Coronary artery disease is one of the non-communicable diseases that lead to the cause of death g... more Coronary artery disease is one of the non-communicable diseases that lead to the cause of death globally. It not only can disturb of physical, psychological, and social aspects, but also decrease the quality of life (QoL). The perception of QoL is a difference among patients with coronary artery disease. Characteristic demographic can assist patients in identifying and addressing QoL declined. This study examined the relationship between demographic characteristics and quality of life in patients with coronary artery disease. This is a cross-sectional study that reviewed patients with coronary artery disease. Participants were 124 (96 males and 28 females) with purposive sampling. Quality of life was measured with (SF-36) questionnaire. Spearman rho correlation has utilized the relationships between the independent and dependent variables. Spearman rho correlation coefficient analysis indicated that demographic characteristics (age (0.216), gender (0.075), marital status (0.224), an...
Journal of Interventional Cardiac Electrophysiology
Purpose To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Paci... more Purpose To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Pacific patients with non-valvular atrial fibrillation (NVAF) at risk of ischemic stroke. The need for such a region-specific consensus was indicated by the relative paucity of clinical evidence for LAAO and oral anticoagulation therapy obtained in Asian-Pacific populations and the specific stroke and bleeding characteristics of this population. Methods Consensus was developed by discussion and evaluation of available evidence and expert opinions during a 2-day meeting attended by clinical experts from the Asian-Pacific regions. Results The consensus statement arrived at provides recommendations based on available evidence and expert opinions regarding LAAO in Asian-Pacific patients. Gaps in the evidence and other areas requiring further research were identified. Conclusion LAAO is an alternative device-based therapy in carefully selected patients with NVAF at risk of ischemic stroke. However, evidence for LAAO is primarily obtained from Caucasian populations, and data on LAAO in Asian-Pacific patients are scarce. While the present consensus statement addresses several therapy-related aspects based on careful interpretation of available evidence and expert opinions, other areas require additional evidence derived from Asian-Pacific populations.
The development of bioresorbable vascular scaffold (BRS) offers a new treatment strategy for coro... more The development of bioresorbable vascular scaffold (BRS) offers a new treatment strategy for coronary artery lesion by replacement of a permanent metallic scaffold with a temporary scaffold and eradicating a nidus for very late adverse events. The first-in-human MeRes-1 trial reported favorable
FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of ... more FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. Between May 2012 and September 2013, a total of 1,476 patients who had FFR<0.8 at maximal and at baseline underwent DES
Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A... more Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A systematic two-stent approach is widely used for complex bifurcation lesions (CBLs). However, a randomised comparison of PS and two-stent techniques for CBLs has never been studied. Accordingly, the present study is designed to elucidate the benefits of two-stent treatment over PS in patients with CBLs. This DEFINITION II study is a prospective, multinational, randomised, endpoint-driven trial to compare the benefits of the two-stent technique with PS for CBLs. A total of 660 patients with CBLs will be randomised in a 1:1 fashion to receive either PS or the two-stent technique. The primary endpoint is the rate of 12-month target lesion failure defined as the composite of cardiac death, target vessel myocardial infarction (MI) and clinically driven target lesion revascularisation. The major secondary endpoints include all causes of death, MI, target vessel revascularisation, in-stent res...
Journal of the American College of Cardiology, Jan 20, 2017
Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurc... more Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurcation lesions in patients with unprotected LM coronary artery disease undergoing percutaneous coronary intervention. The double kissing (DK) crush planned 2-stent technique has been shown to improve clinical outcomes in non-LM bifurcations compared with PS, and in LM bifurcations compared with culotte stenting, but has never been compared with PS in LM bifurcation lesions. The authors sought to determine whether a planned DK crush 2-stent technique is superior to PS for patients with true distal LM bifurcation lesions. The authors randomized 482 patients from 26 centers in 5 countries with true distal LM bifurcation lesions (Medina 1,1,1 or 0,1,1) to PS (n = 242) or DK crush stenting (n = 240). The primary endpoint was the 1-year composite rate of target lesion failure (TLF): cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Routine...
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Jan 26, 2017
The shear stress distribution assessment can provide useful insights for the hemodynamic performa... more The shear stress distribution assessment can provide useful insights for the hemodynamic performance of the implanted stent/scaffold. Our aim was to investigate the effect of a novel bioresorbable scaffold, Mirage on local hemodynamics in animal models. The main epicardial coronary arteries of 7 healthy mini-pigs were implanted with 11 Mirage Microfiber sirolimus-eluting Bioresorbable Scaffolds (MMSES). Optical coherence tomography (OCT) was performed post scaffold implantation and the obtained images were fused with angiographic data to reconstruct the coronary artery anatomy. Blood flow simulation was performed and Endothelial Shear Stress(ESS) distribution was estimated for each of the 11 scaffolds. ESS data were extracted in each circumferential 5-degree subunit of each cross-section in the scaffolded segment. The generalized linear mixed-effect analysis was implemented for the comparison of ESS in two scaffold groups; 150-µm strut thickness MMSES and 125-µm strut thickness MMSE...
After scaffold implantation, local flow dynamics, particularly endothelial shear stress (ESS), is... more After scaffold implantation, local flow dynamics, particularly endothelial shear stress (ESS), is restored by the newly constituted luminal surface. Scaffold design and strut embedment/protrusion—which is related to the underlying atherosclerotic plaque type—have an impact on the local flow
The primary objective of this study was to evaluate the safety and effectiveness of the Mirage bi... more The primary objective of this study was to evaluate the safety and effectiveness of the Mirage bioresorbable microfiber sirolimus-eluting scaffold compared with the Absorb bioresorbable vascular scaffold in the treatment of stenotic target lesions located in native coronary arteries, ranging from ≥2.25 to ≤4.0 mm in diameter. Secondary objectives were to establish the medium-term safety, effectiveness, and performance of the Mirage device. The current generation of bioresorbable scaffolds has several limitations, such as thick square struts with large footprints that preclude their deep embedment into the vessel wall, resulting in protrusion into the lumen with microdisturbance of flow. The Mirage sirolimus-eluting bioresorbable microfiber scaffold is designed to address these concerns. In this prospective, single-blind trial, 60 patients were randomly allocated in a 1:1 ratio to treatment with a Mirage sirolimus-eluting bioresorbable microfiber scaffold or an Absorb bioresorbable v...
This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reser... more This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. Between May 2012 and September 2013, a total of 1,476 patients who had FFR <0.8 at maximal and underwent DES implantation were prospectively studied in 9 centers. Post-DES FFR was repeat measured. The primary endpoint was the 1-year TVF rate after procedures. Receiver-operating characteristic curves were used to calculate the post-DES FFR value for TVF, then patients were classified on the basis of this value and followed up for 3 years. By the end of the first year, 88 (6.0%) TVFs were recorded. A post-DES FFR ≤0.88 strongly correlated with TVF. Disease in the left anterior descending coronary artery (LAD), stent length, and stent diameter were i...
Circulation. Cardiovascular interventions, Feb 1, 2017
Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush s... more Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years. The primary end point was the occurrence of a major adverse cardiac event at 5 years. Patients were classified by simple and complex bifurcation lesions according to the DEFINITION criteria (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents). At 5 years, the major adverse cardiac event rate (23.8%) in the provisional sten...
Journal of the American College of Cardiology, 2016
Bioresorbable scaffolds may potentially overcome many pitfalls related to drug eluting stents. Cu... more Bioresorbable scaffolds may potentially overcome many pitfalls related to drug eluting stents. Current generation BRS,Absorb Bioresorbable Vascular Scaffold (ABSORB BVS)has several limitations,such as vessel wall conformability, reduced strut protrusion into lumen,fracture resistance allowing rapid
Clinical Trials and Regulatory Science in Cardiology, 2016
Abstract Background Provisional stenting (PS) is effective for great majority of patients with co... more Abstract Background Provisional stenting (PS) is effective for great majority of patients with coronary bifurcation lesions. Double kissing (DK) crush approach demonstrated significant reduction of target lesion revascularization (TLR) for patients with more complex bifurcation lesion when compared with PS. Furthermore, DK crush technique was associated with lower rate of composite major adverse cardiac event (MACE), revascularization and stent thrombosis (ST) for patients with unprotected distal left main coronary artery bifurcation lesions (ULMb), compared to culotte stenting approach. The DKCRUSH V trial is designed to elucidate the benefits of DK crush over PS in patients with ULMb. Study design DKCRUSH V is a randomized, prospective, multinational clinical trial designed to evaluate the efficacy and safety of DK crush over PS for patients with ULMb. Subjects with Medina 1,1,1 or 0,1,1 ULMb will be randomized in a 1:1 fashion to PS or DK crush. The primary endpoint is target lesion failure (TLF) including target vessel myocardial infarction, cardiac death and TLR. Other endpoints address individual event of primary endpoint, and target vessel revascularization. The safety objective is the ST. Recruitment began in January 2012 and was completed in December 2015; 484 patients were randomized. The trial will continue until at least 56 adjudicated primary endpoints occur. Conclusions The DKCRUSH V study is investigating if DK crush approach versus PS will reduce the incidence of TLF in patients with symptomatic ULMb.
Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, ... more Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, there is little information on patient selection or deployment technique here. This document investigates the experiences of leading interventional cardiologists from the Asia-Pacific region with a focus on patient characteristics, deployment techniques and management. A detailed questionnaire was distributed to 28 highly-experienced interventional cardiologists ('Authors') from 13 Asia-Pacific countries. The results were discussed at a meeting on patient selection, technical consideration, deployment practices and patient management. Potential patient benefits of Absorb compared to metallic DES, the learning curve for patient selection and preparation, device deployment, and subsequent patient management approaches are presented. Current practices are derived from guidelines optimized for European patients. Differences in approach exist in the Asia-Pacific context, including lim...
Background: The human inflammatory response plays an important role in the pathogenesis of athero... more Background: The human inflammatory response plays an important role in the pathogenesis of atherosclerosis. An increase in the inflammatory responses notable by the levels of highly sensitive C-Reactive Protein (hsCRP) may be able to predict future cardiovascular events and the prognosis of post-acute coronary syndrome (ACS). In animal experiments and human in-vitro experiments, curcumin has been proved to have anti-inflammatory effects. The effect of curcumin against the inflammatory response in ACS has not been identified. This study observes the effects of curcumin against the human inflammatory responses in patients with ACS. Methods: This multicenter double-blinded placebo controlled randomized trial was located at the Intensive Coronary Care Unit (ICCU) of Cipto Mangunkusumo General Hospital, Persahabatan General Hospital and MMC Hospital in Jakarta, Indonesia. 75 ACS patients were randomized into four groups, with the three intervention group (group I-III) consisting of 15 patients and 30 patients in the placebo group (IV). The participants of this study was randomly allocated curcumin in three different doses, group I was provided 15 mg t.i.d, group II was provided 30 mg t.i.d., group III was provided 60 mg t.i.d, and group IV was provided placebo. Results: In this study, we discovered that group I experienced a significant decrease in the level of hsCRP compared to placebo during the first month (p=0.04). Curcumin in low doses proved to be most effective in reducing the hsCRP levels, rather than moderate- or high doses. Moderate-dose curcumin was in second place, followed by high-dose curcumin. Conclusion: The use of low-dose curcumin in AC patients has significantly reduced the level of hsCRP after one week of use.
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, Jan 17, 2016
Coronary artery disease is one of the non-communicable diseases that lead to the cause of death g... more Coronary artery disease is one of the non-communicable diseases that lead to the cause of death globally. It not only can disturb of physical, psychological, and social aspects, but also decrease the quality of life (QoL). The perception of QoL is a difference among patients with coronary artery disease. Characteristic demographic can assist patients in identifying and addressing QoL declined. This study examined the relationship between demographic characteristics and quality of life in patients with coronary artery disease. This is a cross-sectional study that reviewed patients with coronary artery disease. Participants were 124 (96 males and 28 females) with purposive sampling. Quality of life was measured with (SF-36) questionnaire. Spearman rho correlation has utilized the relationships between the independent and dependent variables. Spearman rho correlation coefficient analysis indicated that demographic characteristics (age (0.216), gender (0.075), marital status (0.224), an...
Journal of Interventional Cardiac Electrophysiology
Purpose To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Paci... more Purpose To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Pacific patients with non-valvular atrial fibrillation (NVAF) at risk of ischemic stroke. The need for such a region-specific consensus was indicated by the relative paucity of clinical evidence for LAAO and oral anticoagulation therapy obtained in Asian-Pacific populations and the specific stroke and bleeding characteristics of this population. Methods Consensus was developed by discussion and evaluation of available evidence and expert opinions during a 2-day meeting attended by clinical experts from the Asian-Pacific regions. Results The consensus statement arrived at provides recommendations based on available evidence and expert opinions regarding LAAO in Asian-Pacific patients. Gaps in the evidence and other areas requiring further research were identified. Conclusion LAAO is an alternative device-based therapy in carefully selected patients with NVAF at risk of ischemic stroke. However, evidence for LAAO is primarily obtained from Caucasian populations, and data on LAAO in Asian-Pacific patients are scarce. While the present consensus statement addresses several therapy-related aspects based on careful interpretation of available evidence and expert opinions, other areas require additional evidence derived from Asian-Pacific populations.
The development of bioresorbable vascular scaffold (BRS) offers a new treatment strategy for coro... more The development of bioresorbable vascular scaffold (BRS) offers a new treatment strategy for coronary artery lesion by replacement of a permanent metallic scaffold with a temporary scaffold and eradicating a nidus for very late adverse events. The first-in-human MeRes-1 trial reported favorable
FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of ... more FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. Between May 2012 and September 2013, a total of 1,476 patients who had FFR<0.8 at maximal and at baseline underwent DES
Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A... more Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A systematic two-stent approach is widely used for complex bifurcation lesions (CBLs). However, a randomised comparison of PS and two-stent techniques for CBLs has never been studied. Accordingly, the present study is designed to elucidate the benefits of two-stent treatment over PS in patients with CBLs. This DEFINITION II study is a prospective, multinational, randomised, endpoint-driven trial to compare the benefits of the two-stent technique with PS for CBLs. A total of 660 patients with CBLs will be randomised in a 1:1 fashion to receive either PS or the two-stent technique. The primary endpoint is the rate of 12-month target lesion failure defined as the composite of cardiac death, target vessel myocardial infarction (MI) and clinically driven target lesion revascularisation. The major secondary endpoints include all causes of death, MI, target vessel revascularisation, in-stent res...
Journal of the American College of Cardiology, Jan 20, 2017
Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurc... more Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurcation lesions in patients with unprotected LM coronary artery disease undergoing percutaneous coronary intervention. The double kissing (DK) crush planned 2-stent technique has been shown to improve clinical outcomes in non-LM bifurcations compared with PS, and in LM bifurcations compared with culotte stenting, but has never been compared with PS in LM bifurcation lesions. The authors sought to determine whether a planned DK crush 2-stent technique is superior to PS for patients with true distal LM bifurcation lesions. The authors randomized 482 patients from 26 centers in 5 countries with true distal LM bifurcation lesions (Medina 1,1,1 or 0,1,1) to PS (n = 242) or DK crush stenting (n = 240). The primary endpoint was the 1-year composite rate of target lesion failure (TLF): cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Routine...
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Jan 26, 2017
The shear stress distribution assessment can provide useful insights for the hemodynamic performa... more The shear stress distribution assessment can provide useful insights for the hemodynamic performance of the implanted stent/scaffold. Our aim was to investigate the effect of a novel bioresorbable scaffold, Mirage on local hemodynamics in animal models. The main epicardial coronary arteries of 7 healthy mini-pigs were implanted with 11 Mirage Microfiber sirolimus-eluting Bioresorbable Scaffolds (MMSES). Optical coherence tomography (OCT) was performed post scaffold implantation and the obtained images were fused with angiographic data to reconstruct the coronary artery anatomy. Blood flow simulation was performed and Endothelial Shear Stress(ESS) distribution was estimated for each of the 11 scaffolds. ESS data were extracted in each circumferential 5-degree subunit of each cross-section in the scaffolded segment. The generalized linear mixed-effect analysis was implemented for the comparison of ESS in two scaffold groups; 150-µm strut thickness MMSES and 125-µm strut thickness MMSE...
After scaffold implantation, local flow dynamics, particularly endothelial shear stress (ESS), is... more After scaffold implantation, local flow dynamics, particularly endothelial shear stress (ESS), is restored by the newly constituted luminal surface. Scaffold design and strut embedment/protrusion—which is related to the underlying atherosclerotic plaque type—have an impact on the local flow
The primary objective of this study was to evaluate the safety and effectiveness of the Mirage bi... more The primary objective of this study was to evaluate the safety and effectiveness of the Mirage bioresorbable microfiber sirolimus-eluting scaffold compared with the Absorb bioresorbable vascular scaffold in the treatment of stenotic target lesions located in native coronary arteries, ranging from ≥2.25 to ≤4.0 mm in diameter. Secondary objectives were to establish the medium-term safety, effectiveness, and performance of the Mirage device. The current generation of bioresorbable scaffolds has several limitations, such as thick square struts with large footprints that preclude their deep embedment into the vessel wall, resulting in protrusion into the lumen with microdisturbance of flow. The Mirage sirolimus-eluting bioresorbable microfiber scaffold is designed to address these concerns. In this prospective, single-blind trial, 60 patients were randomly allocated in a 1:1 ratio to treatment with a Mirage sirolimus-eluting bioresorbable microfiber scaffold or an Absorb bioresorbable v...
This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reser... more This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. Between May 2012 and September 2013, a total of 1,476 patients who had FFR <0.8 at maximal and underwent DES implantation were prospectively studied in 9 centers. Post-DES FFR was repeat measured. The primary endpoint was the 1-year TVF rate after procedures. Receiver-operating characteristic curves were used to calculate the post-DES FFR value for TVF, then patients were classified on the basis of this value and followed up for 3 years. By the end of the first year, 88 (6.0%) TVFs were recorded. A post-DES FFR ≤0.88 strongly correlated with TVF. Disease in the left anterior descending coronary artery (LAD), stent length, and stent diameter were i...
Circulation. Cardiovascular interventions, Feb 1, 2017
Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush s... more Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years. The primary end point was the occurrence of a major adverse cardiac event at 5 years. Patients were classified by simple and complex bifurcation lesions according to the DEFINITION criteria (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents). At 5 years, the major adverse cardiac event rate (23.8%) in the provisional sten...
Journal of the American College of Cardiology, 2016
Bioresorbable scaffolds may potentially overcome many pitfalls related to drug eluting stents. Cu... more Bioresorbable scaffolds may potentially overcome many pitfalls related to drug eluting stents. Current generation BRS,Absorb Bioresorbable Vascular Scaffold (ABSORB BVS)has several limitations,such as vessel wall conformability, reduced strut protrusion into lumen,fracture resistance allowing rapid
Clinical Trials and Regulatory Science in Cardiology, 2016
Abstract Background Provisional stenting (PS) is effective for great majority of patients with co... more Abstract Background Provisional stenting (PS) is effective for great majority of patients with coronary bifurcation lesions. Double kissing (DK) crush approach demonstrated significant reduction of target lesion revascularization (TLR) for patients with more complex bifurcation lesion when compared with PS. Furthermore, DK crush technique was associated with lower rate of composite major adverse cardiac event (MACE), revascularization and stent thrombosis (ST) for patients with unprotected distal left main coronary artery bifurcation lesions (ULMb), compared to culotte stenting approach. The DKCRUSH V trial is designed to elucidate the benefits of DK crush over PS in patients with ULMb. Study design DKCRUSH V is a randomized, prospective, multinational clinical trial designed to evaluate the efficacy and safety of DK crush over PS for patients with ULMb. Subjects with Medina 1,1,1 or 0,1,1 ULMb will be randomized in a 1:1 fashion to PS or DK crush. The primary endpoint is target lesion failure (TLF) including target vessel myocardial infarction, cardiac death and TLR. Other endpoints address individual event of primary endpoint, and target vessel revascularization. The safety objective is the ST. Recruitment began in January 2012 and was completed in December 2015; 484 patients were randomized. The trial will continue until at least 56 adjudicated primary endpoints occur. Conclusions The DKCRUSH V study is investigating if DK crush approach versus PS will reduce the incidence of TLF in patients with symptomatic ULMb.
Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, ... more Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, there is little information on patient selection or deployment technique here. This document investigates the experiences of leading interventional cardiologists from the Asia-Pacific region with a focus on patient characteristics, deployment techniques and management. A detailed questionnaire was distributed to 28 highly-experienced interventional cardiologists ('Authors') from 13 Asia-Pacific countries. The results were discussed at a meeting on patient selection, technical consideration, deployment practices and patient management. Potential patient benefits of Absorb compared to metallic DES, the learning curve for patient selection and preparation, device deployment, and subsequent patient management approaches are presented. Current practices are derived from guidelines optimized for European patients. Differences in approach exist in the Asia-Pacific context, including lim...
Background: The human inflammatory response plays an important role in the pathogenesis of athero... more Background: The human inflammatory response plays an important role in the pathogenesis of atherosclerosis. An increase in the inflammatory responses notable by the levels of highly sensitive C-Reactive Protein (hsCRP) may be able to predict future cardiovascular events and the prognosis of post-acute coronary syndrome (ACS). In animal experiments and human in-vitro experiments, curcumin has been proved to have anti-inflammatory effects. The effect of curcumin against the inflammatory response in ACS has not been identified. This study observes the effects of curcumin against the human inflammatory responses in patients with ACS. Methods: This multicenter double-blinded placebo controlled randomized trial was located at the Intensive Coronary Care Unit (ICCU) of Cipto Mangunkusumo General Hospital, Persahabatan General Hospital and MMC Hospital in Jakarta, Indonesia. 75 ACS patients were randomized into four groups, with the three intervention group (group I-III) consisting of 15 patients and 30 patients in the placebo group (IV). The participants of this study was randomly allocated curcumin in three different doses, group I was provided 15 mg t.i.d, group II was provided 30 mg t.i.d., group III was provided 60 mg t.i.d, and group IV was provided placebo. Results: In this study, we discovered that group I experienced a significant decrease in the level of hsCRP compared to placebo during the first month (p=0.04). Curcumin in low doses proved to be most effective in reducing the hsCRP levels, rather than moderate- or high doses. Moderate-dose curcumin was in second place, followed by high-dose curcumin. Conclusion: The use of low-dose curcumin in AC patients has significantly reduced the level of hsCRP after one week of use.
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, Jan 17, 2016
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