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"Latar Belakang: Restenosis katup mitral didefinisikan sebagai penurunan mitral valve area (MVA) <1,5 cm2 atau penurunan MVA >50% pasca KMTP. Restenosis katup mitral bersifat time-dependent dan dikaitkan dengan major adverse cardiovascular events (MACE), seperti gagal jantung kongestif, kematian, operasi penggantian katup dan KMTP ulangan. Mekanisme penyebab restenosis katup mitral belum diketahui secara pasti tetapi diduga berkaitan dengan proses inflamasi kronik. Tujuan: Mengetahui hubungan inflamasi kronik dengan restenosis katup mitral pasca KMTP. Metode: Total 40 pasien stenosis katup mitral yang telah menjalani tindakan KMTP dikelompokkan menjadi kelompok kasus (n=20) dan kelompok kontrol (n=20) berdasarkan matching. Diambil data sekunder dari rekam medis berupa karakteristik pasien (jenis kelamin, usia dan profilaksis sekunder), data ekokardiografi pre KMTP (Skor Wilkins dan MVA pre KMTP), dan data ekokardiografi post KMTP (MVA pasca KTMP). Dilakukan pemeriksaan ekokardiografi (MVA follow-up) dan pemeriksaan lab (kadar IL-6). Kemudian dilakukan analisis statistik untuk mencari hubungan antara kadar penanda inflamasi kronik serta variabel bebas lainnya dengan restenosis katup mitral. Hasil: Median konsentrasi IL-6 adalah 2,39 (0,03 - 11,4) pg/mL. Tidak terdapat perbedaan statistik yang bermakna kadar IL-6 pada kedua kelompok (nilai p >0,05). Penurunan MVA adalah 0,13 (0 - 0,62) cm2/tahun dengan laju penurunan MVA ≥0,155 cm2/tahun merupakan prediktor kejadian restenosis katup mitral (nilai p <0.001, OR = 46,72, 95% CI 6,69 - 326,19). Simpulan: Inflamasi kronik yang dinilai dengan IL-6 tidak berhubungan dengan restenosis katup mitral.

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Background: Mitral valve restenosis is defined as decreased mitral valve area (MVA) <1.5 cm2 or decreased MVA >50% after PTMC. It is time-dependent and associated with major adverse cardiovascular events (MACE), such as congestive heart failure, cardiac death, mitral valve replacement, and redo PTMC. The mechanism is not yet known; however, chronic inflammation may have a role.

Objective: To know the association between chronic inflammation and mitral valve restenosis after PTMC.

Methods: A total of 40 patients with mitral valve stenosis who underwent successful PTMC were matched and classified into restenosis/case group (n=20) and no restenosis/control group (n=20). Secondary data was taken from electronic medical records such as patient characteristics (gender, age & 2nd prophylaxis), echocardiography data before PTMC (Wilkins’ score and MVA before PTMC), and echocardiography data after PTMC (MVA after PTMC). Follow-up echocardiography examination (follow-up MVA) and laboratory assessment of chronic inflammation marker (IL-6) were done on all patients. Statistical analyses were done to look for an association between the level of chronic inflammation marker & other independent variables with mitral valve restenosis.

Results: Median IL-6 concentration was 2.39 (0.03 - 11.4) pg/mL. There was no statistically significant difference in IL-6 levels between both groups (p-value >0.05). MVA decrement was 0.13 (0 - 0.62) cm2/year with rate of MVA decrement ≥0.155 cm2/year was predictor of mitral valve restenosis (p-value <0.001, OR = 46.72, 95% CI 6.69 - 326.19).

Conclusion: Chronic inflammation assessed by IL-6 was not associated with mitral valve restenosis"

"Latar belakang: Penyakit kardiovaskular adalah salah satu masalah kesehatan di seluruh dunia, khususnya di negara berkembang. Dengan tingginya kejadian penyakit jantung koroner akan berakibat makin meningkatnya tindakan intervensi di bidang kardiovaskuler untuk mengurangi tingkat morbiditas dan mortalitas pada pasien. Pada akhir dekade ini intervensi koroner perkutan IKP digunakan secara luas untuk menangani penyakit arteri koroner dimana timbulnya restenosis masih menjadi hambatan utama. Beberapa penelitian menunjukkan bahwa inflamasi lokal dan sistemis mempunyai peranan penting pada terjadinya patogenesis in-stent restenosis ISR. Sejumlah penanda inflamasi telah diajukan untuk memprediksi angka mortalitas baik jangka pendek maupun jangka panjang terhadap sindroma koroner akut SKA, ISR dan trombosis stent, termasuk disini adalah eosinophil cationic protein ECP. Laporan mengenai korelasi antara kadar ECP dengan ISR belum pernah dilaporkan di Indonesia. Metode: Dilakukan studi potong lintang pada pasien jantung koroner yang mengalami ISR pasca dilakukan tindakan IKP yang berobat di unit Pelayanan Jantung Terpadu PJT Rumah Sakit Cipto Mangunkusumo pada bulan April-Mei 2018. Pasien yang diketahui mengalami ISR dimasukkan sebagai subyek penelitian dan dilakukan pemeriksaan kadar ECP dengan metode Enzyme-Linked Immunosorbent Assay Human Eosinophil Cationic Protein ELISA. Analisa data menggunakan Analisa Bivariat dan uji korelasi Spearman. Hasil: Penelitian mendapatkan 32 subyek yang terdiri dari 27 subyek laki-laki 84,4 dan 5 subyek perempuan 15,6. Rerata usia pasien adalah 60,69 tahun dengan simpang baku 10,17. Tidak terdapat korelasi antara kadar ECP dan ISR r=0,099 ; p=0,589. Simpulan: Tidak terdapat korelasi antara kadar ECP dan ISR pada pasien PJK pasca dilakukannya IKP.

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Background Cardiovascular disease is one of the major health problems worldwide, especially in developing countries. With the high incidence of coronary heart disease will result in increased interventions in the field of cardiovascular to reduce the level of morbidity and mortality in patients. By the end of this decade percutaneous coronary intervention PCI is widely used to treat coronary artery disease where the onset of restenosis remains a major obstacle. Several studies have shown that local and systemic inflammation plays an important role in the development of in stent restenosis ISR pathogenesis. A number of inflammatory markers have been proposed to predict both short and long term mortality rates for acute coronary syndrome ACS, ISR and stent thrombosis, including here is eosinophil cationic protein ECP. Reports on the correlation between ECP and ISR levels have not been reported in Indonesia. Metods Cross sectional study was performed on coronary heart patients who had ISR after PCI performed treatment at Integrated Heart Service Unit of Cipto Mangunkusumo Hospital in April May 2018. Patients who were known to have ISR were included as research subjects and examined ECP levels by method of Enzyme Linked Immunosorbent Assay Human Eosinophil Cationic Protein ELISA. Data analysis using Bivariate Analysis and Spearman correlation test Result The study obtained 32 subjects consisting of 27 male subjects 84,4 and 5 female subjects 15,6. The average age of the patient is 60,69 years with standar deviation 10,17. There is no correlation between ECP and ISR levels r 0,09 p 0,589. Conclusion There was no correlation between ECP and ISR levels in CHD patients after PCI."

"Latar belakang: Pada iskemia tungkai kritis (ITK) infrapoplitea, tatalaksana utama bertujuan untuk revaskularisasi. Salah satu teknik revaskularisasi ITK infrapoplitea adalah plain old balloon angioplasty. Namun, masih terdapat re-stenosis yang terjadi setelah prosedur tersebut. Oleh karena itu, perlu dilakukan penelitian mengenai luaran prosedur disertai faktor-faktor yang mempengaruhinya. Metode: Penelitian ini merupakan penelitian kohort retrospektif, dengan populasi seluruh pasien ITK infrapoplitea yang menjalani tatalaksana revaskularisasi plain old balloon angioplasty di RSUPN Dr. Cipto Mangunkusumo dari Januari 2013-Mei 2017. Faktor inklusi yaitu subjek dengan PAP Rutherford derajat ≥ 4 dan kontrol minimal 1 kali pasca prosedur. Pengambilan data dilakukan melalui rekam medis dan registrasi pasien divisi bedah vaskular Departemen Ilmu Bedah RSUPN Dr. Cipto Mangunkusumo. Luaran yang dinilai adalah kejadian re-stenosis, amputasi, dan penyembuhan luka 1 tahun pasca-tindakan. Faktor yang diteliti pada penelitian ini adalah demografi, indeks massa tubuh (IMT),ankle-Brachial Index (ABI) komorbiditas, dan derajat Rutherford. Hasil: Terdapat 28 pasien subjek dalam penelitian ini. Kejadian re-stenosis terjadi pada 53,6% subjek. Kejadian amputasi terjadi pada 50% subjek. Luka semakin memburuk ditemukan pada 46,4% subjek. Terdapat hubungan antara perburukan luka pasca tindakan dengan derajat Rutherford subjek (p = 0,030). Terdapat hubungan antara riwayat penyakit jantung koroner (PJK) dengan perbaikan luka pasca tindakan (p = 0,014). Tidak didapatkan hubungan faktor lain dengan luaran ITK infrapoplitea yang menjalani plain old balloon angioplasty. Kesimpulan: Luaran ITK infrapoplitea yang menjalani plain old balloon angioplasty belum baik dilihat dari tingginya luaran re-stenosis, amputasi, dan penyembuhan luka. Derajat Rutherford sebelum tindakan berhubungan dengan luaran penyembuhan luka pasca tindakan.

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Background: In infrapopliteal critical limb ischemia (CLI), the treatment aimed to re-vascularized the vessel. One of infrapopliteal CLI re-vascularization technique is plain old balloon angioplasty. However, there were re-stenosis reported after that procedure. A study to evaluate the procedure outcome and the factors affecting it.

Methods: The design of this study is retrospective cohort, with population include all infrapopliteal CLI patients underwent plain old balloon angioplasty re-vascularization in Cipto Mangunkusumo General Hospital from Janury 2013-May 2017. Subjects with Rutherford category ≥ 4 and return to hospital to control minimal 1 time after procedure. Data acquired through medical record and Vascular Surgery Division registry. Outcome evaluated including re-stenosis, amputation, and wound healing 1-year post-procedure. Factors analysed in this study were demography, body mass index (BMI), ankle-brachial index (ABI), comorbidity, and rutherford category.

Results: There were 28 patients acquired in this study. Re-stenosis occurred in 53.6% subjects. Amputation occurred in 50% subjects. Wound worsen in 46.4% subjects. There were association of wound worsening and Rutherford category (p = 0.030). There were association of history of coronary artery disease (CAD) with wound healing post-procedure (p = 0.014). There were no association of other factors with infrapopliteal CLI underwent plain old balloon angioplasty.

Discussion: Infrapopliteal CLI outcome underwent plain old balloon angioplasty were not yet favourable from re-stenosis, amputation rate, and wound healing. Rutherford category pre-procedure associated with wound healing after procedure."