Comparison of Coronary Angiography Characteristics among Acute Coronary Syndrome Patients in Young and Old Age Patients at Cipto Mangunkusumo Hospital Jakarta

Aim: to identify the difference between coronary angiography in patients with acute coronary syndrome (ACS) aged ≤45 years and those aged >45 years. Methods: a total of 322 ACS patients who underwent coronary angiography in ICCU of Cipto Mangunkusumo Hospital, Jakarta between January 2008 and December 2012 were included in this study. The severity of coronary stenosis was determined by vessel score and coronary score. A significant vessel score was defined as a stenosis of coronary vessel of >70%. Patients were divided into two groups: those aged ≤45 years (72 cases) and those aged >45 years (250 cases). The statistical analysis was performed with Chi-square test for categorical data with two-unpaired groups and the t-test or Mann-Whitney for numerical data. Results: the highest distribution of 1-VD (single-vessel disease) patients was found the group of patients aged ≤45 years (43.1% vs 26.0%); while for 3-VD (triple-vessel disease) patients, the highest distribution was noticed in the group of patients aged >45 years (31.6% vs 18.1%). The stenosis score was lower in patients aged ≤45 years compared those aged >45 years (median stenosis score 4 vs 8), p45 years. Key words: acute coronary syndrome, coronary angiography, young ag

Evaluasi Elektrokardiogram Interval QTc dan JTc pada Penderita Malaria Vivaks yang Diberikan Dihidroartemisinin-Piperakuin dan Primakuin

Dihidroartemisinin-piperakuin (DHA-PPQ) telah digunakan secara global sebagai terapi malaria vivaks. Salah satu efek samping DHA-PPQ adalah pemanjangan repolarisasi ventrikel yang dapat menimbulkanaritmia ventrikuler yaitu Torsade de Pointes (TdP). Studi before-after ini bertujuan untuk mengetahuiperbedaan rerata interval QTc dan JTc penderita malaria vivaks sebelum dan sesudah pemberian DHA-PPQdan primakuin (PQ). Penelitian dilakukan di Lembaga Biologi Molekuler Eijkman, Jakarta pada bulan Mei-Juli2015. Sumber data adalah data sekunder hasil rekaman EKG pada penelitian utama “Safety, tolerability, andefficacy of artesunat-pyonaridine or dihydroartemisinin-piperaquine in combination with primaquine as radicalcure for P.vivax in Indonesian soldiers” tahun 2010. Subyek yang masuk kriteria seleksi pada pemberianDHA-PPQ dan PQ, masing-masing berjumlah 24 subyek dan 14 subyek. Interval QT dan JT dalam penelitianini menggunakan dua formula yang sudah dikoreksi terhadap frekuensi denyut jantung yaitu formula Bazett(QTcB, JTcB) dan Fridericia (QTcF, JTcF). Pemberian DHA-PPQ menunjukkan pemanjangan rerata intervalQTcF secara bermakna dibandingkan baseline yaitu sebesar 14,42 milidetik terjadi di D3 predose dan 20,53milidetik di D3 postdose. Rerata pemanjangan interval JTcF setelah pemberian DHA-PPQ adalah 13,43milidetik di D3 postdose. Pada pemberian PQ terdapat perbedaan nilai rerata interval QTcB dibandingkanbaseline sebesar 19,42 milidetik. Rerata pemanjangan interval JTcF dibandingkan baseline 16,50 milidetik diD42 postdose dan secara statistik bermakna. Kata kunci: dihidroartemisinin-piperakuin, primakuin, malaria vivaks, Torsade de Pointes, interval QTc, interval JTc.   Electrocardiogram Evaluation of QTc and JTc Interval of DihydroartemisininPiperaquine and Primaquine Therapies Given to The Vivax Malaria Patient

Cardiotoxicity Complication of Radiotherapy

Radiation is an important modality in the management of malignancy. Some cases of malignancy requiring radiotherapy in the chest include breast cancer, Hodgkin's lymphoma, or lung cancer.Cardiotoxicity due to radiotherapy can occur within 3 to 29 years after radiotherapy, mostly in the second or third decade after therapy. Some cardiovascular complications resulting from radiotherapy may affect pericardial, myocardial, vascular, heart valves and conduction disturbances. Symptomatic cardiotoxicity may occurs 10% in patients undergoing radiotherapy in the chest area. It is important for clinicians to understand the cardiotoxicity of radiotherapy for educational purposes, therapeutic and dosing considerations, treatment monitoring and early detection. Early detection and post-radiation monitoring have an important role to reduce morbidity and mortality due to cardiovascular disease after radiotherapy and comprehensive management is necessary

Five-Year Survival in Patients with 3-Vessels Coronary Artery Disease and Diabetes Mellitus Undergoing Coronary Artery Bypass Graft, Coronary Percutaneus Intervention, or Receiving Pharmacological Therapy in Cipto Mangunkusumo Hospital

Introduction. Revascularization results in patients with diabetes mellitus (DM) and coronary artery disease involving 3 vessels (CAD 3VD) undergo coronary artery bypass surgery (CABG) are better compared with those undergo percutaneous coronary intervention (PCI) or medical therapy. However, CABG is not always done despite being recommended in accordance with Syntax Score because some patients unwilling to undergo CABG or PCI . This trial determined whether the choice of revascularization affect 5-years survival. Methods. This was a retrospective cohort study with survival analysis to examine the 5-years survival rate of CAD 3VD DM patients undergoing CABG, PCI, or medical therapy. The study was conducted using secondary data of 126 CAD 3VD DM patients who underwent CABG, PCI, or medical therapy at Cipto Mangunkusumo Hospital in 2006-2007 and followed up to 2011-2012 if there any incident died. Results. Best survival was seen in the CABG group (93.5%). The largest proportion of death occured in the medical therapy group (36.1%). The CABG survival was significantly better than the IKP (p=0.01) and medical therapy (p=0.001). PCI group had better survival than medical therapy (69.5% vs. 63.9%). Although not statistically significant, but the proportion of complaints after revascularization in PCI group were found less than medical therapy group (52% vs. 38%). Syntax score that assesses the complexity of stenosis had a significant association with survival (p 0.039). Conclusions.5-years survival of CAD 3VD DM patients is best obtained in the group that underwent CABG. 5-year survival of CAD 3VD DM patients who underwent PCI better than medical therapy but was not statistically significant. Factor that affect the 5-years survival is the complexity stenosis viewed by the Syntax score

Ilmu penyakit dalam

viii, 301 hl

Ilmu Penyakit Dalam

viii, 301 hlm.; ilus.; 21 c

Ilmu penyakit dalam

viii, 301 hlm. : ilus. ; tab. ; 21 cm

Ilmu penyakit dalam

Buku ini terdiri dari tiga bagian: pengantar umum mekanisme penyakit, survei sistematis penyakit organ dan sistem organ yang menekankan pathophysiologi umum, dan berikutnya aspek-aspek klinis penyakit-penyakit ini.viii, 301 hlm.: ilus.; 21 c

lmu penyakit dalam

vii+301 hlm. ; 20c

Ilmu penyakit dalam

viii, 301 hlm.; ilus.; 21 c