Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: micro-RNA saat ini telah diketahui berperan dalam patofisiologi berbagai penyakit termasuk di bidang kardiovaskular. miR-26a platelet dikaitkan dengan aktifitas platelet tinggi.Resistensi klopidogrel telah diketahui memiliki prevalensi yang cukup tinggi di populasi Asia, yang mana dapat mempengaruhi mortalitas serta kejadian kardiovaskular mayor. Hubungan antara ekspresi miR-26a platelet dengan resistensi klopidogrel begitu pula dengan TIMI flow pasca IKPP pada IMA-EST di populasi Asia, belum pernah dilaporkan. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi miR-26a platelet terhadap reaktivitas platelet dan perfusi miokardium pasca IKPP. Metode: Pada pasien IMA-EST yang menjalani IKPP dan mendapatkan terapi dosis loadingklopidogrel 600 mg, dimasukkan kedalam populasi penelitian. Kami mengukur reaktivitas platelet dengan menggunakan VerifyNow P2Y12, aktifitas platelet tinggi didefiniskan jika memiliki nilai > 208 PRU. Metode RealtimePCR Taqman dilakukan untuk analisa ekspresi miR-26a platelet. Ekspresi miR-26a platelet dan reaktivitas platelet dikorelasikan dengan TIMI flowpasca IKPP pada pasien IMA-EST. Hasil: Terdapat 100 subyek yang direkrut pada studi ini. Diantaranya, 59% menunjukkan peningkatan ekspresi miR-26a. Reaktifitas platelet meningkat pada 27 % pasien studi ini dikategorikan non-responder terhadap klopidogrel. Terdapat hubungan antara ekspresi dengan penurunan fungsi penghambatan platelet (OR 4.2, p = 0.006). Indeks reaktivitas platelet >208 PRU meningkatkan risiko TIMI flow < 3 (OR 3.3, p= 0.015). Tidak terdapat hubungan langsung antara ekspresi miR-26a platelet dan TIMI flow < 3. Kesimpulan: Pasien dengan peningkatan ekspresi miR-26a platelet memiliki risiko untuk mengalami menjadi non-responderklopidogrel. Tidak terdapat hubungan langsung antara ekspresi miR-26a platelet dan TIM flowpasca IKPP.

---

Background: micro-RNA has now been known to play a role in the pathophysiology of various diseases including cardiovascular disease. Clopidogrel resistance has been known prevalent in Asian population, that may affect mortality and major cardiovascular events. The relationship between the expression of platelet miR-26a and clopidogrel resistance as well as TIMI flow post primary PCI in STEMI among Asian populations, has never been done.

Objective: the aim of this study is to define whether miR-26a platelet expression has a relation with platelet reactivity and myocardial perfusion after primary PCI.

Methods: STEMI patients who underwent primary PCI and has received 600 mg loading dose of clopidogrel were recruited for the study. We measured platelet reactivity by VerifyNow P2Y12, high platelet reactivity was defined as > 208 PRU. Realtime PCR by taqman method were performed to asses the expression of miR-26a platelet. miRNA-26a platelet expression and platelet reactivity were correlated with TIMI flow post primary PCI in STEMI.

Hasil: there were 100 patients recruited for this study. among them, 59% of patients with high expression of miR-26a platelet. Platelet reactivity showed 27% of the patients were clopidogrel non-responders. There was a relationship between high miR-26a expression and decreased function of platelet inhibition (OR 4.2, p = 0.006). Platelet reactivity index > 208 increased the risk of suboptimal reperfusion (OR 3.3, p = 0.015). There was no direct correlation between miR-26a expression and TIMI flow < 3.

Conclusion: Patients with high miR-26a platelet expression had increased risk of being clopidogrel non responders. There is no direct relationship between miR-26a platelet expression and TIMI flow after primary PCI."

"Penyakit Arteri Perifer (PAP) merupakan obstruksi total atau parsial dari arteri perifer yang terutama disebabkan oleh proses aterosklerosis. Disfungsi endotel telah dikenal sebagai penanda dini dari aterosklerosis. Dari penelitian sebelumnya, diketahui polimorfisme Gly972Arg gen IRS-1 berhubungan dengan disfungsi endotel. Hingga saat ini belum ada penelitian yang menghubungkan secara langsung antara polimorfisme IRS-1 dengan penyakit arteri perifer. Penelitian ini bertujuan untuk mengetahui hubungan antara polimorfisme Gly972Arg dengan nilai Ankle-Brachial Index (ABI) sebagai penanda penyakit arteri perifer. Studi observasional (potong lintang) ini dilakukan pada 104 subjek populasi Desa Gunung Sari Kecamatan Pamijahan. Dilakukan pemeriksaan lab untuk polimorfisme Gly972Arg gen IRS-1 dengan metode Taqman Assay. Data pemeriksaan ABI diambil dari data retrospektif di Desa Gunung Sari, Kecamatan Pamijahan, Jawa Barat yang diambil pada tahun 2017. Terdapat 104 subjek yang diikutsertakan dalam penelitian ini, yaitu grup wildtype/CC (6,7%), heterozigot/CT (82,7%), dan homozigot mutan/TT (10,6%). Tidak terdapat hubungan yang bermakna antara polimorfisme Gly972Arg gen IRS-1 dengan nilai ABI (p= 0,7). Setelah dilakukan penyesuaian terhadap merokok, hipertensi, diabetes melitus dan indeks massa tubuh, dapat disimpulkan bahwa hasil hubungan tidak bermakna antara polimorfisme Gly972Arg gen IRS-1 dengan ABI tidak dipengaruhi oleh faktor lain.

---

Peripheral Artery Disease (PAD) is defined as a total or partial obstruction of peripheral arteries, which mainly caused by an atherosclerotic process. Endothelial dysfunction is widely known as an early predictor of atherosclerosis. From previous studies, Gly972Arg polymorphism of IRS-1 gene is associated with endothelial dysfunction. To date, there is still very limited study about the association between Gly972Arg polymorphism of IRS-1 gene with Ankle-Brachial Index (ABI) as a marker of atherosclerosis in peripheral arteries. Therefore, we attempt to perform a study of association between Gly972Arg polymorphism of IRS-1 gene with ABI values. We performed a cross sectional study on 104 subjects from a rural population in Gunung Sari Village, Pamijahan District, West Java, Indonesia. Laboratory examinations for polymorphism detection uses Taqman Assay Method. Demographic, risk factors, and ABI data were obtained from a retrospective data in 2017. There were 104 subjects in this study. The prevalence of genotypes are as follows: Wildtype (6,7%), heterozygous carrier/CT (82,7%), and homozygous mutant/TT (10,6%). We found no significant association between Gly972Arg of IRS-1 gene with ABI values (p=0,7). After the adjustments for smoking, hypertension, diabetes, and body mass index, we concluded that none of those risk factors affected the results of our study."

"Latar Belakang : Infeksi COVID-19 telah diketahui masih dapat menyebabkan gejala sampai 90 hari dan bahkan lebih, meski infeksi akutnya telah berlalu. Hal ini disebabkan karena adanya fenomena sindroma pasca COVID-19. Mekanisme kejadian tersebut sampai saat ini masih belum diketahui pasti. Hal tersebut diduga kuat akibat adanya fibrosis di beberapa organ, terutama jantung dan paru. Sementara itu, beberapa studi telah menyebutkan bahwa sST2 merupakan penanda fibrosis jantung. Meskipun demikian, sampai saat ini belum ada penelitian yang mencoba mengetahui faktor-faktor apa saja yang memiliki hubungan dengan kejadian fibrosis pasca infeksi COVID-19. Kadar sST2 pada pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, khususnya di Indonesia juga belum diketahui.Tujuan : Mengetahui perbandingan kadar sST2 pada pasien komorbid kardiovaskular 12 minggu pasca infeksi COVID-19 dengan pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, serta hubungannya dengan faktor-faktor admisi.Metode : Penelitian ini merupakan studi observasional potong lintang. Kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dibandingkan dengan komorbid kardiovaskular akan dibandingkan dengan kelompok kontrol, yaitu kontrol 1 yang merupakan pasien komorbid kardiovaskular tanpa COVID-19 dan kontrol 2 yang merupakan populasi orang sehat. Kelompok kontrol dipilih menggunakan metode matching. Hubungan faktor klinis dan laboratoris saat dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dianalisis menggunakan analisis multivariat.Hasil : Terdapat 162 subjek yang menyelesaikan rangkaian penelitian yang terdiri atas 100 subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular (kelompok kasus), 31 subjek dengan komorbiditas kardiovaskular tanpa COVID-19 (kelompok kontrol 1), dan 31 subjek sehat tanpa riwayat COVID-19 dan komorbiditas kardiovaskular (kelompok kontrol 2). Ketiga kelompok memiliki karakteristik yang sama. Terdapat perbedaan signifikan rerata nilai sST2 antara kelompok kasus dibandingkan kontrol 1 dan kontrol 2 (2786 ± 73 vs 2666 ± 162 pg/l, p <0.001 dan 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001), serta kontrol 1 dibandingkan kontrol 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Analisis multivariat menunjukkan PaO2 (p < 0.001) dan nilai CT (p = 0.04) memiliki hubungan dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19.Kesimpulan : Terdapat perbedaan signifikan antara kadar sST2 sebagai penanda fibrosis jantung pada ketiga kelompok subjek penelitian, dengan kadar sST2 lebih tinggi pada subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular. Terdapat hubungan PaO2 dan nilai CT saat admisi dengan kadar sST2.

---

Background : Recent findings showed that symptoms associated with COVID-19 infection may persist up to 90 days even after the acute disease period has passed. This condition is now termed as post COVID-19 syndrome. Several pathophysiologic mechanisms of this event had been proposed, all of which still needed further elaboration. One of the proposed mechanisms involves fibrotic processes in several organs, especially heart and the lungs. SST2 has been suggested as a novel biomarker for cardiac fibrosis. However data are still needed to further elucidate the factors which are associated with the incidence of fibrosis post COVID-19 infection. Furthermore, data regarding sST2 levels in patients with cardiovascular comorbidities and in healthy subjects are still limited.

Objective : Knowing the differences on sST2 levels between subjects with cardiovascular comorbidities 12 weeks post COVID-19 infection, those without history of COVID-19 but with cardiovascular comorbidities, and healthy population, as well as knowing its relationship with admission factors.

Methods : This study is a cross-sectional observational study on patients 3 months after COVID-19 infection presented with cardiovascular comorbidities. Age and sex-matched control groups were used as comparison. The results were compared with a group without history of COVID-19 and healthy populations. Relationship between admission factors was assessed using multivariate analysis

Results : 162 subjects completed the study series, consisting of 100 subjects with COVID-19 survivors with cardiovascular comorbidities (case group), 31 subjects with cardiovascular comorbidities without COVID-19 (control group 1), and 31 healthy subjects without a history of COVID-19 and cardiovascular comorbidities (control group 2). All three groups had similar characteristics. There was a significant difference in the mean sST2 value between the case groups compared to control 1 and control 2 (2786 ± 73 vs 2666 ± 162 pg/l, p < 0.001 and 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001 respectively), and control 1 compared to control 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Multivariate analysis revealed PaO2 (p < 0.001 and CT values (p = 0.04) as admission factor associated with increased sST2 3 months after initial COVID-19 infection.

Conclusion : SST2 levels were found to be significantly different between the three groups, with the highest level on the case group (subjects with history of COVID-19 and cardiovascular comorbidities). Factors upon admissions which include Arterial oxygen partial pressure (PaO2) (p < 0.001) and CT value (p = 0.04) were found to be associated with increased sST2 levels."

"Latar Belakang : Infeksi COVID-19 dewasa ini telah diketahui memiliki implikasi jangka panjang meski periode akut telah tertangani, suatu fenomena yang dinamakan long COVID syndrome atau sindrom pasca COVID-19. Patofisiologi dari kejadian ini masih belum diketahui dengan jelas. Studi melaporkan bahwa sindrom pasca COVID-19 melibatkan beberapa organ, diantaranya adalah sistem kardiovaskular. Pemeriksaan nilai LV GLS dan RV LS pada ekokardiografi dinilai akurat dalam mendeteksi disfungsi miokard dan fibrosis endomiokardial. Selain itu, hingga saat ini, data mengenai faktor-faktor saat admisi sebagai prediktor terhadap kejadian sindrom pasca COVID-19 masih terbatas. Tujuan : Mengetahui nilai parameter ekokardiografi LV GLS dan RV LS sebagai penanda disfungsi miokard dan fibrosis jantung serta mengidentifikasi faktor-faktor saat admisi yang berpengaruh terhadap kejadian sindrom pasca COVID-19.Metode : Penelitian ini adalah deskriptif-analisis menggunakan metode potong lintang. Pemilihan subjek dilakukan dengan metode consecutive sampling. Pemeriksaan ekokardiografi termasuk pemeriksaan global longitudinal strain (GLS) dilakukan oleh dua orang observer 4 bulan pasca perawatan rumah sakit. Selanjutnya, analisis multivariat berupa regresi linear dilakukan untuk mengetahui faktor admisi yang berpengaruh terhadap perbedaan nilai GLS pada kelompok penelitian. Hasil : 100 subjek dengan komorbiditas kardiovaskular dan riwayat COVID-19 memenuhi kriteria dan syarat penelitian. Ditemukan nilai penurunan nilai LV-GLS pada kelompok ini. Subjek dengan komorbiditas kardiovaskular tanpa riwayat COVID-19 (n=31, kontrol 1) yang telah melalui proses matching berdasarkan usia, gender, dan faktor resiko, serta subjek sehat (n-31, kontrol 2) sebagai pembanding validitas GLS. Terdapat perbedaan signifikan rerata nilai LV GLS antar 3 kelompok (p<0.05, rerata ±SB -16.17 ± 3.379, -19.48 ± 1.141, -21.48 ± 1.777 berturut-turut untuk kelompok kasus, kontrol 1, kontrol 2), dengan nilai paling rendah pada kelompok kasus. Faktor saat admisi yaitu status CAD memiliki hubungan yang signifikan (p 0.038) dengan penurunan LV GLS pada pasien post covid-19 dengan komorbid kardiovaskular. Kesimpulan : Terdapat penurunan nilai LV GLS yang signifikan pada sindrom pasca COVID-19 disertai komorbiditas kardiovaskular. CAD merupakan prediktor penurunan fungsi maupun fibrosis jantung sebagai manifestasi sindrom pasca COVID-19.

---

Background : Recently, COVID-19 infection has been known to have a longer implication, even after the initial acute phase has been managed, a phenomenon termed as long COVID syndrome or “sindroma pasca COVID-19”. The exact pathophysiological mechanism of this event is still unknown. Previous studies reported that long COVID syndrome involves multiple organs, one of which is the cardiovascular system. Measurement of echocardiography LV GLS and RV LS values are reported to be accurate to detect myocardial dysfunction and endomyocardial fibrosis. Moreover, up until now, data regarding admission factors as predictors for long COVID syndrome incidences are still limited.

Objective : Assessing echocardiography LV GLS and RV LS values as a marker for myocardial dysfunction and heart fibrosis and identifying admission factors which may predict the incidence of long COVID syndrome

Methods : This is an observational study with a cross-sectional using a consecutive sampling method. Echocardiography including global longitudinal strain (GLS) measurement was done by two examiners 3 months after initial hospitalization. Multivariate analysis linear regression was subsequently used to investigate admission factors which are associated with differences in GLS measurement.

Results : Total of 100 subjects with cardiovascular comorbidities and prior COVID-19 infection were enrolled. Echocardiography examination showed lower GLS values in this group compared to the normal population. Age, sex and risk factors-matched subjects with cardiovascular comorbidity without a history of COVID-19 (n=31, Control 1) and healthy subjects (n-31, Control 2) were subsequently used as comparisons to validate GLS results. There were significant differences in LV-GLS levels between the three groups, with the lowest values measured in the case group (p<0.05, mean ±SD -16.17 ± 3.379, -19.48 ± 1.141, -21.48 ± 1.777 respectively for case, control 1, and control 2 groups). A history of coronary artery disease upon admission was found to be associated with decreased LV GLS values in recovered COVID-19 patients with cardiovascular comorbidity.

Conclusion : LV GLS values significantly decrease in long COVID syndrome with cardiovascular comorbidities. Having a previous history of CAD upon admission may serve as predictors of deteriorated functions or heart fibrosis as manifestations of long COVID syndrome. "

"Polimorfisme CYP2C19 menurunkan metabolisme klopidogrel dan telah diketahui meningkatkan mortalitas serta kejadian kardiovaskular mayor. VerifyNow P2Y12 merupakan salah satu pemeriksaan yang secara spesifik menggambarkan fungsi platelet terhadap agen penghambat P2Y12 yang dikonsumsi. Hubungan antara polimorfisme CYP2C19 dengan TIMI flow pada populasi Asia, khususnya Indonesia, belum pernah dilakukan.Penelitian ini bertujuan untuk mengetahui hubungan antara polimorfisme CYP2C19 terhadap fungsi penghambatan platelet dan TIMI flow, serta hubungan antara fungsi penghambatan platelet dan TIMI flow.Dilakukan pemeriksaan polimorfisme CYP2C19 dengan menggunakan metode Taqman dan pemeriksaan fungsi penghambatan platelet yang diukur dengan VerifyNow P2Y12 pada 90 pasien IMA-EST yang menjalani IKPP yang memenuhi kriteria penelitian.Dari 90 subyek penelitian, studi polimorfisme genetik mengungkapkan 23,3% pasien dengan alel * 2, 11,2% dari * 3 alel pembawa, dan 1,1% membawa kedua alel. 24,4% pasien tergolong non-responder terhadap klopidogrel. Secara keseluruhan tidak terdapat hubungan secara langsung antara polimorfisme CYP2C19 dengan TIMI flow 3, namun terdapat hubungan antara polimorfisme CYP2C19 dengan penurunan fungsi penghambatan platelet (OR 4.7, p = 0.030). Indeks reaktivitas platelet >208 PRU meningkatkan risiko TIMI flow < 3 (OR 3.3, p= 0.046).Tidak terdapat hubungan secara langsung antara polimorfisme CYP2C19 dengan TIMI flow, namun pasien dengan polimorfisme CYP2C19*2 dan/atau *3 memiliki risiko untuk mengalami penurunan penghambatan fungsi platelet. Pasien yang tergolong non-responder terhadap klopidogrel ini juga berisiko untuk mendapatkan reperfusi miokard yang suboptimal.

---

CYP2C19 polymorphism plays an important role in clopidogrel metabolism. The genetic factor is VerifyNow P2Y12 is an examination that specifically describes platelet function against P2Y12 inhibitors. It is unknown whether platelet reactivity measured by P2Y12 reaction unit (PRU) is affected by CYP2C19 polymorphism or predictive of TIMI flow in Asian populations, particularly in Indonesia. We sought to define whether polymorphisms on CYP2C19 genes and platelet reactivity may affect the myocardial perfusion.

STEMI patients who underwent primary PCI and has received 600 mg loading dose of clopidogrel were recruited for the study. We measured platelet reactivity by VerifyNow P2Y12, high platelet reactivity was defined as > 208 PRU. Genetic polymorphisms analysis to assess the presence of CYP2C19*2 and *3 alleles on each patient were performed by Taqman method.

There were 90 patients recruited for study. Genetic polymorphisms studies revealed 23.3% of patients with *2 allele, 11.2% of *3 allele carriers, and 1.1% carried both allele. 23.4% of patients were clopidogrel non-responders. Overall, there was no correlation between CYP2C19 polymorphism and TIMI flow < 3, but there was a relationship between CYP2C19 polymorphism and decreased function of platelet inhibition (OR 4.7, p = 0.030). Platelet reactivity index > 208 increased the risk of suboptimal reperfusion (OR 3.3, p = 0.046).

There is no direct relationship between CYP2C19 polymorphism and TIMI flow, but patients with CYP2C19*2 and/or CYP2C19*3 had increased risk of being clopidogrel non responders. After adjusted to confounding factors, VerifyNow > 208 PRU is associated with suboptimal myocardial reperfusion."