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Abstrak :
Latar Belakang: Penyakit Jantung Koroner (PJK) sebagai masalah kesehatan di Indonesia. Terdapat peningkatan kejadian PJK dihubungkan dengan peningkatan sindrom metabolik. Sampai saat ini belum ada data prevalensi sindrom metabolik pada subyek dengan PIK di RSCM. Tujuan: Untuk melihat proporsi sindrom metabolik pads populasi penderita PAC, serta profil komponen sindrom metabolik. Metode Penelitian bersifat deskriptif, dilakukan pada bulan Maret-Nopember 2005 di Poli Kardiologi, Divisi Kardiologi Departemen Penyakit Dalam RSCM.. Subyek adalah penderita PIK di RSCM dengan jumlah responden 92 subyek. Hasil: Dari 92 responden didapatkan hasil yang mengalami sindrom metabolik pada PJK sebesar 45 (48,9%) lebih besar dibandingkan populasi umum (16,5%-31,1%), dengan komposisi laki-laki 30 (66,7%) clan perempuan 15 (33,3%). Rerata usia 59 tahun (1K 95% 55-63), rerata tekanan darah sistolik 133,9 mmHg (IK 95% 129,7-138,1), rerata tekanan darah diastolik 83,2 mmHg (IK 95% 80,8-85,6), rerata indeks massa tubuh 25 kg/m2 (IK 95% 24,3-25,7), rerata lingkar perut 86,5 cm (IK 84,6-88,4), rerata HDL 42,9 mg/dL (IK 95% 41,04,8), rerata LDL 133,7 mg/dL (IK 95% 126,3-141,1), rerata trigliserida 149,9 mgldL (1K 95% 131,6-168,2), rerata glukosa darah puasa 110,4 mg/dL (1K 95% 101,9-118,9). Simpulan Sindrom metabolik ditemukan pada sebagian besar populasi penderita PJK. Kata Kunci : PJK, sindrom metabolik, proporsi.

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Background: Coronary heart disease (CHD) has become one of health problems in Indonesia. The increment in CHD incidence is associated with increment in metabolic syndrome. Currently, there is no data about metabolic syndrome in patient with CHD at Dr. Cipto Mangunkusumo hospital. Purpose_ (1) To find out the proportion of metabolic syndrome among CHD patients. (2) To find out the profiles of the components of metabolic syndrome. Methods: We conducted a descriptive study during March - November 2005 in Cardiology outpatient unit, Dr. Cipto Mangunkusumo hospital. The subjects for this study were CHD patients who came to the outpatient unit. The numbers of subjects included were 92 people. Results: From 92 subjects who participated in this study, we found 45 subjects (48.9%) had metabolic syndrome more than general population 16.5%-31.1%). Thirty six subjects (66.7%) were male. Mean age was 59 years old (95% CI = 55 - 63 years old)_ Mean systolic pressure was 133.9 mmHg (95% CI = 1293 - 138.1 mmHg). Mean diastolic pressure was 83,2 mmHg (95% CI = 80.8 --- 85.6 mmHg). Mean Body Mass Index was 25 kglm2 (95% CI = 24.3 - 25.7 kglm2). Mean waist circumference was 86.5 cm (95% CI = 84.6 - 88.4 cm). Mean HDL level was 42.9 mg/dL (95% CI = 41,0 - 44.8 mg/dL). Mean LDL level was 133.7 mg/dL (95% CI = 126.3 - 141.1). Mean triglyceride level 149.9 mg/dL (95% CI = 131.6 - 168.2 mg/dL). Mean fasting blood glucose level was 110.4 mg/dL (95% CI = 101.9 -118.9). Conclusion. Metabolic syndrome was found in the majority of CHD patients. Keywords : coronary heart disease, metabolic syndrome.

Abstrak :
Latar belakang. Gagal jantung dan aritmia merupakan penyebab kematian tersering pada penderita thalassemia R. Gangguan fungsi jantung, khususnya disfungsi diastolik merupakan komplikasi dini pada jantung akibat muatan besi berlebih (iron overload). Kadar feritin serum sampai saat ini masih secara luas digunakan sebagai parameter muatan besi berlebih (iron overload). Tujuan. Mengetahui perbedaan kadar feritin serum antara penderita thalassemia j3 dewasa yang mengalami dan tidak mengalami disfungsi diastolik ventrikel kiri, dan mengetahui besar proporsi disfungsi diastolik pada penderita thalassemia 13 dewasa. Metodologi. Penelitian ini merupakan studi potong lintang untuk melihat perbedaan kadar feritin serum (sebagai parameter iron overload) pada penderita thalassemia 13 dewasa yang mengalami disfungsi diastolik dibandingkan dengan yang tanpa disfungsi diastolik, serta untuk mendapatkan proporsi disfungsi diastolik pada penderita thalassemia 3 dewasa. Analisis terhadap variabel-variabel yang diteliti menggunakan uji-1 independen untuk mendapatkan perbedaan rerata kadar feritin serum antara kedua kelompok. Hasil. Dari penelitian ini 30 orang penderita thalassemia 13 dewasa, laki-laki 13 orang, perempuan 17 orang, didapatkan rerata usia 25,9 tahun dengan rentang usia antara 18-38 tahun. Rerata Hb sebesar (7,5g%, SB I,4g%) dengan rentang kadar Hb antara 5,2 - 9,9 g%. Rerata kadar feritin serum sebesar (5590ng1m1, SB 4614,7 nglml) dengan rentang kadar, feritin antara 296,4 - 15900 nglml. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%. Kesimpulan. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%. ...... Background. Heart failure and aritmia is the major cause of death in 3 thalassemia major. Heart dysfunction, especially diastolic dysfunction in ji thalassemia seems to be an early involvement of the heart due to iron overload. Serum ferritin level as a parameter of iron overload still widely use for evaluation in 13 thalassemia. Objectives. To know the mean difference of serum ferritin level between adult 13 thalassemia patients who have left ventricular diastolic dysfunction and who do not have Ieft ventricular diastolic dysfunction, and to obtain the proportion of diastolic dysfunction in adult 13 thalassemia patients. Methods. This cross-sectional study was conducted to see the mean difference of Serum ferritin. IeVel'(as a parameter of iron overload) in adult P'thalassemia who have left ventricular diastolic dysfunction and who do not have left ventricular diastolic dysfunction and to know the proportion of diastolic dysfunction among adult 13 thalassemia. The independent t-test was used to analyze the variables to obtain the mean difference of serum ferritin level between the two groups. Results. Thirty adult P thalassemia patients, 13 were male and 17 were female had been enrolled into this study. The age of the patients ranged from 18 to 38 years old, and the average-age was 25,9 years. The Hb level ranged from 5,2 to 9,9 g% and the mean was (7,5g%, SD 1,4g°/o). The serum ferritin level ranged from 296,4 to 15900 nglml, and the mean was (5590ng/ml, SD 4614,7 nglml). There was no significance mean difference serum ferritin level in patients who had diastolic dysfunction and those who do not have diastolic dysfunction. The proportion of diastolic dysfunction in adult 13 thalassemia patients in this study was 70%. Conclusions. There was no significannce mean difference serum ferritin level in patients who had. diastolic dysfunction and those. who. did, not have diastolic dysfunction . The proportion of diastolic dysfunction in adult thalassemia 3 patients in this study was 70%.

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Penyakit Graves merupakan penyakit autoimun pada kelenjar tiroid dengan manifestasi berbagai sistem organ, termasuk sistem kardiovaskular akibat hipertiroid. Pada pasien hipertiroid terjadi peningkatan fungsi sistolik ventrikel kiri dibandingkan populasi normal. Beberapa penelitian tentang kadar hormon tiroid mendapatkan hasil yang berbeda-beda. Hipotesis pada penelitian ini adalah peningkatan kadar hormon tiroid akan diikuti peningkatan fungsi ventrikel kiri. Tujuan Diketahui korelasi kadar tiroksin bebas dan fraksi ejeksi ventrikel kiri pada pasien Graves yang belum diobati. Metode Pada penelitian potong lintang ini digunakan kadar tiroksin bebas sebagai parameter hormon tiroid dan fraksi ejeksi ventrikel kiri (LVEF) menurut cara Simpson yang dimodifikasi dengan ekokardiografi sebagai parameter fungsi sistolik ventrikel kiri. Kadar tiroksin bebas diperiksa di laboratorium sedangkan fraksi ejeksi ventrikel kiri cara Simpson dinilai dengan alat ekokardiografi. Hasil Didapatkan 10 pasien, 7 laki-laki dan 3 perempuan, dengan usia 18-52 tahun. Lama gejala dirasakan pasien 2-12 bulan. Pada pasien didapatkan rerata kadar fT4 5,75 (SB 0,96) ngldL dan rerata fraksi ejeksi ventrikel kiri 70,57 (SB 4,50) %. Didapatkan koefisien korelasi positif antara kadar tiroksin bebas dan fraksi ejeksi ventrikel kiri (r=0,711, p=0,021) pada pasien Graves yang belum diobati Kesimpulan Pada penelitian ini didapatkan korelasi positif kuat antara kadar tiroksin bebas (fT4) dan fraksi ejeksi ventrikel kiri (LVEF) pada pasien Grave yang belum mendapat pengobatan.

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Graves' disease is an autoimmune disease of thyroid gland which can be manifested in many organ system, especially cardiovascular system due to hyperthyroid. Hyperthyroid patients have a higher left ventricular systolic function than normal. Several studies of correlation between thyroid hormone level and cardiac function have showed different results. The hypotesis tested in this study is the increasing thyroid level will followed by the increase of left ventricular systolic function in Graves' disease. Objective To determine the correlation between thyroid hormone level and left ventricular ejection fraction in newly diagnosed Graves' patients. Methods In this cross-sectional study, we use the free thyrosine level as a parameter of thyroid hormon and use left ventricular ejection fraction as a parameter of left ventricular systolic function. Free thyroxine level was measured in the laboratory and the LVEF were assessed by Simpson's methods of echocardiography study. Results Ten patients (7 men and 3 women; age 18-52 years old) were studied. Their average of ff4 was 5.75 (SD 0.96) ngldL and their average of LVEF was 70.57 (SD 4.50) %. There was positive correlation coefficient between free thyroxine level and left ventricular ejection fraction (r=0.711, p=0.021) in newly diagnosed Graves' patients. Conclusion In this study there was strong positive correlation between free thyroxine (fT4) and left ventricular ejection fraction (LVEF) in newly diagnosed Graves' patients.

Abstrak :
Latar belakang. Menurut hasil survey Kesehatan Rumah Tangga (SKRT) Indonesia 1992, angka kematian akibat penyakit kardiovaskular telah menduduki urutan teratas. Obesitas berhubungan dengan peningkatan mortalitas kardiovaskular. Pengaruh peningkatan berat Madan sebagai faktor independen komorbiditas terhadap kelainan struktur dan fungsi jantung ini belum dapat dibuktikan. Tujuan. Penelitian ini bertujuan untuk membuktikan adanya peningkatan massa ventrikel kiri pada wanita obes sebagai bagian yang menentukan fungsi ventrikel kin. Metode. Sebanyak 90 subyek penelitian terdiri dari 45 orang obes (BMI > 25 KgIM2) dan non obese (BM <25 kgfM2) sebagai kontroi. Dengan menggunakan M mode Ekokardiografi dilakukan pengukuran massa ventrikel kin jugs dilakukan pemeriksaan CT Abdomen untuk menilai ketebalan lemak viseral. Faktor lain seperti tekanan darah, resistensi insulin, dan lingkar pinggang juga dievaluasi. Hasil. Didapatkan perbedaan bermakna massa ventrikel kin antara kelompok obes dan non obes (P=0,000), juga tekanan darah sistolik (P-0,005), tekanan dash diastolik (P=0,006), lingkar pinggang (P=0,000), lemak viseral (P=0,000), HOMA-IR (P=0,000). Penelitian ini membuktikan korelasi yang bermakna antara massa ventrikel kin dengan ketebalan lemak viseral (r = 0,67 , P = 0,000), dengan IMF (r = 0,67 , P = 0,000), dengan lingkar pinggang (r = 0,69 , P = 0,000), dengan HOMA-IR (r = 0,57 , P = 0,000). Kesimpulan. Penelitian ini adalah penelitian pertama yang mengkorelasikan antara massa ventrikel kiri dengan peningkatan tebal lemak viseral, IMT, lingkar pinggang dan HOMA-IR pada populasi wanita Indonesia usia produktif. Lebih jauh pads penelitian ini memperlihatkan hubungan antara obesitas dengan peningkatan kelainan kardiovaskular.

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Background. Based on Indonesia Household Health Survey 1992, the leading cause of death is cardiovascular diseases. Obesity is related to the increase of cardiovascular mortality rate. The role of body weight as an independent co-morbidity factor for structure abnormality and cardiac function has not been proven yet. Objective . This study aims to measure left ventricular mass of obese women which partly determines the function of left ventricular. Method. The total study subjects is 90, which consists of 45 obese women (BMI > 25 KgIm2) and 45 non-obese women (BMI < 25 Kg/m2) as control group. They are evaluated by M mode echocardiography and CT Scan abdomen to measure visceral fat, blood pressure, insulin resistance and waist circumference. Both groups were correlated. Result. There are significant differences in left ventricular mass of obese and non-obese group (P = 0.000), systolic blood pressure (P = 0.000), diastolic blood pressure (P = 0.006), waist circumference (P = 0.000), visceral fat (P = 0.000), and HOMA-IR (P = 0.000). With bivariant analysis, it comes to a conclusion that there are significant correlation between left ventricular mass and visceral fat (r = 0.67, P = 0.000); between BMI and left ventricular mass (r = 0.67, P = 0.000); between waist circumference and left ventricular mass (r = 0.72, P = 0.000); and also between HOMA-IR and left ventricular mass (r = 0.57, P = 0.000). Conclusion . This is the first study that correlation between increasing of left ventricular mass and visceral fat, BMI, waist circumference and HOMA-IR on The Indonesian Women Population. So far, this study shows a relationship between obesity and high cardiovascular risk.

Abstrak :
Latar Belakang: Carotid stiffness (CS) merupakan perubahan fungsional pada arteri karotis akibat aterosklerosis. Diabetes mellitus tipe 2 (DMT2) akan mempercepat dan memperburuk aterosklerosis sehingga meningkatkan risiko kejadian kardiovaskular. Sampai saat kini belum ada data di Indonesia tentang CS pada pasien penyakit jantung koroner (PJK) stabil dengan DMT2 yang menggunakan sistem otomatis echotracking ultrasound berbasis frekuensi radio. Penelitian ini bertujuan untuk membandingkan CS pada pasien PJK stabil dengan dan tanpa DMT2. Metode: Comparative cross-sectional antara kelompok pasien PJK stabil dengan dan tanpa pasien DMT2. Pemeriksaan CS dilakukan dengan posisi pasien berbaring telentang secara non-invasif pada 1 cm sebelum bulbus arteri karotis kiri dan kanan menggunakan automatic echotracking radiofrequency-based ultrasound dengan probe linear 3-13 MHz. Pengukuran CS dilakukan sebanyak enam kali pada masing-masing sisi arteri karotis dengan nilai tertinggi rerata carotid Pulse Wave Velocity (car-PWV) sebagai nilai CS individu. Hasil: Dari total 42 pasien (21 pasang) yang diperiksa didapatkan nilai rerata car-PWV pasien PJK stabil dengan DMT2 lebih tinggi dibandingkan pasien PJK stabil tanpa DMT2 (9,8±1,3m/s vs 6,7±1,3m/s, p< 0,001). Kesimpulan: Nilai carotid stiffness pasien PJK stabil dengan DMT2 lebih tinggi dibandingkan pasien PJK stabil tanpa DMT2. ...... Background: Carotid stiffness (CS) represents the functional changes in carotid arteries due to atherosclerosis. Progression of atherosclerosis was more accelerated in type 2 diabetes mellitus (T2DM) compared to non-diabetic patient, thus increasing the risk of cardiovascular events. Until now there is no data of CS in stable coronary artery disease (CAD) with T2DM in Indonesia using automatic echotracking radiofrequency-based ultrasound. The aim of this study was to compare CS in stable CAD with and without T2DM patient. Method: Comparative cross-sectional between group of stable CAD with and without T2DM patients. CS was measured in patient lying down non-invasively at 1 cm proximal to bulbus of the left and right carotid artery using automatICechotracking radiofrequency-based ultrasound system, 3-13 MHz linear probe. The highest mean carotid pulse wave velocity (car-PWV) value of six measurements of both side was used as an individual CS. Result: Total 42 patients (21 pairs) was examined. Mean value of car-PWV stable CAD with T2DM patient is higher than stable CAD without T2DM patient (9.8 1.3 m/s vs. 6.7 1.3 m/s, p<0.001). Conclusion: Carotid stiffness value of stable CAD with T2DM patient is higher than stable CAD without T2DM patient.

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ABSTRAK
Tujuan: mendapatkan kuesioner Minnesota Living with Heart Failure MLHFQ versi bahasa Indonesia yang sahih dan handal untuk digunakan di Indonesia. Metode: studi ini merupakan studi potong lintang dengan 85 subyek rerata usia 58 11, pria 55 pasien gagal jantung kronik di poli kardiologi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta. Kesahihan diuji dengan menilai kesahihan konstuksi multitrait multimethod analysis dan kesahian eksternal dengan membandingkan dengan kuesioner SF-36. Keandalan dinilai dengan menggunakan cronbach ?, dan intraclass coefficient correlation ICC . Hasil: MLHFQ bahasa Indonesia memiliki korelasi sedang-kuat antara domain dan item pertanyaan r 0,571-0,748, ABSTRACT
Aim to obtain a valid and reliable Indonesian version of MLHFQ for Indonesian application. Methods This cross sectional study enroled 85 patients mean age 58 11, male 55 with chronic heart failure of of cardiology clinic Ciptomangunkusumo Central Hospital Jakarta. Validity of MLHFQ was evaluated by measuring construct validity using multitrait multimethod analysis and by compairing MLHFQ with SF 36. Reliability of MLHFQ was evaluated by calculating Intraclass Correlation Coefficient ICC and by calculating cronbach to determine internal consistency Results Indonesian version of MLHFQ has moderated strong correlation item to domain correlation r 0,571 0,748, p

Abstrak :
Latar Belakang: Pasien infark miokard akut (IMA) dengan hipertensi memiliki risiko yang lebih tinggi untuk terjadinya major adverse cardiac events (MACE). Pengukuran left ventricular mass index (LVMI) dengan ekokardiografi dapat membantu mengidentifikasi pasien IMA dengan hipertensi yang memiliki risiko untuk terjadinya MACE. Namun, penelitian mengenai hubungan antara LVMI dengan kejadian MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan belum ada di Indonesia. Tujuan: Mengetahui hubungan antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan. Metode: Penelitian ini merupakan studi kohort retrospektif di RSUPN Dr. Cipto Mangunkusumo dengan menggunakan data rekam medis pada periode tahun 2018–2022. Nilai LVMI didapatkan berdasarkan pemeriksaan ekokardiografi. Kejadian MACE dinilai pada saat perawatan Intensive Cardiology Care Unit (ICCU). Analisis menggunakan uji univariat, bivariat (chi-square), dan multivariat (regresi logistik) untuk melihat hubungan antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan. Hasil: Dari 160 pasien dengan IMA dan hipertensi yang menjalani revaskularisasi perkutan, terdapat 38 subjek (23,8%) yang mengalami MACE selama perawatan di ICCU. Dari 51,9% subjek dengan nilai LVMI meningkat, terdapat 34,9% yang mengalami MACE. Terdapat hubungan yang bermakna antara LVMI dan MACE dengan RR 2,99 (IK 95% 1,51-5,90) p 0,002). Pada analisis multivariat regresi logisitk, setelah memperhitungkan variabel perancu (usia dan penyakit ginjak kronik), LVMI secara independen terkait dengan peningkatan risiko kejadian MACE, dengan adjusted RR yang disesuaikan sebesar 2,869 (IK 95% 1,443–5,703) p 0,003. Kesimpulan: Terdapat hubungan yang bermakna antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan. ......Background: Patients with acute myocardial infarction (AMI) and hypertension have a higher risk of major adverse cardiac events (MACE) complications. Measuring the left ventricular mass index (LVMI) with echocardiography can help to identify AMI patients with hypertension who are at risk for MACE. However, study regarding the association between LVMI and MACE occurrence in patient with AMI and hypertension post-percutaneous coronary intervention (PCI) has not been conducted in Indonesia. Objective: To determine the association between LVMI and MACE in patients with AMI and hypertension after PCI. Methods: This is a retrospective cohort study at Dr. Cipto Mangunkusumo National General Hospital utilizing medical record data from the period of 2018 to 2022. The LVMI values were obtained based on echocardiographic examinations. MACE events were assessed during ICCU (Intensive Cardiology Care Unit) admission. The analysis utilized univariate, bivariate (chi-square), and multivariate (logistic regression) tests to examine the association between LVMI and MACE in patients with AMI and hypertension post-PCI. Results: A total of 160 patients with AMI and hypertension undergoing PCI, 38 subjects (23.8%) experienced MACE during follow up in ICCU. Among 51,9% subjects with increased LVMI, 34.9% experienced MACE. There was a significant association between LVMI and MACE with a relative risk (RR) of 2,99 (95% CI 1,51–5,90, p 0,002). After adjustment for the confounders (age and chronic kidney disease) in a multivariate analysis logistic regression, LVMI was independently associated with risk for MACE with adjusted RR 2,869 (95% CI 1,443–5,703, p 0,003) Conclusion: There was a significant association between LVMI and MACE in patients with AMI and hypertension who have undergone percutaneous revascularization.

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Latar Belakang: Studi epidemiologi menunjukkan bahwa DM merupakan salah satu faktor dalam proses terjadinya aterosklerosis dan mempengaruhi secara nyata kesaldtan dan kematian akibat PIK. Dibandingkan dengan penderita bukan DM, penderita DM 2-4 kali lebih banyak menderita P3K dan 2-4 kali lebih banyak mengalami kematian jangka pendek setelah menderita serangan infark miokard akut Dewabrata mendapati 23,2% penderita infark miokard akut yang di rawat di RSCM selama periode 1994-1999. Data di Indonesia tersebut belum banyak menggambarkan bagaimana karakteristik penderita DM tersebut saat terbukti menderita infark miokard akut. Dengan demildan, gambaran penderita DM yang mengalami sindrom koroner akut merupakan ha! yang renting untuk diketahui, baik karakteristik klinis maupun komplikasi yang muncul akibat S1CA tersebut. Tujuan. Penelitian ini ingin mengetahui prevalensi SKA pada penderita DM tipe-2. Penelitian ini juga ingin mengetahui karakteristik klinis dan komplikasi SKA pada penderita DM tipe-2 serta perbandingannya dengan penderita bukan DM. Metodologi. Studi potong lintang retrospektif untuk mengetahui prevalensi dan karakteristik klinis serta studi kohort retrospektif untuk mengetahui perbandingan komplikasi SKA pads penderita DM tipe-2 dan penderita bukan DM, terhadap penderita yang dirawat di ICCU RSCM periode 1 Januari 2001 s.d. 31 Desember 2005. Hasil. Didapatkan data: Prevalensi SKA penderita DM tipe-2: 34,2%. Awitan nyeri penderita DM lebih lama, 70,7% vs 53,4%, p=0,001; 1K 95%; DR=2,259 (1,372-3,719). Nyeri dada tidak khas, didapati penderita DM lebih banyak, 17,3% vs 9,8% p~ 0,041; 1K 95%; OR=1,713 (1,019-2,881)_ Komplikasi: Gagal jantung: penderita DM tipe-2 Iebih banyak: 39,35% vs 16,8%, p=0,001; 11(95%; RR-3,213 (1,992-5,182). Untuk komplikasi syok kardiogenik, didapati penderita DM tipe-2 Iebih banyak, 16,2% vs 8,9%, p= 0,031; IK 95%; RR==1,983 (1,057-3,721). Sedangkan komplikasi kematian didapati penderita DM tipe-2 lebih banyak, 17,3% vs 6,3%, dengan p= 0,001; 1K 95%; RR= 3,116 (1,556-6,239). Simpulan. Didapatkan perbedaan karakteristik klinis SKA antara penderita DM tipe-2 dengan penderita SKA bukan DM. Awitan nyeri lebih lama dan keluhan nyeri dada yang tidak khan, Iebih banyak didapati Dada penderita DM tipe-2. Didapatkan juga perbedaan dalam hat komplikasi SKA. Kejadian gagal jantung, syok kardiogenik dan kematian didapatkan lebih tinggi pada penderita DM tipe-2.

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Background. Epidemiologic studies revealed diabetes mellitus (DM) as one of the factors involved in atherosclerosis process. DM also influence morbidity and mortality-related to coronary artery disease (CAD). Compared to non diabetic patients, type -2 DM patients suffer CAD 2-4 times more often and had increased short term mortality rate due to acute myocardial infarction 2-4 times more likely. During 1994-1999, Dewabrata found 23.2% of all acute myocardial infarction patients was diabetic patients treated in ICCU Cipto Mangunkusumo hospital. Unfortunately these data did not describe the clinical characteristic and complication ACS in type -2 DM patients. Therefore it is important to know the clinical characteristics and ACS related complications in type-2 DM patients. Objectives. To know the prevalence of type-2 DM among ACS patients, to learn clinical characteristics and ACS related complications in type-2 DM compared to non diabetic patients. Methods. A cross sectional retrospective study was performed to know the prevalence of ACS in type -2 DM patients and their clinical characteristics_ A retrospective cohort study was performed to compare the differences in ACS related complications in type -2 DM and non diabetic patients who were hospitalized in ICCU Cipto Mangunkusumo hospital during 5 years period (January 1st, 200I December 31st, 2005). Results. Prevalence of Type-2 DM among ACS patients : 34.2%. The onset of chest pain in type-2 DM patients was longer, 70.7% vs 53.4%, p=0.40l; CI 95%; OR=2.259 (1.372-3.719). Aypical chest pain were often in type-2 DM patients, 17.3% vs 9.8%; p= 0.041; CI 95%; OR 1.713 (L019 2.881). Heart failure as complications were more often found in type-2 DM patients, 39.35% vs 16.8%, p=0.001; CI 95%; RR=3.213 (1.992-5.182), cardiogenic shock were more often found in type-2 DM patients, 16.2% vs 8.9%, p= 0.031; CI 95%; RR 1.983 (1.057-3.721), and death were more often found in type-2 DM patients, 17.3% vs 6.3%, p= 0.001; CI 95%; RR= 3.116 (L556-6.239). Conclusions. There are differences in clinical characteristics of ACS between type-2 DM patients and non diabetic patients; which are longer onset of chestpain and atypical chestpain more often in type-2 DM patients. There are also differences in complications related ACS between Type-2 DM patients and non diabetic patients; heart failure, cardiogenic shock, and death more often in Type-2 DM patients.

Abstrak :
Penyakit jantung koroner (PJK) merupakan suatu penyakit multisistemik yang dapat berkembang ke dalam spektrum penyakit yang luas. Sebagai suatu penyakit kompleks, PJK dapat muncul dari interaksi kompleks beragam faktor termasuk faktor lingkungan dan genetik. Protein HDAC9 dan BAZ2B berperan penting dalam proses regulasi transkripsi selama proses aktivasi proinflamasi endotelial yang bertanggungjawab dalam pembentukan aterosklerosis di pembuluh darah. Kanal ion natrium utama jantung yang dikode oleh gen SCN5A bertanggungjawab dalam proses depolarisasi potensial aksi jantung. Mutasi pada gen SCN5A berasosiasi dengan kelainan irama jantung yang dapat meningkatkan progresivitas PJK. Adapun tujuan dalam penelitian ini yaitu untuk mengetahui adanya hubungan antara variasi gen SCN5A, HDAC9, dan BAZ2B dengan penyakit jantung koroner di Jakarta, Indonesia. Penelitian kasus-kontrol terdiri dari 90 pasien PJK dan 100 orang kontrol. Metode Sanger sequencing digunakan untuk mendeteksi adanya polimorfisme gen. Hasil penelitian ini menunjukkan bahwa terdapat hubungan yang signifikan antara varian pada gen SCN5A rs1720524 dengan PJK. Alel C gen SCN5A rs11720524 secara signifikan berhubungan dengan PJK (p=0,029; OR=2,082). Analisis variasi gen BAZ2B rs4665058 juga menunjukkan adanya hubungan yang signifikan dengan PJK. Genotipe AA atau alel A gen BAZ2B rs4665058 berasosiasi secara signifikan dengan PJK (p=0,005; OR=2,942). Tidak ada hubungan antara variasi gen SCN5A rs41312391 dan HDAC9 rs2107595 dengan penyakit jantung koroner. ......Coronary heart disease (CHD) is a multisystemic disease that can develop into a broad spectrum of diseases. As a complex disease, CHD appears from complex interactions with various factors including environmental and genetic factors. HDAC9 and BAZ2B play an important role in transcriptional regulation during endothelial proinflammatory activation. The cardiac sodium channel encoded by the SCN5A gene is responsible for the depolarization phase of the cardiac action potential. Genetic mutation of SCN5A is associated with irregular heart rhythm, leading to CHD progression. The aim of this study is to determine the association of genetic variation in the SCN5A, HDAC9, and BAZ2B with the risk of coronary heart disease in Jakarta, Indonesia. A case-control study was performed on 90 patients with CHD and 100 controls. Sanger sequencing methods were used to detect gene polymorphisms. Results showed that the rs11720524 in SCN5A genes and BAZ2B rs4665058 were significantly associated with the risk of coronary heart disease. The C allele of rs11720524 polymorphism of the SCN5A gene is significantly associated with CHD (p=0,029; OR=2,082). Genetic variation analysis showed that the AA genotype and A allele of the BAZ2B rs4665058 variant had a significant association with the risk of CHD (p=0,005; OR=2,94). There is no association between genetic variations in SCN5A rs41312391 and HDAC9 genes with CHD risk.

Abstrak :
Latar Belakang. Lama rawat intensif pasien pascabedah jantung yang memanjang mempengaruhi alur pasien bedah jantung berikutnya. Pengaturan pasien berdasarkan lama rawat diperlukan agar alur pasien lancar. Tujuan. Membuat prediksi lama rawat intensif 48 jam berdasarkan nilai skor dari model EuroSCORE dan model yang dimodifikasi dari faktor-faktor EuroSCORE. Metode. Penelitian restrospektif dilakukan pada Januari 2012 - Desember 2013 pada 249 pasien yang menjalani bedah jantung di Unit Pelayanan Jantung RSUPN Dr Cipto Mangunkusumo Jakarta. Analisis survival dan regresi Cox dilakukan untuk membuat prediksi lama rawat intensif 48 jam. Hasil. Median kesintasan lama rawat intensif 43 jam. Nilai skor EuroSCORE tidak memenuhi asumsi hazard proporsional. Model baru telah dibuat dari 7 variabel EuroSCORE yang secara substansi berhubungan dengan lama rawat intensif (AUC 0,67). Kesimpulan. Model baru dari tujuh faktor EuroSCORE cukup dapat memprediksi lama rawat intensif 48 jam. ......Background. Prolonged intensive care unit length of stay (ICU-LOS) in a postcardiac surgery may shortage of ICU beds due to clog of patient flow. Improving ICU-LOS may lead to better patient flow. Objectives. To predict 48-hour ICU-LOS based on EuroSCORE model and to create a modified EuroSCORE factors model. Methods. A retrospective study was conducted from January 2012 to December 2013 among 249 patients who underwent cardiac surgery at Integrated Cardiac Services, Cipto Mangunkusumo Hospital, Jakarta. Survival analysis and Cox?s regression were performed to make a prediction model for 48-hour ICU-LOS. Results. Median survival of ICU-LOS was 43-hour. The EuroSCORE model did not meet the proporsional hazard assumption. A new substantial model from 7- EuroSCORE factors was created to predict 48 hours ICU-LOS (AUC 0.67). Conclusions. Seven EuroSCORE factors was sufficient as a new model to predict the 48-hour ICU-LOS.