Objective: In this study, we aimed to evaluate whether the trimetazidine administration before CA... more Objective: In this study, we aimed to evaluate whether the trimetazidine administration before CAG and/or PCI reduces the incidence of contrast-induced nephropathy (CIN). We also aimed to evaluate the factors affecting the effect and the certainty of the evidence. Materials and methods: A systematic literature search was performed to obtain studies that assess trimetazidine's effect on the incidence of CIN in CAG/PCI patients up until 21 January 2021 through PubMed, Embase, and Scopus. The main outcome is CIN, defined as the increase in serum creatinine level ≥ 0.5 mg/dL (44.2 mmol/L) or > 25% of the baseline value 48-72 h after contrast media (CM) administration. Results: This systematic review and meta-analysis includes seven studies involving a total of 1590 patients. The prevalence of CIN was 11% [8%, 14%]. CIN's prevalence was 6% [4%, 8%] in the trimetazidine group and 16% [12%, 20%] in the control group. Trimetazidine use is associated with a lower incidence of CIN (RR 0.46 [0.34, 0.63], p<0.001; I2: 0%) with a high certainty of evidence, with an absolute risk reduction of 78 fewer per 1000. Subgroup analysis in patients with renal insufficiency showed that trimetazidine lowers the risk of CIN (RR 0.40 [0.26, 0.61], p<0.001; I2: 0%). The CIN reducing effect of trimetazidine was not significantly influenced by the age (p=0.960), body mass index (p=0.816), hypertension (p=0.595), diabetes (p=0.362), ejection fraction (p=0.261), baseline serum creatinine (0.579), and contrast media volume (p=0.958). Conclusions: Trimetazidine administration decreases the risk of CIN in patients undergoing CAG/PCI.
Nutrition Metabolism and Cardiovascular Diseases, Oct 1, 2021
BACKGROUND AND AIMS Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistan... more BACKGROUND AND AIMS Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistance, which is potentially associated with adverse cardiovascular events. We aimed to assess the dose-response relationship between Triglyceride-Glucose (TyG) Index and Major Adverse Cardiovascular Events (MACE) in patients with Acute Coronary Syndrome (ACS). METHODS AND RESULTS A systematic literature search was performed using PubMed, Scopus, and Embase for records published from the inception up until 7 February 2021. Studies that fulfilled all of these criteria were included: 1) prospective or retrospective observational studies reporting patients with ACS and 2) assessing the impact of TyG index on MACE with at least three quantitative classifications. The outcome of interest is MACE across the TyG index intervals. MACE was a composite of all-cause mortality, myocardial infarction, unstable angina pectoris, target vessel revascularization, cerebrovascular accidents, and heart failure. The effect estimates were reported as relative risks (RRs). There are 13,684 subjects from 4 studies included in this meta-analysis. This meta-analysis showed that the highest category of TyG index was associated with twofold MACE (RR 2.09 [1.59, 2.76], p < 0.001; I2: 68.4%, p = 0.02) compared to the lowest category in patients with ACS. Dose-response meta-analysis showed that the relationship between TyG index and MACE was non-linear (p < 0.001), with statistical significance reached around TyG index 8.9 and increased non-linearly. The dose-response curve became significantly steeper after TyG index of 9.1-9.2. CONCLUSION TyG index was associated with MACE in patients with ACS in a non-linear fashion. PROSPERO CRD42021235765.
Introduction The management of the no-reflow phenomenon is still being debated by experts as ther... more Introduction The management of the no-reflow phenomenon is still being debated by experts as there is no specific algorithm, limited recommended drug choices, and insufficient data regarding the combination of drugs in currently available guidelines. Thus, in this case report, we would like to propose a new combination of drugs as an alternative to the recommended drugs of choice in the treatment of no-reflow phenomenon. Case Presentation A 41-year-old man arrived at the emergency department complaining of chest pain 30 minutes prior to arrival. However, the patient was later diagnosed with extensive anterior ST-elevation myocardial infarction, KILLIP classification I, which was caused by the entire blockage of the proximal left anterior descending coronary artery. Angiography was conducted after stent placement during the main percutaneous coronary intervention and revealed grade I thrombolysis in myocardial infarction (TIMI)-flow with no coronary artery blockage. We then used an intracoronary approach to give nitroglycerin, heparin, and eptifibatide. The findings of posttreatment angiography revealed an improvement in coronary blood flow with a grade II TIMI flow. Furthermore, intravenous injection of eptifibatide and morphine effectively restored perfusion to a grade III TIMI flow. Conclusion Aggressive and precise treatment with a drug of choice is required to counteract the no-reflow phenomenon. Presently, only a limited range of first-line medications are available to treat this condition. Not only that, but several of the prescribed medications are not easily accessible, especially in developing countries. Therefore, we offer a novel combination medicaments consisting of nitroglycerin, heparin, and glycoprotein IIb/IIIa inhibitor as an alternative treatment of the no-reflow phenomenon.
Thyroid heart disease is one of the many and frequent complication of thyrotoxicosis, which also ... more Thyroid heart disease is one of the many and frequent complication of thyrotoxicosis, which also manifest in extra cardiovascular system. Opthalmopathy is a well-known and well-studied complication of thyrotoxicosis, and another is dermopathy, which manifests as pretibial edema. This case presentation describes a patient of long standing thyrotoxicosis with thyroid heart disease. In this particular case, the patient developed unilateral pretibial edema which posed a diagnostic challenge.
Electrocardiographic (ECG) left ventricular hypertrophy (LVH) has been associated with increased ... more Electrocardiographic (ECG) left ventricular hypertrophy (LVH) has been associated with increased mortality in patients with asymptomatic aortic stenosis (AS) and hypertension. However, patients with symptomatic AS undergoing transcatheter aortic valve replacement (TAVR) have higher percentages of myocardial fibrosis or amyloidosis that have been associated with decreased ECG voltage and worse outcomes. We tested the hypothesis that baseline ECG LVH is independently associated with increased all-cause mortality after TAVR. A total of 231 patients (96 men; mean age 84.7 ± 7.8 years) that underwent TAVR at our institution were included. Cornell voltage, defined as S + R was used to assess for presence of ECG LVH using gender-specific cut-off values. We used the Kaplan-Meier estimator to derive survival curves. Multivariate Cox regression analysis was used to compare mortality between patients without vs with ECG LVH and adjust for echocardiographic LVH and predictors of mortality in th...
Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debat... more Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debatable, with limited studies available. In contrast, moderate-intensity aerobic exercise is well known to decrease aortic stiffness. We provide novel research to determine the effect of e-cigarette and aerobic moderate-intensity exercise on the aortic structure of Wistar rats. A total of 26 male Wistar rats (Rattus norvegicus) 8 weeks aged, 200-250 g b.w., were randomly divided into 4 groups, namely, K0 (normal rats), K1 (rats were given moderate-intensity aerobic exercise by animal treadmill 20 m/30 min), K2 (rats were given e-cigarette with 6 mg nicotine, 40% propylene glycol, and 60% vegetable glycerine 30 min for 5 days/week), and K3 (rats were given e-cigarette and moderate-intensity aerobic exercise). After exposure for 6 weeks, all animals were sacrificed to isolate the aorta for histopathological analysis with hematoxylin-eosin stain to evaluate the elastic fiber layer and intimal-...
Background The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratif... more Background The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.Patients and methods: A retrospective cohort, Single-centered study enrolled 1393 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.Results Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hosp...
Chronic total occlusions (CTO) merupakan suatu masalah dalam bidang kardiologi intervensi yang se... more Chronic total occlusions (CTO) merupakan suatu masalah dalam bidang kardiologi intervensi yang semakin menarik perhatian, karena tantangan berupa indikasi pemilihan terapi dan tingkat keberhasilan rekanalisasi yang masih dirasakan terbatas, sedangkan data-data mengenai prevalensi dan karakteristik penderita maupun karakteristik angiografi masih terbatas. Konsensus yang dikeluarkan oleh EuroCTO Club mendefinisikan CTO sebagai oklusi total pada pembuluh koroner dengan TIMI 0 flow dan durasi oklusi berkisar bulan. Segmen yang teroklusi pada lumen pembuluh darah koroner mempunyai 2 jenis jaringan, bergantung pada patomekanisme yang terjadi yaitu plak ateromatosis dan trombus lama. Jenis yang pertama terjadi karena proses aterosklerosis yang luas dan progresif yang terjadi secara kronik dan menyebabkan stenosis tingkat lanjut. Jenis yang kedua terjadi karena adanya proses pembentukan dan perkembangan dari sebuah oklusi akut pada masa lampau yang diawali terjadinya robek pada plak (plaque...
Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse... more Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse events in acute ST Elevation Myocardial Infarction (STEMI). Unfortunately, the cost and availability of BNP assay had hampered its use. Natriuresis is one of the hallmark effect of raised BNP and measuring urinary sodium might offer insight to the plasma BNP. This study aims to search for any correlation between measured plasma BNP and urinary sodium in patients presenting with acute STEMI. Methods. In an observational descriptive analytic study, we selectively included patients presenting with acute STEMI and checked for plasma BNP and urinary sodium. All patients had no symptoms or therapy of heart failure prior to admission, had no prior MI, had no valvular abnormalities, and had normal renal function. Plasma BNP was tested using immunoassay method from Abbot Diagnostics, while urinary sodium with ionic specific electrode method. Specimen for plasma BNP were taken at the admission wh...
Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macr... more Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macrovascular complications such as cardiovascular and cerebrovascular diseases can be detected early, one of them by using an ultrasound examination to assess carotid intima-media thickness (CIMT). HbA1c examination had a strong predictive value for the occurrence of T2DM complications. HbA1c levels are associated with CIMT in the non-DM group. In the T2DM group there was an increase in CIMT compared to the non DM group. HbA1c levels can be used as a predictor of the progression of CIMT improvement in the T2DM group, but there is no study on populations with newly diagnosed T2DM. Aims: This study was conducted to find out the correlation between HbA1c in newly diagnosed T2DM and CIMT. Methods: This was a cross-sectional study with correlation analysis carried out on newly diagnosed T2DM in four Primary Health Centers in the city of Bandung who were randomly selected from July to August 2018...
Open Access Macedonian Journal of Medical Sciences
COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertens... more COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertension, diabetes, and cardiovascular disease (CVD) are associated with greater severity and higher mortality. COVID-19 can cause cardiovascular complications, including myocardial injury, myocarditis, heart failure, acute coronary syndrome, and coagulation abnormalities. Possible pathophysiology and molecular pathways driving these disease processes are cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders Myocarditis is one concern among persons who received mRNA-Based COVID-19 vaccines. There are several cardiovascular complications that are possibly caused by COVID-19 treatments, such as QT interval prolongation, arrhythmia, and hypotension. Due to increasingly recognized CVD damage in COVID-19, we need to understand about COVID-19 related to cardiovascular complications and treatment strategies.
PurposeThis meta-analysis aimed to evaluate the prognostic performance of elevated lactate dehydr... more PurposeThis meta-analysis aimed to evaluate the prognostic performance of elevated lactate dehydrogenase (LDH) in patients with COVID-19.MethodsA systematic literature search was performed using PubMed, Embase and EuropePMC on 19 November 2020. The outcome of interest was composite poor outcome, defined as a combined endpoint of mortality, severity, need for invasive mechanical ventilation and need for intensive care unit care. Severity followed the included studies’ criteria.ResultsThere are 10 399 patients from 21 studies. Elevated LDH was present in 44% (34%–53%) of the patients. Meta-regression analysis showed that diabetes was correlated with elevated LDH (OR 1.01 (95% CI 1.00 to 1.02), p=0.038), but not age (p=0.710), male (p=0.068) and hypertension (p=0.969). Meta-analysis showed that elevated LDH was associated with composite poor outcome (OR 5.33 (95% CI 3.90 to 7.31), p<0.001; I2: 77.5%). Subgroup analysis showed that elevated LDH increased mortality (OR 4.22 (95% CI 2....
... Disfungsi diastolik ventrikel kiri merupakan petanda awal gangguan jantung yang terjadi menda... more ... Disfungsi diastolik ventrikel kiri merupakan petanda awal gangguan jantung yang terjadi mendahului timbulnya disfungsi sistolik ventrikel kiri, sehingga disfungsi diastolik dapat merupakan petanda dini dan parameter monitoring kerusakan jantung akibat doxorubicin. ...
Objective: In this study, we aimed to evaluate whether the trimetazidine administration before CA... more Objective: In this study, we aimed to evaluate whether the trimetazidine administration before CAG and/or PCI reduces the incidence of contrast-induced nephropathy (CIN). We also aimed to evaluate the factors affecting the effect and the certainty of the evidence. Materials and methods: A systematic literature search was performed to obtain studies that assess trimetazidine's effect on the incidence of CIN in CAG/PCI patients up until 21 January 2021 through PubMed, Embase, and Scopus. The main outcome is CIN, defined as the increase in serum creatinine level ≥ 0.5 mg/dL (44.2 mmol/L) or > 25% of the baseline value 48-72 h after contrast media (CM) administration. Results: This systematic review and meta-analysis includes seven studies involving a total of 1590 patients. The prevalence of CIN was 11% [8%, 14%]. CIN's prevalence was 6% [4%, 8%] in the trimetazidine group and 16% [12%, 20%] in the control group. Trimetazidine use is associated with a lower incidence of CIN (RR 0.46 [0.34, 0.63], p<0.001; I2: 0%) with a high certainty of evidence, with an absolute risk reduction of 78 fewer per 1000. Subgroup analysis in patients with renal insufficiency showed that trimetazidine lowers the risk of CIN (RR 0.40 [0.26, 0.61], p<0.001; I2: 0%). The CIN reducing effect of trimetazidine was not significantly influenced by the age (p=0.960), body mass index (p=0.816), hypertension (p=0.595), diabetes (p=0.362), ejection fraction (p=0.261), baseline serum creatinine (0.579), and contrast media volume (p=0.958). Conclusions: Trimetazidine administration decreases the risk of CIN in patients undergoing CAG/PCI.
Nutrition Metabolism and Cardiovascular Diseases, Oct 1, 2021
BACKGROUND AND AIMS Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistan... more BACKGROUND AND AIMS Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistance, which is potentially associated with adverse cardiovascular events. We aimed to assess the dose-response relationship between Triglyceride-Glucose (TyG) Index and Major Adverse Cardiovascular Events (MACE) in patients with Acute Coronary Syndrome (ACS). METHODS AND RESULTS A systematic literature search was performed using PubMed, Scopus, and Embase for records published from the inception up until 7 February 2021. Studies that fulfilled all of these criteria were included: 1) prospective or retrospective observational studies reporting patients with ACS and 2) assessing the impact of TyG index on MACE with at least three quantitative classifications. The outcome of interest is MACE across the TyG index intervals. MACE was a composite of all-cause mortality, myocardial infarction, unstable angina pectoris, target vessel revascularization, cerebrovascular accidents, and heart failure. The effect estimates were reported as relative risks (RRs). There are 13,684 subjects from 4 studies included in this meta-analysis. This meta-analysis showed that the highest category of TyG index was associated with twofold MACE (RR 2.09 [1.59, 2.76], p < 0.001; I2: 68.4%, p = 0.02) compared to the lowest category in patients with ACS. Dose-response meta-analysis showed that the relationship between TyG index and MACE was non-linear (p < 0.001), with statistical significance reached around TyG index 8.9 and increased non-linearly. The dose-response curve became significantly steeper after TyG index of 9.1-9.2. CONCLUSION TyG index was associated with MACE in patients with ACS in a non-linear fashion. PROSPERO CRD42021235765.
Introduction The management of the no-reflow phenomenon is still being debated by experts as ther... more Introduction The management of the no-reflow phenomenon is still being debated by experts as there is no specific algorithm, limited recommended drug choices, and insufficient data regarding the combination of drugs in currently available guidelines. Thus, in this case report, we would like to propose a new combination of drugs as an alternative to the recommended drugs of choice in the treatment of no-reflow phenomenon. Case Presentation A 41-year-old man arrived at the emergency department complaining of chest pain 30 minutes prior to arrival. However, the patient was later diagnosed with extensive anterior ST-elevation myocardial infarction, KILLIP classification I, which was caused by the entire blockage of the proximal left anterior descending coronary artery. Angiography was conducted after stent placement during the main percutaneous coronary intervention and revealed grade I thrombolysis in myocardial infarction (TIMI)-flow with no coronary artery blockage. We then used an intracoronary approach to give nitroglycerin, heparin, and eptifibatide. The findings of posttreatment angiography revealed an improvement in coronary blood flow with a grade II TIMI flow. Furthermore, intravenous injection of eptifibatide and morphine effectively restored perfusion to a grade III TIMI flow. Conclusion Aggressive and precise treatment with a drug of choice is required to counteract the no-reflow phenomenon. Presently, only a limited range of first-line medications are available to treat this condition. Not only that, but several of the prescribed medications are not easily accessible, especially in developing countries. Therefore, we offer a novel combination medicaments consisting of nitroglycerin, heparin, and glycoprotein IIb/IIIa inhibitor as an alternative treatment of the no-reflow phenomenon.
Thyroid heart disease is one of the many and frequent complication of thyrotoxicosis, which also ... more Thyroid heart disease is one of the many and frequent complication of thyrotoxicosis, which also manifest in extra cardiovascular system. Opthalmopathy is a well-known and well-studied complication of thyrotoxicosis, and another is dermopathy, which manifests as pretibial edema. This case presentation describes a patient of long standing thyrotoxicosis with thyroid heart disease. In this particular case, the patient developed unilateral pretibial edema which posed a diagnostic challenge.
Electrocardiographic (ECG) left ventricular hypertrophy (LVH) has been associated with increased ... more Electrocardiographic (ECG) left ventricular hypertrophy (LVH) has been associated with increased mortality in patients with asymptomatic aortic stenosis (AS) and hypertension. However, patients with symptomatic AS undergoing transcatheter aortic valve replacement (TAVR) have higher percentages of myocardial fibrosis or amyloidosis that have been associated with decreased ECG voltage and worse outcomes. We tested the hypothesis that baseline ECG LVH is independently associated with increased all-cause mortality after TAVR. A total of 231 patients (96 men; mean age 84.7 ± 7.8 years) that underwent TAVR at our institution were included. Cornell voltage, defined as S + R was used to assess for presence of ECG LVH using gender-specific cut-off values. We used the Kaplan-Meier estimator to derive survival curves. Multivariate Cox regression analysis was used to compare mortality between patients without vs with ECG LVH and adjust for echocardiographic LVH and predictors of mortality in th...
Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debat... more Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debatable, with limited studies available. In contrast, moderate-intensity aerobic exercise is well known to decrease aortic stiffness. We provide novel research to determine the effect of e-cigarette and aerobic moderate-intensity exercise on the aortic structure of Wistar rats. A total of 26 male Wistar rats (Rattus norvegicus) 8 weeks aged, 200-250 g b.w., were randomly divided into 4 groups, namely, K0 (normal rats), K1 (rats were given moderate-intensity aerobic exercise by animal treadmill 20 m/30 min), K2 (rats were given e-cigarette with 6 mg nicotine, 40% propylene glycol, and 60% vegetable glycerine 30 min for 5 days/week), and K3 (rats were given e-cigarette and moderate-intensity aerobic exercise). After exposure for 6 weeks, all animals were sacrificed to isolate the aorta for histopathological analysis with hematoxylin-eosin stain to evaluate the elastic fiber layer and intimal-...
Background The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratif... more Background The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.Patients and methods: A retrospective cohort, Single-centered study enrolled 1393 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.Results Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hosp...
Chronic total occlusions (CTO) merupakan suatu masalah dalam bidang kardiologi intervensi yang se... more Chronic total occlusions (CTO) merupakan suatu masalah dalam bidang kardiologi intervensi yang semakin menarik perhatian, karena tantangan berupa indikasi pemilihan terapi dan tingkat keberhasilan rekanalisasi yang masih dirasakan terbatas, sedangkan data-data mengenai prevalensi dan karakteristik penderita maupun karakteristik angiografi masih terbatas. Konsensus yang dikeluarkan oleh EuroCTO Club mendefinisikan CTO sebagai oklusi total pada pembuluh koroner dengan TIMI 0 flow dan durasi oklusi berkisar bulan. Segmen yang teroklusi pada lumen pembuluh darah koroner mempunyai 2 jenis jaringan, bergantung pada patomekanisme yang terjadi yaitu plak ateromatosis dan trombus lama. Jenis yang pertama terjadi karena proses aterosklerosis yang luas dan progresif yang terjadi secara kronik dan menyebabkan stenosis tingkat lanjut. Jenis yang kedua terjadi karena adanya proses pembentukan dan perkembangan dari sebuah oklusi akut pada masa lampau yang diawali terjadinya robek pada plak (plaque...
Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse... more Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse events in acute ST Elevation Myocardial Infarction (STEMI). Unfortunately, the cost and availability of BNP assay had hampered its use. Natriuresis is one of the hallmark effect of raised BNP and measuring urinary sodium might offer insight to the plasma BNP. This study aims to search for any correlation between measured plasma BNP and urinary sodium in patients presenting with acute STEMI. Methods. In an observational descriptive analytic study, we selectively included patients presenting with acute STEMI and checked for plasma BNP and urinary sodium. All patients had no symptoms or therapy of heart failure prior to admission, had no prior MI, had no valvular abnormalities, and had normal renal function. Plasma BNP was tested using immunoassay method from Abbot Diagnostics, while urinary sodium with ionic specific electrode method. Specimen for plasma BNP were taken at the admission wh...
Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macr... more Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macrovascular complications such as cardiovascular and cerebrovascular diseases can be detected early, one of them by using an ultrasound examination to assess carotid intima-media thickness (CIMT). HbA1c examination had a strong predictive value for the occurrence of T2DM complications. HbA1c levels are associated with CIMT in the non-DM group. In the T2DM group there was an increase in CIMT compared to the non DM group. HbA1c levels can be used as a predictor of the progression of CIMT improvement in the T2DM group, but there is no study on populations with newly diagnosed T2DM. Aims: This study was conducted to find out the correlation between HbA1c in newly diagnosed T2DM and CIMT. Methods: This was a cross-sectional study with correlation analysis carried out on newly diagnosed T2DM in four Primary Health Centers in the city of Bandung who were randomly selected from July to August 2018...
Open Access Macedonian Journal of Medical Sciences
COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertens... more COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertension, diabetes, and cardiovascular disease (CVD) are associated with greater severity and higher mortality. COVID-19 can cause cardiovascular complications, including myocardial injury, myocarditis, heart failure, acute coronary syndrome, and coagulation abnormalities. Possible pathophysiology and molecular pathways driving these disease processes are cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders Myocarditis is one concern among persons who received mRNA-Based COVID-19 vaccines. There are several cardiovascular complications that are possibly caused by COVID-19 treatments, such as QT interval prolongation, arrhythmia, and hypotension. Due to increasingly recognized CVD damage in COVID-19, we need to understand about COVID-19 related to cardiovascular complications and treatment strategies.
PurposeThis meta-analysis aimed to evaluate the prognostic performance of elevated lactate dehydr... more PurposeThis meta-analysis aimed to evaluate the prognostic performance of elevated lactate dehydrogenase (LDH) in patients with COVID-19.MethodsA systematic literature search was performed using PubMed, Embase and EuropePMC on 19 November 2020. The outcome of interest was composite poor outcome, defined as a combined endpoint of mortality, severity, need for invasive mechanical ventilation and need for intensive care unit care. Severity followed the included studies’ criteria.ResultsThere are 10 399 patients from 21 studies. Elevated LDH was present in 44% (34%–53%) of the patients. Meta-regression analysis showed that diabetes was correlated with elevated LDH (OR 1.01 (95% CI 1.00 to 1.02), p=0.038), but not age (p=0.710), male (p=0.068) and hypertension (p=0.969). Meta-analysis showed that elevated LDH was associated with composite poor outcome (OR 5.33 (95% CI 3.90 to 7.31), p<0.001; I2: 77.5%). Subgroup analysis showed that elevated LDH increased mortality (OR 4.22 (95% CI 2....
... Disfungsi diastolik ventrikel kiri merupakan petanda awal gangguan jantung yang terjadi menda... more ... Disfungsi diastolik ventrikel kiri merupakan petanda awal gangguan jantung yang terjadi mendahului timbulnya disfungsi sistolik ventrikel kiri, sehingga disfungsi diastolik dapat merupakan petanda dini dan parameter monitoring kerusakan jantung akibat doxorubicin. ...
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