bluuebunny/crossref_metadata_2025_split huggingface dataset:
OR31. Effect of Selective Thrombus Aspiration on Clinical Outcomes in Patients with ST-Segment Elevation Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention
Authors: Bramantyo L V , Rifqi S , Ardhianto Bahrudin P 
Published: April 2022

Abstract

Aims
Manual thrombus aspiration (TA) can reduce distal embolization and improve microvascular perfusion in patients with ST-segment elevation acute coronary syndrome (STE-ACS), especially in patients with high thrombus burden. The aim of this study is to determine the effect of selective TA on clinical outcomes after primary PCI.

Methods and Results
A retrospective cohort study was performed on STE-ACS patients within 12 hours onset and initial TIMI Thrombus grade ≥3 undergoing primary PCI and selective TA in Dr. Kariadi General Hospital from January 2016 to December 2019. The measured clinical outcome was in-hospital MACE which consisted of mortality, cardiogenic shock, acute lung oedema, arrhythmia, urgent revascularization, and stroke. There were 196 patients fulfiling the criteria, consisted of 96 patients in TA group and 100 patients in non-TA group. Angiographic success in TA group was 97.9%. TA group achieved a better reduction of TIMI thrombus than in non-TA group (4.31 vs 4.11, p = 0.012). There were 15 patients in TA group (15.6%) and 20 patients in non-TA group (20%) who experienced in-hospital MACE after primary PCI (RR 1.055, 95% CI 0.926-1.202, p = 0.424). In patients with initial TIMI Thrombus grade 5, MACE in TA group occurred less than non-TA group (13.2% vs 42.9%, p = 0.01).

Conclusions
Selective TA did not affect in-hospital MACE after primary PCI. In patients with initial TIMI Thrombus Grade 5, TA might be beneficial to reduce MACE after primary PCI.
OR36. External validation of in-hospital major adverse cardiovascular events’ predictor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Authors: Raharjo Robert Adrianto , Herminingsih Susi , Ardhianto Pipin , Herry Yan 
Published: April 2022

Abstract

Aims
KARIADI risk score is a 0-to-9 point scoring system based on Killip class, final TIMI flow, total ischemic time, creatinine level, blood glucose, systolic blood pressure, and age. This score was developed to predict the risk of in-hospital major adverse cardiovascular events (MACE) (composite of death, stroke, urgent revascularization, cardiogenic shock, acute pulmonary edema, or arrhythmia) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI). KARIADI risk score was claimed to be able to predict MACE with a rate of 1.2% at lowest score until 99.9% at highest score, but its performance has never been validated externally. This study aims to perform external validation on KARIADI risk score.

Methods and Results
This study was a prospective cohort study on 109 STEMI patients undergoing PPCI in Dr. Kariadi General Hospital during January-November 2020. Each sample underwent KARIADI risk score assessment and follow-up for in-hospital MACE. The risk score validation was performed by assessing calibration [measured with calibration-in-the-large (alpha), calibration slope (beta), and calibration plot] and discrimination performance [measured with c-statistic and receiver operating characteristic (ROC) curve). Eighteen patients (16.5%) had MACE. The calibration plot of KARIADI risk score demonstrated moderate calibration with alpha -0.39, beta 0.71, and reasonably close calibration to line of identity; meanwhile the ROC curve demonstrated moderate discrimination with c-statistic 0.75, 95% CI 0.62-0.87.

Conclusion
KARIADI risk score has moderate external validation in predicting in-hospital MACE in patients with STEMI undergoing PPCI.
OR38. Hematological Parameter of Contrast Induced Acute Kidney Injury in ST Elevation Myocardial Infarction Patient Underwent Percutaneous Coronary Intervention
Authors: Widyastuti W , Hanika R , Syukri M , Syafri M 
Published: April 2022

Abstract

Aim
To determine the relationship of Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) as simple inflammatory parameter to incident of Contrast Induce - Acute Kidney Injury (CI-AKI) in ST Elevation Myocardial Infarction (STEMI) patient underwent Percutaneous Coronary Intervention (PCI).

Method and Result
We collected laboratory and angiographic data of 113 consecutive STEMI patient that treated with PCI in M. Djamil Hospital Padang since April 2020 – April 2021. CI-AKI define as increasing creatinine serum 25% or 0,5 gr/dl over 48 hours after contrast administration. Patient with end stage renal failure were exclude. In this study we found 17.6 % patient developed CI-AKI after PCI. These patients have older age (mean 61 ± 8.7 years) with hypertension as majority of risk factor (65%). PLR and NLR were higher in CI-AKI group (220.11 ± 144.57; 7.49 ± 5.36) with significant differences in PLR (p &lt; 0.08). Hemoglobin was lower in CI-AKI group (mean 12.56 ± 1.50) and amount of contrast used during PCI were more in CI-AKI group (mean 135.75 ± 27.63) but there was no significant differences.

Conclusion
STEMI patient who underwent PCI with higher baseline PLR and NLR value have higher incident of CI-AKI. PLR have the most significant correlation to incident of CI -AKI in this population.
OR40. Human umbilical cord blood-mesenchymal stem cell-derived secretome in combination with atorvastatin enhances endothelial progenitor cells proliferation and migration: an insight for new coronary artery disease therapeutic
Authors: Hutomo S A , Oktaviono Y H , Sandra F , Soemantri D 
Published: April 2022

Abstract

Aims
Human umbilical cord blood-mesenchymal stem cell (hUCB-MSC)-derived secretome is known to be able to promote neovascularization and angiogenesis, so it is also thought to have a capability to modulate endothelial progenitor cell (EPC) functions. Atorvastatin is the cornerstone of coronary artery disease (CAD) treatment which can enhance EPCs proliferation and migration. This study aims to analyze the effect of the hUCB-MSC-derived secretome and its combination with atorvastatin toward EPCs proliferation and migration.

Methods
EPCs were isolated from a CAD patient’s peripheral blood. Cultured EPCs were divided into a control group and treatment group of 2.5 µM atorvastatin, hUCB-MSC-derived secretome (2%, 10%, and 20% concentration) and its combination. EPCs proliferation was evaluated using an MTT cell proliferation assay, and EPC migration was evaluated using a Transwell migration assay kit.

Results
This research showed that hUCB-MSC-derived secretomes significantly increase EPC proliferation and migration in a dose-dependent manner. The high concentration of hUCB-MSC-derived secretome were shown to be superior to atorvastatin in inducing EPC proliferation (OD, 1.585±0.029 vs 0.738±0.025; p &lt; 0.001) and migration (51.00±5.15 vs 34.40±3.05, p &lt; 0.001). Combination of the hUCB-MSC-derived secretome and atorvastatin shown to improve EPCs proliferation and migration compared to hUCB-MSC-derived secretome treatment or atorvastatin alone (p &lt; 0.001).

Conclusions
This study concluded that the hUCB-MSC-derived secretome work synergistically with atorvastatin treatment in improving CAD patient-derived EPCs proliferation and migration. Hence, it could be the basis for secretome as the new CAD treatment modality.
OR44. Impact of the COVID-19 Pandemic on Admission of Acute Coronary Syndrome Patients: A Local Insight from iSTEMI Registry
Authors: Nugraha Krishna Ari , Nurudinulloh Akhmad Isna , Satrijo Budi , Anjarwani Setyasih 
Published: April 2022

Abstract

Aims
Despite the spike in COVID-19 hospitalizations, the number of acute coronary syndrome (ACS) admissions has declined significantly. It raises concerns about the long-term consequences of cardiovascular problems. This study aims to provide new insights into our awareness of the pandemic situation in ACS settings.

Methods
We performed a single centre retrospective analysis of 397 patients from iSTEMI Registry between March-October 2019 (Pre-COVID-19 pandemic) and March-October 2020 (COVID-19 pandemic) with ACS (i.e., unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and STEMI). We analyzed case fatality rate, delay to First Medical Contact (FMC), and troponin findings.

Results
The number of ACS patients admissions in March-October 2019 (254 patients) and 2020 (143 patients) had significantly reduced by 43.7%. Admission of ACS significantly dropped for STEMI (35.76%, p=0.048) and NSTEMI (65.70%, p=0.001), but not for UA (31.90%, p=0.262). There was non-significant case fatality rate between-group of STEMI (p = 0.168), NSTEMI (p = 0.388), or UA (p = 0.343). We found a significant delay to FMC during pandemic (39.8%, p=0.000) and correlated with the higher troponin I level (30,6%, p=0.001).

Conclusion
This study reveals that local conditions in our institution are similar to the other centers during the COVID-19 pandemic. In parallel to the COVID-19 burden, we will have to deal with the morbidity and mortality caused by delays in FMC and patients severity in the future. Further studies are needed to analyze the factors that decreased ACS patients' admission.
OR46. Increased of Ventricular Repolarization Abnormalities in Hemodialytic End-Stage Renal Disease
Authors: Mulia E P B , Fauzia K A , Julario R 
Published: April 2022

Abstract

Background and Aims
Cardiac or ventricular arrhythmia risks, including sudden cardiac death, are highly increased in patients with CKD, especially when reaching end-stage renal disease (ESRD). Several electrocardiographic (ECG) methods can be used to assess ventricular arrhythmia risk on the standard 12-lead ECG. This study aimed to evaluate ventricular repolarization abnormalities in patients with hemodialytic ESRD.

Methods and Results
Fifty-three patients with hemodialytic ESRD and thirty-two pre-dialytic CKD as controls were enrolled in the study. ECG parameters: QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc were measured manually using callipers on ECG recordings from all participants. The normality of the data was analyzed with the Shapiro-Wilk test. The independent-samples T-test for normal distribution and the Mann-Whitney U test for abnormal distribution were used for analysis. Mean age in hemodialytic and pre-dialytic groups were 46.6±11.5 and 56.1±10.6 years old, respectively. Mean creatinine serum in hemodialytic and pre-dialytic groups were 9.9±4.7 and 2.4±0.7 mg/dL. Ventricular repolarization abnormalities in hemodialytic compared to pre-dialytic group: QTc (448.2±33.9 vs. 427.9±31.3 msec, p = 0.007), Tp-e (80[40:130] vs. 70[40:120] msec, p = 0.022), Tp-e/QT (0.23±0.06 vs. 0.20±0.05, p = 0.043) were found to be significantly different. While QT (360.4±47.8 vs. 355.9±36.6 msec, p = 0.646) and Tp-e/QTc (0.18[0.08:0.33] vs. 0.16[0.09:0.25], p = 0.196) were increased in hemodialytic group but not significantly different.

Conclusion
Ventricular repolarization abnormalities were found to be increased in patients with hemodialytic end-stage renal disease. Measuring ECG parameters of ventricular repolarization may help to identify risk for arrhythmogenesis and sudden cardiac death.
OR48. Major risk factors for in-hospital mortality events of acute coronary syndrome patients in the rural hospital setting
Authors: Sukmadja D , Hartoko B 
Published: April 2022

Abstract

Aims
This study was performed to find major risk factors for all-cause in-hospital mortality events of acute coronary syndrome (ACS) patients in the rural hospital setting, where diagnostic and therapeutic resources were limited.

Methods and Results
We enrolled 57 ACS patient data that were admitted from January to December 2020 from medical records. Patient baseline data, clinical characteristics, risk factors and their association with in-hospital all-cause mortality events were analyzed. The median age of all patients was 58.0 ± 10.63 years, with predominantly male patients (68.4%). There were 35.1% ST-elevation acute coronary syndrome (STEACS) and 64.9% non-ST-elevation acute coronary syndrome (NSTEACS) cases, with 17.5% all-cause in-hospital death cases. All of the dead patients were male and had active smoking behaviour. The other most prevalent risk factors were history of chronic heart failure (60.0%), ST-segment deviation (50%) and atrioventricular block findings on electrocardiogram (50%). Bivariate Fischer’s exact test showed significant correlation in male patients (OR: 0.74; 95% CI: 0.62 to 0.89; p: 0.022), history of chronic heart failure (OR: 0.16; 95% CI: 0.04 to 0.68; p: 0.015), and active smoking behaviour (OR: 0.72; 95% CI: 0.59 to 0.84; p: 0.009) with all-cause in-hospital mortality events.

Conclusion
Active smoking behaviour, history of chronic heart failure and male patients were found to be major risk factors for all-cause in-hospital mortality events in acute coronary syndrome patients in the rural hospital setting.
OR51. Prognostic Value and Influencing Factors of High D-dimer Levels for Critical Care Needs in Coronavirus Disease 2019 (COVID-19) Patients
Authors: Suyani N A , Laitupa F S , Ruspiono E , Wibisono A , Astiawati T , Nugraha A W , Kusuma M A , Kumara K C , Kawiartha M M , Budiarti P , Mustafida R Y , Muhardian R A , Sungkono R D 
Published: April 2022

Abstract

Aims
Coronavirus disease 2019 (COVID-19) stimulates pro-thrombotic changes that lead to poor prognosis-associated conditions. Early and effective predictors of clinical outcomes are urgently needed to improve management. This study aims to explore the value and influencing factors of high D-dimer levels on the prognosis of critical care needs in COVID-19 patients.

Methods and Results
Patients admitted with confirmed COVID-19 in Dr. Iskak General Hospital from June to December 2020 were retrospectively enrolled. We examined the relationship between peripheral blood levels of D-dimer on admission, clinical characteristic, prognosis, and its related influencing factors. One hundred forty-eight patients were included in analysis. D-dimer levels of patients who need critical care needs were significantly higher (p &lt; 0.001). The Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of D-dimer in predicting critical care needs. The optimal cut-off value of D-dimer to predict critical care needs was 1,707 ng/ml with a sensitivity of 84.6% and specificity of 84.4% (AUC=92.6%; 95% CI = 0.87-0.98). In addition, we found that patients with advanced age (OR 10.5, 95% CI 1.94-57.35, p = 0.005), history of stroke (OR 4.1, 95% CI 1.11-15.22, p = 0.039) and renal failure (OR 8.1, 95% CI 1.41-46.71, p = 0.020) had higher D-dimer levels.

Conclusion
D-dimer can be used to evaluate the prognosis of critical care needs of COVID-19 patients. The D-dimer value of 1,707 ng/ml was the optimal probability cut-off for judging critical care needs. Advanced age, history of stroke and renal failure are influencing factors for D-dimer levels, which impact the prognosis of patients.
OR56. Risk Factors of Diabetes Mellitus Type 2 and Chronic Kidney Disease In Patients With All Types of Cardiovascular Disease at Sanglah Hospital Denpasar, Bali, Indonesia In 2021 : A Cross-Sectional Hospital-Based Study
Authors: Upadhana P S , Sastrawan I G G , Cahyarini I G A A C , Umam A K , Wibhuti I B R 
Published: April 2022

Abstract

Background and Aims
This study aims to determine the risk factors of diabetes mellitus type 2 (DMT2) and chronic kidney disease (CKD) in a patient with all types of cardiovascular disease (CVD).

Methods and Results
This study was carried out using the analytical observational and cross-sectional design methods. Data were collected from 219 patients diagnosed with all types of CVD at Sanglah Hospital from January 2021 – April 2021. The result showed that the majority of the patients were male (n = 116, 53%), with a median of age 53 (14-80). Coronary artery disease (CAD) was the most common CVD found in patients (n = 111, 50.7%), while the most common comorbidity in patients were CKD (n = 162, 74%). Obesity (p = 0.030; PR: 1.879; 95%CI: 1.097-3.219) and CAD (p = 0.029; PR: 1.774; 95%CI: 1.046-3.011) were significantly associated with DMT2, while age (p = 0.000; PR: 1.435; 95%CI: 1.180-1.745), and hypertension heart disease (HHD) (p = 0.008; PR: 1.243; 95%CI: 1.072-1.440) were significantly associated with CKD. Meanwhile, age &gt; 50 years old (p = 0.004; PR: 5.740; 95%CI: 1.384-23.803), HHD (p = 0.035; PR: 2.385; 95%CI: 1.050-5.419), and CAD (p = 0.009, PR: 4.091; 95 %CI: 1.253-13.354) were significantly associated with DMT2 comorbid with CKD. In logistic regression analysis, age (p = 0.015; PR: 2.909; 95%CI: 1.235-6.852), and obesity (p = 0.023, PR: 2.765; 95%CI: 1.149-6.307) were significantly associated with DMT2.

Conclusion
Clinical characteristics and medical history of the patient are significantly associated with DMT2 and CKD. Early intervention against these factors tends to improve the outcome of the patient.
OR60. The acef (age, creatinine, ejection fraction) score predicts major adverse cardiac events in patients hospitalized for acute coronary syndrome
Authors: Ardining H , Niazta N A , Karimullah D H 
Published: April 2022

Abstract

Background and Aims
Age, Creatine, and Ejection Fraction (ACEF) score is a simple model for predicting mortality in patients undergoing elective cardiac surgery. However, the ability of ACEF score to predict other outcomes, such as major adverse cardiac events (MACE) in patients hospitalized with ACS, is less established.

Method and Result
In this study, 71 patients who were admitted with ACS to Kediri General Hospital between January and June 2020 with echocardiography data were included. The follow-up period to observe MACE was 6 months. The ACEF score was calculated using the following formula: age (years)/left ventricular ejection fraction (%) + 1 (if baseline serum creatinine was &gt; 2 mg/dl). The median ACEF score was 1.15 (0.6-5.08). A higher ACEF score was linked with higher SGOT, the presence of diabetes mellitus, anaemia, and left bundle branch block (LBBB) on admission. ACEF score's predictive performance was then evaluated. Receiver-operating characteristic (ROC) curve analysis was used to assess the ability of ACEF score to predict MACE. The observed AUC was 0.8 (95% CI 0.6-0.98). Using ACEF score cut-off of 1.79, the sensitivity was 85.7% and the specificity was 82.8% to predict future MACE. The AUC in this study was higher than that in previous studies. Kristic et al (2021) found AUC of 0.63 (0.55-0.7) for ACEF score in predicting MACE in NSTE-ACS.

Conclusion
ACEF score may serve a simple way to predict risk of future MACE in patients hospitalized for ACS.
OR61. The Association Between Blood Glucose on Admission and Myocardial Infarct Size Measured by QRS Selvester Score
Authors: Dewi M R , Priyambodo S , Pintaningrum Y 
Published: April 2022

Abstract

Aim
Acute myocardial infarction (AMI) is one the highest cause of death out of all cardiovascular disease. Risk factors of AMI includes diabetes which causes hyperglycemia. Acute hyperglycemia post-AMI is called stress hyperglycemia. Hyperglycemia will increase oxidative stress which causes further inflammation that affects myocardial infarct size. This researchs aims to know the association between blood glucose on admission and myocardial infarct size measured by QRS Selvester Score.

Method and Result
This research is a cross-sectional study done in RSU Kota Mataram. The datas are collected from patient’s medical records from November 2019 – August 2020. Subjects that are included in this study are STEMI patients with ECG recording within 1 hour of arrival before given any definitive treatment, glucose on admission level before given any blood glucose lowering treatment, and patient’s identity consisting of name, age, and gender. The samples are taken with a consecutive sampling method. The amount of samples taken are 52 samples in which consists of 45 male and 7 female. The datas are distributed normally with a sig. value of 0.53 and 0.200 for myocardial infarct size and glucose on admission level respectively. The result from the correlation test using pearson method shows that there is no significant correlation with a p value of = 0.787 and r = 0.038.

Conclusion
There is no significant correlation between blood glucose on admission level and myocardial infarct size measured by QRS Selvester Score.
OR62. The Association Between Cardiovascular Diseases and Underlying Comorbidities in Patients with All Types of Cardiovascular Disease at Sanglah General Hospital Denpasar, Bali, Indonesia In 2021: a Hospital-Based Cross-Sectional Study
Authors: Upadhana P S , Sastrawan I G G , Cahyarini I G A A C , Umam A K , Wibhuti I B R 
Published: April 2022

Abstract

Background and Aims
Cardiovascular disease accompanied by underlying comorbidities increases morbidity, worsens the outcome of therapy and decreases a patient's quality of life. Therefore, this study aims to determine the distribution and association between various comorbidities and cardiovascular diseases.

Methods and Results
This study was carried out using the analytical observational and cross-sectional design methods. Data were collected from 219 patients diagnosed with all types of cardiovascular diseases (CVD) at Sanglah General Hospital from January 2021 to April 2021. The result showed that the majority of the patients were male (n = 116; 53%) with a median age of 53 (14-80) years. Furthermore, approximately 140 patients (63.9%) had more than one CVD, and comorbid (n = 123, 56.2%). The most common CVD and comorbid found in patients were coronary artery (n = 111; 50.7%) and chronic kidney (n = 162; 74%) diseases, respectively. The strongest associations within CVDs were between valvular and rheumatic heart diseases (PR: 12,121; 95%CI: 3,813-38,535). Meanwhile, diabetes mellitus (PR: 1.38; 95%CI: 1.061-1.797), chronic kidney disease (PR: 1.818; 95%CI: 1.213-2.724), dyslipidemia (PR: 1.715; 95%CI: 1.319-2.230), and obesity (PR: 1.473; 95% CI: 1.123–1.932) were strongly associated with the incidence of coronary artery disease. Patients with diabetes mellitus had a higher risk of having more than one cardiovascular disease (PR: 1.463; 95%CI: 1.016-2.107).

Conclusion
Cardiovascular disease accompanied by underlying comorbidity has a significant effect on the course of the disease. Early identification and intervention against these comorbidities and CVDs prevents morbidity and improves the patient’s outcome.