Cardiovascular and Cardiometabolic Journal (CCJ) <p><strong><em>Cardiovascular and Cardiometabolic Journal (CCJ) </em>(<a href="" target="_blank" rel="noopener">P-ISSN: 2746-6930</a> and <a href="" target="_blank" rel="noopener">e-ISSN: 2722-3582</a>) </strong>is an open-access scientific journal published by Department of Cardiology and Vascular Medicine Universitas Airlangga for the Indonesian Heart Association. The journal publishes articles related to research in and the practice of cardiovascular diseases, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in applied (translational) and basic research. Each volume of <strong><em>Cardiovascular and Cardiometabolic Journal (CCJ)</em></strong> is counted in each calendar year that consists of 2 issues. <strong><em>Cardiovascular and Cardiometabolic Journal (CCJ) </em></strong>is published two times per year every March and September. </p> Universitas Airlangga en-US Cardiovascular and Cardiometabolic Journal (CCJ) 2746-6930 <ul> <li>Cardiovascular and Cardiometabolic Journal (CCJ) is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License</li> <li> <p>Authors who publish with Cardiovascular and Cardiometabolic Journal (CCJ) agree to the following terms:</p> </li> <li> <p>The journal allows the author to hold the copyright of the article without restrictions.</p> </li> <li> <p>The journal allows the author(s) to retain publishing rights without restrictions.</p> </li> <li> <p>The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution ShareAlike 4.0 International License (CC BY-SA).</p> </li> </ul> Antiarrhythmic Effect of SGLT-2 Inhibitors in high-degree AV Block Caused by Heart Failure: A Case Report <p><strong>Highlights:</strong></p> <p>1. The antiarrhythmic effect of SGLT-2 inhibitors, particularly empagliflozin, is a very interesting topic to discuss further.</p> <p>2. In patients with high degree AV block due to HF in rural areas, the use of SGLT-2 inhibitors is quite rare in Indonesia.</p> <p>-</p> <p><strong>Background:</strong> According to WHO's Top 10 Global Health Threats, non-communicable diseases such as heart failure contribute to more than 70% of all deaths worldwide. Several studies have shown that SGLT-2 inhibitors can considerably reduce HF. As research progresses, SGLT-2 inhibitors may lessen the risk of arrhythmias in HF patients.</p> <p><strong>Case Summary</strong>: A 57-year-old female with uncontrolled hypertension came to the ED after collapsing at home. The vital signs and physical examination are normal. The preliminary ECG showed a high degree AV Block with multiple multifocal PVC. Early laboratory revealed mild hypokalemia. The patient experienced a seizure the next day, and an ECG showed total AV block with a non-sustained VT episode with PVC R on T. Following critical cardiac care and stabilization, the patient underwent echocardiography, which showed mild MR and AR with a reduced ejection fraction (47.7%). Once the patient's condition has stabilized, the patient is given 1x10mg Empagliflozin PO.</p> <p><strong>Discussion: </strong>SGLT-2 inhibitors are beneficial in the treatment of heart failure and arrhythmia. SGLT-2 inhibitors have antiarrhythmic effects through a variety of pathways, such as lowering preload and afterload, inhibition of sodium-hydrogen exchange in myocardial cells, and suppression of the sympathetic nervous system.</p> <p> </p> Ngurah Agung Reza Satria Nugraha Putra I Ketut Susila Copyright (c) 2024 Ngurah Agung Reza Satria Nugraha Putra, I Ketut Susila 2024-03-31 2024-03-31 5 1 49 61 10.20473/ccj.v5i1.2024.49-61 Silent Threat: Ascending Aortic Dissection Triggering Congestive Heart Failure in A Young Indonesian Woman Suspected of Marfan Syndrome – A Case Report <p><strong>Highlights:</strong></p> <p>1. Thoracic Aortic Aneurysm is not frequently discussed. However, this study analyzed it and pointed out how life-threatening a disease with silent nature could be.</p> <p>2. It shows how screening for patient needed to be conducted thoroughly to ensure there is no potential threat left undiagnosed.</p> <p>-</p> <p><strong>Background: </strong>A considerable number of thoracic aortic aneurysms (TAAs) remain unidentified or misdiagnosed owing to the silent nature of the disease and the lack of a screening program. The diagnostic process is frequently intricate, leading to potentially catastrophic outcomes.</p> <p><strong>Case presentation: </strong>A 32-year-old woman presented with shortness of breath and swelling in both legs, resembling symptoms of heart failure. Despite the absence of known cardiovascular risk factors, echocardiography unveiled a critical condition; painless ascending aortic aneurysm with dissection, posing a life-threatening risk.</p> <p><strong>Conclusion: </strong>Initially, the patient's susceptibility to the disease was not readily apparent. Interestingly, aortic dissection patients presenting with heart failure symptoms were less inclined to experience chest pain compared to those without such symptoms. This disparity might triple the time required for diagnosis and elevate mortality risk to 33%. Thus, this case report aims to increase awareness in the medical community about rare and subtle cases that might be overlooked or misdiagnosed due to atypical presentations.</p> Shinta Dewi Rasti Richardus Rukma Juslim Febryanti Hartono Copyright (c) 2024 Shinta Dewi Rasti, Rukma , Febryanti Hartono 2024-03-31 2024-03-31 5 1 62 71 10.20473/ccj.v5i1.2024.62-71 Pulmonary Hypertension in Pregnancy: A Cardiological Approach to Maternal Outcomes as well as Neonatal and Therapeutic Management <p><strong>Highlights:</strong></p> <p>1. Pulmonary hypertension is threatening to both the mother and the infant in the womb.</p> <p>2. This report discusses the complexity of physiological changes in pregnant women with pulmonary hypertension.</p> <p>-</p> <p><strong>Abstract</strong></p> <p><strong>Background: </strong>Maternal morbidity and mortality with pulmonary hypertension in pregnancy usually occur during labor until early postpartum. Historical reports have shown mortality rates as high as 30–56%. We report a 32-year-old female patient pregnant with her second child, with complaints of bleeding from the birth canal since 1 hour before admission to the hospital and a history of atrial septal defect type secundum.</p> <p><strong>Case presentation: </strong>The patient was diagnosed with G2P1A0, 16–17 weeks pregnant, with death conception, thrombocytopenia, and ASD secundum with pulmonary hypertension. The patient was planned for dilation and curettage by the obstetrics and gynecology departments. As a result of consultation with the cardiology department, medication management was given, and the decision to tolerate CRI IV very high-risk surgery was given.</p> <p><strong>Conclusion: </strong>Despite progress, pregnancy remains poorly tolerated in cases of pulmonary hypertension. Management should remain focused on contraceptive counseling and offering early termination when pregnancy does occur</p> Zainur Hafiz Yusa Iqbal Maulana Copyright (c) 2024 Zainur Hafiz Yusa, Iqbal Maulana 2024-03-31 2024-03-31 5 1 72 81 10.20473/ccj.v5i1.2024.72-81 The Risk Factors and Hospital Mortality of Percutaneous Coronary Intervention Patients in Prepandemic and During Pandemic COVID-19: A Systematic Review <p><strong>Highlights:</strong></p> <p>1. COVID-19 pandemic remains one of the interesting subject to discuss due to its large scale impact.</p> <p>2. PCI is one of the popularly known method to screen COVID-19, however, depending on the prior screening, this may or may not be conducted. Thus, its frequency is reviewed in this study.</p> <p>-</p> <p><strong>Backgroud: </strong>The COVID-19 pandemic is a global health issue that impact healthcare systems. COVID-19 infections affect the risk factors and mortality in patients undergoing PCI. The aim of this study is to determine the differences in risk factors and mortality rates of patients undergoing PCI before and during the COVID-19 pandemic.</p> <p><strong>Method</strong>: We performed a systematic search on risk factors and hospital mortality of PCI patients in prepandemic and during pandemic COVID-19. Study reporting patient after year 2022 are excluded. The article published between 2019 - 2022. The literature selection was conducted following the PRISMA algorithm.</p> <p><strong>Result: </strong>Eight journals were utilized, ensuring their relevance, compatibility, and adherence to the inclusion and exclusion criteria. In this study, it is explained that there has been a decrease in the number of patients undergoing PCI procedures during the COVID-19 pandemic. The increase of risk factor and there is no significant different hospital mortality of PCI patients before and during pandemic.</p> Hidtsa Aqila Noor Arasyi Rizky Pratama Muhammad Hendi Saputra Copyright (c) 2024 Hidtsa Aqila Noor Arasyi, Rizky Pratama; Muhammad Hendi Saputra 2024-03-31 2024-03-31 5 1 35 48 10.20473/ccj.v5i1.2024.35-48 Correlation Between Cardiopulmonary Bypass Time (CPB Time) during Coronary Artery Bypass Graft on ICU Length of Stay <p><strong>Highlight:</strong></p> <p>1. CHD remains one of the most threatening CVD in Indonesia. Studies discussing CHD will contribute in future studies for cardiologists to assert better options for treatment.</p> <p>-</p> <p><strong>Abstract</strong></p> <p><strong>Background: </strong>Coronary heart disease (CHD) is one of the deadliest diseases in Indonesia. Coronary artery bypass graft using cardiopulmonary bypass (CPB) is an integral measure in its treatment. The objective of this study is to identify the correlation of CPB Time and Length of Stay (LOS) in the Intensive Care Unit (ICU) in Dr.Soetomo General Academic Hospital, Surabaya.</p> <p><strong>Material and Methods: </strong>This study was conducted using observational and analytic methods. The population are coronary heart disease patients who underwent coronary artery bypass graft. A total sampling method was used from the medical records of Dr. Soetomo General Academic Hospital, Surabaya from October 2021 until September 2022. The research variables are: CPB time and ICU LOS. The relationship between CPB and ICU LOS was analyzed using the Spearman correlation test and logistic regression as well Mann-Whitney test using Microsoft Excel and SPSS version 25.</p> <p><strong>Results:</strong> From the results of the correlation test, there is no correlation between CPB Time and ICU LOS with a correlation coefficient of r=0212, there is no significant difference between CPB ≤180 minutes and CPB &gt;180 minutes on ICU LOS p=0.123. From the overall sample, the average age was 62.24+7.765 years, with the majority of the sample were male 87.3%.</p> <p><strong>Conclusion:</strong> There is no correlation between the CPB Time and ICU LOS in patients after coronary artery bypass graft at RSUD Dr. Soetomo.</p> Andreas Rama Arkananta Nugraha Danang Himawan Limanto Philia Setiawan Atika Copyright (c) 2024 Andreas Rama Arkananta Nugraha, Danang Himawan Limanto, Philia Setiawan, Atika 2024-03-31 2024-03-31 5 1 1 10 10.20473/ccj.v5i1.2024.1-10 Changes in Nutritional Status of Children Under Five with Acyanotic Congenital Heart Disease Left to Right Shunt Type After Defect Closure by Catheterization <p><strong>Highlights:</strong></p> <p>1. The nutritional status of children with CVD after therapy is interesting to discuss especially because children antibody varies.</p> <p>2. Changes in their nutrition intake after the surgery would help for future treatments with related disease and same operation.</p> <p>-</p> <p><strong>Background: </strong>One of the impacts that occur in patients with congenital heart disease (CHD) is malnutrition. Malnutrition will affect the growth of the child. Closure therapy with catheterization can improve nutritional status after a few months. This study aims to determine the nutritional status of toddlers with simple left to right shunt-type acyanotic CHD before and after closure therapy with catheterization.</p> <p><strong>Material and Methods: </strong>This study is an analytical observational study with a retrospective cohort method using medical record data involving pediatric patients less than 5 years old with simple left to right shunt-type acyanotic CHD who received closure by catheterization at Dr. Soetomo General Hospital from January 2020 to December 2020.</p> <p><strong>Results:</strong> From 10 samples, the characteristics of the most samples were women (90%), age group 2-5 years (60%), and PDA abnormalities (50%). In addition, nutritional status after closure by catheterization improved.</p> <p><strong>Conclusion:</strong> There was an improvement in nutritional status (W/H) after defect closure with catheterization in patients aged less than 5 years with simple left to right shunt type acyanotic CHD within several months.</p> Marsa Hendra Utomo Taufiq Hidayat Heroe Soebroto Copyright (c) 2024 Marsa Hendra Utomo, Taufiq Hidayat, Heroe Soebroto 2024-03-31 2024-03-31 5 1 11 22 10.20473/ccj.v5i1.2024.11-22 Prevalence and Impact of Modifiable Risk Factors on Acute Coronary Syndrome: A Case Control Study <p><strong>Highlights:</strong></p> <p>1. <span style="font-size: 0.875rem;">Smoking duration, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia, are significantly associated with ACS.</span></p> <p>2. Obesity and hypertension are identified as risk factors for inpatient ACS.</p> <p>-</p> <p><strong>Background: </strong>Acute coronary syndrome (ACS) is defined by the abrupt reduction or total obstruction of blood flow to the myocardium. Recognized risk factors for ACS include conditions such as hypertension, dyslipidemia, smoking, obesity, diabetes mellitus, hyperuricemia, as well as variables like age, gender, and family history of the ailment. The objective of this research was to examine the prevalence and importance of modifiable risk factors associated with ACS.</p> <p><strong>Material and Methods: </strong>The study is structured as a prospective case-control study. The research sample comprises 100 ACS patients, categorized into three groups: STEMI, NSTEMI, and UAP. The Chi-Square test and logistic regression were used to examine the samples. The threshold for statistical significance was set at p&lt;0.05.</p> <p><strong>Results: </strong>ACS occurred more frequently in male patients (54%) and those aged ≥ 40 years (85%). Several factors demonstrated significant associations with ACS, including smoking habits, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia. Among these, inpatient ACS was notably linked with obesity (OR: 7.42; 95% CI: 1.48-37.11; p=0.015) and hypertension (OR: 0.13; 95% CI: 0.03-0.53; p=0.005). The presence of ACS was also correlated with a notable increase in inpatient care, with obesity and hypertension emerging as risk factors for inpatient ACS.</p> <p><strong>Conclusion: </strong>ACS was more common in males and individuals aged 40 or older, with significant associations identified between ACS and various factors, including smoking, dyslipidemia, diabetes, obesity, hyperuricemia, and hypertension, with obesity and hypertension specifically linked to inpatient ACS.</p> Anak Agung Ngurah Anindya Kusuma I Gede Bagus Gita Pranata Putra Copyright (c) 2024 Anak Agung Ngurah Anindya Kusuma, I Gede Bagus Gita Pranata Putra 2024-03-31 2024-03-31 5 1 23 34 10.20473/ccj.v5i1.2024.23-34