyspnea and a history of chronic thrombo-embolic pulmonary hypertension (CTEPH). Multiple diagnostic approaches were employed, including a CT scan of the thorax with contrast, CT pulmonary angiography, CT coronary angiography, and a Ventilation/Perfusion test, but the results were inconclusive. A Cardiac MRI was ultimately performed, which led to a diagnosis of cardiac sarcoidosis.Case Discussion: The patient had been stable and asymptomatic over the years, despite her history of CTEPH, until she developed a sudden onset of dyspnea. The presence of pitting edema, ECG results, and echocardiography data initially suggested a diagnosis of congestive heart failure. However, tests from the pulmonary system and cardiac coronary were normal. This highlights the elusive nature of cardiac sarcoidosis, which can often go unnoticed and be frequently misdiagnosed. Given the inconclusive results from previous tests, a Cardiac MRI was performed to further characterize the pathology. This led to the findings of Late Gadolinium Enhancement (LGE) and the diagnosis of CS.Conclusion: Cardiac sarcoidosis is a master imitator of many diseases, with patients sometimes presenting with only dyspnea. In such cases, Cardiac MRI plays a pivotal role as a diagnostic test, especially when results from other diagnostic workups are nonspecific.
Co-Authors Aligheri, Dicky Alsagaff, Mochamad Yusuf Ambari, Ade Meidian Amir Aziz Alkatiri Bagus Herlambang Damay, Vito Anggarino Desandri, Dwita Rian Diansari, Rienna Dwiputra, Bambang Hananto Andriantoro Medel, Brian Purnomo, Nathania Raynaldo, Abdul Halim Rejeki, Vidya Gilang Rina Artha, I Made Junior Suko Adiarto Sunanto Ng Yaniarti, Dian