Background: Several inflammatory cell markers have been addressed in recent studies and one of them is the Ratio of Monocyte-High Density Lipoprotein (RMH) as a new predictor and prognostic indicator of cardiovascular disease. There is, however, still little evidence to relate RMH parameters to the severity of coronary lesions in patients with Acute Myocardial Infarction (AMI). In order to determine whether RMH was a predictor of Major Cardiovascular Events (MACE) in AMI patients who underwent percutaneous coronary intervention at the Sanglah General Hospital during hospitalization, this analysis was carried out.Methods: This study was an observational study design with a cohort study approach. The selection of study subjects was carried out by consecutive sampling, with a total of 60 patients. AMI patients who underwent percutaneous coronary intervention were included in the affordable population and met the inclusion and exclusion criteria during the study period. Data were analyzed with SPSS version 23 for Windows.Results: An independent measure of the occurrence of MACE during hospitalization in AMI patients is a high RMH value (RR = 1.459; p = 0.046; 95 percent CI = 1.028–25.366). In addition, it was found that independent predictors of mortality were smoking (RR = 1.555; p = 0.039; 95% CI = 1.131-116.058), diabetes mellitus type 2 (DM-2) (RR = 1.507; p = 0.036; 95% CI = 1.133-45,368) and high TIMI (RR = 1.512; p = 0.026; 95% CI = 1.268-43.772).Conclusion: In acute myocardial infarction patients, the high RMH value is an independent indicator of major cardiovascular events during hospitalization. Other variables such as diabetes mellitus, smoking, and the TIMI score were also found as predictors of major cardiovascular events during treatment in patients with acute myocardial infarction. Latar Belakang: Berbagai studi terakhir, banyak membahas tentang penanda dari sel inflamasi, dan salah satunya Rasio Monosit-High Density Lipoprotein (RMH) sebagai prediktor baru dan indikator prognosis dari penyakit kardiovaskular. Namun masih sedikit data yang menghubungkan parameter RMH terhadap derajat keparahan lesi koroner pada pasien Infark Miokard Akut (IMA). Studi ini dilakukan untuk mengetahui apakah RMH merupakan prediktor terhadap Kejadian Karviovaskular Major (KKM) pada pasien IMA yang menjalani intervensi koroner perkutan selama rawat inap di Rumah Sakit Umum Pusat Sanglah.Metode: Penelitian ini merupakan rancang studi observasional dengan pendekatan studi kohort. Pemilihan subjek penelitian dilakukan secara consecutive sampling dengan total 60 pasien. Pasien IMA yang menjalani intervensi koroner perkutan yang masuk populasi terjangkau dan memenuhi kriteria inklusi maupun eksklusi selama periode penelitian. Data dianalisis dengan SPSS versi 23 untuk Windows.Hasil: Nilai RMH yang tinggi (RR=1,459; p=0,046; 95% IK=1,028–25,366) merupakan prediktor independen terhadap kejadian KKM selama rawat inap pada pasien IMA. Selain itu didapatkan bahwa merokok (RR=1,555; p=0,039; 95% IK=1,131-116,058), Diabetes Mellitus Tipe 2 (DM-2) (RR=1,507; p=0,036; 95% IK=1,133-45,368), dan TIMI yang tinggi (RR=1,512; p=0,026; 95% IK=1,268-43,772) merupakan prediktor independen terhadap mortalitas.Kesimpulan: Nilai RMH yang tinggi merupakan prediktor indedepnden terhadap kejadian kardiovaskular mayor selama rawat inap pada pasien infark miokard akut. Didapatkan juga faktor lain seperti diabetes mellitus, merokok, dan skor TIMI sebagai prediktor terhadap kejadian kardiovaskular mayor saat perawatan pada pasien infark miokard akut.
Introduction: Coronavirus disease 2019 (COVID-19) is a health problem that is still engulfing the world that contributes to the high mortality rate globally. Death arises from the severity of the disease due to complications in important organs such as the heart. The purpose of this study was to systematically review the manifestations of cardiovascular disease in COVID-19 patients and their management in terms of published articles. Method: This research is a systematic review research. The research was conducted using the PRISMA method. Article searches are carried out by online publications throughPubMed, Science Direct and Google Scholarthat meet the inclusion and exclusion criteria. The population is articles about the manifestations of cardiovascular disease in COVID-19 patients and their management between 2011 and 2021. Inclusion criteria are studies that examine the manifestations of cardiovascular disease in COVID-19 patients and their management using primary data in the form of cohort research designs, in English and full text available. The exclusion criteria were a case study, review study and used secondary data. The data were analyzed by univariate analysis by calculating the frequency and percentage. Result: The results show that several manifestations of cardiovascular disease in COVID-19 patients include cardiac injury, heart failure, myocardial infarction, myocarditis, cardiomegaly and others.Complications of these diseases occur with or without comorbidities and the risk increases with comorbid cardiovascular disease. The management of COVID-19 patients is basically done with antiviral agents, reducing symptoms and protecting important organs such as the heart. Conclusion: In the treatment of COVID-19 patients with cardiovascular complications, the use of antiviral agents such as lopinavir or ritonavir should be used with caution because: may interact with cardiovascular drugs. Mechanical circulation support is suggested and the use of extracorporeal membrane oxygenation (ECMO) can also be performed totreat cardiovascular complications in COVID-19 patients. Keywords: COVID-19, cardiovascular, manifestation, management, systematic review.
Aims This study was conducted to determine the clinical characteristics and risk factors of reduced ejection fraction (EF) in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). Methods and Results Analytical observational study with a cross-sectional study design was conducted. All patients diagnosed with CAD and had a history of PCI at Sanglah Hospital from December 2020 – June 2021 were enrolled. Univariate analysis was performed to demonstrate the baseline characteristics of the patients. Chi-Square analysis was performed to determine the association between variables. Kruskal-Wallis analysis was performed to determine the differences in clinical characteristics between groups of patients based on the EF. There were 196 patients included in this study. Most of the patients were male (n = 135, 68.9%), with median age of 59 (22-81). The median of the EF was 59.2% (22-81). The most common comorbid found in the patients was hypertension (n = 108, 55.1%). Chi-Square analysis showed a significant association between hyperuricemia (p = 0.019; PR = 1.815; 95%CI= 1.163-2.831), arrhythmias (p = 0.002; PR = 2.271; 95%CI=1.491-3.459), and cardiomegaly (p = 0.011; PR = 1.722; 95%CI=1.151-2.577) with the reduced EF. In logistic regression analysis, arrhythmia (p = 0.009; PR = 4.191; 95%CI=1.426-12.320) was significantly associated with reduced EF. Kruskal-Wallis analysis showed a significant difference in white blood cell (p = 0.021), neutrophil (p = 0.027), and serum glutamic pyruvic transaminase (p = 0.013) in patients based on the EF. Conclusion The comorbidity of CAD had a significant association with the reduced EF. Early intervention against this factor can improve the quality of management in the patient.
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