Coronaryheartdisease (CHD) due to atherosclerosis is a multifactorial process with multiple interdependent factors. At present time, atherosclerosis is considered to be an inflammatory process. It has been proven that inflammation plays a mayor role in the initiation, progression as well as the destabilitation of the atherosclerosis plaque. High sensitivity C-reactive protein (hs-CRP) is one of the most important inflammatory marker in CHD and directly related to the extent and severity of atherosclerosis, extent of myocardial ischemia and myocardial necrosis. The purpose of this study is to determine hs-CRP levels in patients with acute coronary syndrome (ACS), chronic CHD and non CHD. And, to determine the correlation between hs-CRP levels and CKMB enzyme level in patients with acute myocardial infarction (AMI). This is a descriptive observational analytic study with cross sectional design. hs-CRP levels were measured by using chemiluminescent method on 21 ACS patients, 20 chronic CHD patients and 20 non CHD patients. The mean hs- CRP level in ACS, chronic CHD and non CHD patients were respectively 8.40 (SD 5.53) mg/l, 2.81 (SD 2.09) mg/l and 1.07 (SD 0.81) mg/l. A statistically significant difference in hs-CRP level was found between ACS, chronic CHD and non CHD (p = 0.000 ). A positive correlation was found between hs-CRP level and CKMB enzyme level in AMI patients (p = 0.004). In conclusion hs-CRP level is consistently higher in patients with ACS compared to patients with chronic CHD and non CHD. A positive correlation was found between the increased level of hs-CRP and CKMB enzyme level. (Med J Indones 2004; 13: 102-6)
Abstract : The purpose of this study to correlate body mass index with triglyceride levels at coronaryheartdisease. This study is an analytic observational by using cross sectional design. Subjects of this study were 96 people with consecutive sampling method. Data retrieved by observing the patient's medical record from Haji Adam Malik Hospital Medan, North Sumatera, Indonesia. The result this study showed that 60 subjects CHD (62.5%) were male and as many as 36 subjects CHD (37.5%) were women. The largest age group suffering from this disease are aged between 60 to 74 years. Obesity Type I is the highest body mass index abnormalities in patients with CHD as many as 58 subjects (60.4%). Based on the analysis by the chi-square test p-value = 0.032 for BMI with triglycerides, which means there is a significant relationship. And coclusion that excessive body mass index had a significant relationship with levels of triglycerides.
Proof that associated C.pneumoniae infection and atherosclerosis was conducted sero-epidemiologically, through direct detection of bacterial components in the atherosclerotic lesion and isolation of the bacteria from carotid and coronary atherome tissue. Many sero- epidemiological studies have associated increased C.pneumoniae serology with myocardial infarction, coronaryheartdisease, and stroke. Prospective studies that have been performed do not provide strong evidence that support a relationship between C.pneumoniae, cytomegalovirus, and H.pylori infection with coronaryheartdisease. In C.pneumoniae infection, the risk- ratio towards coronaryheartdisease is 1.22 (95% CI 0.96-1.54), the risk ratio for cytomegalovirus is 0.91 (95%, CI 0.69-1.19), and the risk ratio for H.pylori is 1.13 (95%, 0.93-1.38). 12 Even though we must understand the diagnostic criteria, the limit of the titer used may be different. We also have to take into consideration the possibility of confounding factors such as smoking, and also the number of samples being studied. 14 In addition, when performing the evaluation, we also need to consider the fact that over 50% adults have antibodies against C.pneumoniae. The evaluation of antibody levels should be conducted serially, since there is a tendency for re-
Atherosclerosis is a process underlies the occurrence of various diseases that have an increasing prevalence from year to year, such as coronaryheartdisease and stroke. Atherosclerosis is based on disruption of the balance that called homeostasis in endothelial cells that was de ﬁ ned as endothelial dysfunction. Endothel of blood vessels is a major regulator for vascular homeostasis in the artery. Endothelial layer has the ability to maintain a balance between vasodilation and vasoconstriction of blood vessels, prevent and stimulate proliferation and migration of smooth muscle cells, thrombogenesis and ﬁ brinolysis. Mechanical and chemical stressors can disrupt the balance caused endothelial dysfunction that can initiate the process of atherosclerosis such as an increase in endothelial permeability, platelet aggregation, leukocyte adhesion, and release
CoronaryHeartDisease (CHD) has affected multidimensional aspects of human live nowadays. Yet, quality of life and factors associated with quality of life among people who live with heartdisease has not been explored in Indonesia. This study aimed to identify factors influenced the quality of life among people with CHD received outpatient services. Those factors are gender, income, revascularization, cardiac rehabilitation, anxiety, depression and spiritual well- being. Zung Self-rating Anxiety Scale was used to measure anxiety where depression level measured using Beck Depression Inventory II. Spirituality index was used to measure spiritual well-being. The quality of life level was measured using the Seattle Angina Questionnaire. This study used quantitative descriptive with multivariate analysis using logistic regression. 100 respondents were randomly selected from the Cardiac Outpatient Unit. Findings indicated factors influenced the quality of life of CHD patients using a significance of ƿ-value < 0.005 were: anxiety (ƿ=0,002, OR = 4,736, 95% CI, 1,749 – 12,827); depression (ƿ=0,003; OR=5,450, 95% CI, 1,794 – 16,562); and revascularizations (ƿ=0,033; OR=3,232, 95% CI, 1,096 – 9,528). Depression was considered as the most significant factor; therefore, managing depression is a priority in the discharge planning or cardiac rehabilitation programme.
Coronaryheartdisease (CHD) is a non-transmitted disease which is particular concern at the global, national, and local level. CHD has become a concern because it has caused a lot of deaths. Risk factors linked with CHD consist of permanent risk factors and variable risk factors. The purpose of the research is to analyze the correlation between variable risk factors and CHD in the Minahasa ethnic society in Manado City. This research was an observational case- control study conducted by Prof. dr. R. D. Kandou Hospital, Manado, from August to October 2016. In total, there were 220 patients included. The sampling used a simple random sampling method and the data obtained were analyzed by chi-squared test. According to the results, hypertension, smoking, and behavioral type were connected to cases of CHD. The correlation degree showed that the respondents suffering hypertension were 5.70 times more likely to suffer CHD, the smoking respondents were 2.25 times more likely to experience, and behavior type A respondents were 2.96 times more likely to suffer CHD. Hypertension, smoking, and behavioral type are linked with CHD, so there should be some promotion and preventive actions from the health governmental institution to society, especially aimed at adults, about the quality of life enhancement by healthy behavior and avoiding CHD risk factors.
The process of examination of the diagnosis of coronaryheartdisease will generate clinical data with many attributes. The number of attributes may cause mutual contradictions between attributes, which can degrade the system performance diagnosis. This study proposes a model for a diagnosis system consisting of a combination of process, resample, removal of duplicate data, dimensional reduction and data mining techniques. Dimensional reduction techniques used are feature selection type filtering with an Information Gain (IG) algorithm. Used data mining techniques involve the classification, the algorithm k-NN, Support Vector Machine, C4.5 and multilayer perceptron (MLP). System performance is measured with a parameter sensitivity, specificity, accuracy, and Area Under the Curve (AUC). The test results indicate that the attribute generated by using information gain and the best performance is chest pain type (cp), scintigraphy (thal) and flouroscopy (ca). The performance result are for sensitivity 86.14%, specificity 89.04%, AUC 86.9% and accuracy 87.36%. The performance produced by the system is included in good categories.
Platelet aggregation plays an important role in atherosclerosis process in CoronaryHeartDisease (CHD) patients. Antiplatelet acts to prevent platelet aggregation and thrombus subsequently. Thrombus will block artery coronaries. Antiplatelet responsiveness can be seen by aggregation platelet profile. Based on the background, the aim of this research was to review platelet aggregation and cardiovascular event profile in CHD patients with dual antiplatelet. Prospective study was used in this study. CHD patients with dual antiplatelet therapy, willing to follow this research, and compliance with therapy were recruited into this study. Blood samples from patients were collected for platelet aggregation test. Platelet aggregation was analyzed by Light Aggregometry which used three platelet inducer (ADP, Collagen, Epinephrine). Cardiovascular event was defined by ischemic attack that CHD patients got in 3 months. 12 patients were recruited for this research. From the 12 patients, 5 patients occured ischemic attack within follow up. Platelet aggregation for that 5 patients which had ischemic attack, was normal and under normal platelet aggregation. Platelet activation is contributor subsequent atherothrombosis in patients with high inflammatory regulations in artery wall and systemic circulation. Platelet aggregation profile can be reflected as antiplatelet activity. Statistical analysis was done for aggregation profile and cardiovascular event. P- values > 0.05 which means there’s no correlation between platelet aggr egation and cardiovascular event. Platelet aggregation in this research showed in normal and under normal function. Antiplatelet concentration should be measured for filling the gap between aggregation profile and cardiovascular event.
Bivariate analysis between the mean C-reactive protein level and extent of coronary lesion was performed using the Kruskal Wallis test, with a result of p=0.056. This means that that statistically, the mean C-reactive protein level and extent of coronary lesion portrayed as single-vessel disease, double- vessel disease, and three-vessel disease does not show a significant correlation. The results is not far from previous studies, seen from the mean CRP levels for each group of lesion extent, as follows: 5.5 mg/L in single vessel disease (SVD), 6.6 mg/L in double- vessel disease (DVD), and 5.5 mg/L in triple-vessel disease (TVD). 12 The lower CRP level in TVD lesions compared to DVD lesions may be due to the fact that CRP illustrates an ongoing inflammatory process, while coronary angiography demonstrates stenosis in coronary blood vessels. The lesion may be minimal (such as a less than 70% stenosis of only one blood vessel), but if the CRP level is high, references state that there is a greater risk of cardiovascular event such as acute myocardial infarct or sudden death due to cardiac causes compared to in patients without increased CRP levels. Based on the results of the analysis of mean CRP level for each clinical condition, the mean CRP level among patients with stable angina pectoris was 5.4 mg/L, a higher 9.3 mg/L in unstable angina pectoris, and then reduced again at 8.2 mg/L for acute myocardial infarct. Even though the differences in these mean averages were not significant for each clinical indication, with such mean averages, we must continue to be alert for the possibility. 17
50. Ito H, Abe M, Mifune M, Oshikiri K, Antoku S, Takeuchi Y, et al. Hyperuricemia Is Independently Associated with CoronaryHeartDisease and Renal Dysfunction in patients with Type 2 Diabetes MellitusTogane. Plos One. 2011;6(11):e27817-24.
Some things have been mentioned in the risk factors of coronaryheartdisease on the prevention of, among others regulate diet, rest patterns, do not smoke, do not consume alcoholic beverages and doing exercise. One of the efforts to prevent the risk of coronaryheartdisease is by regular exercise in accordance with the proper exercise dose. This exercise has benefits and important role for human survival, namely (1) may improve glucose and fat metabolism, (2) to improve heart function, lung, muscle work, joints and other organs, (3) to control blood pressure, ( 4) burn fat so that they can lose weight, and (5) improving physical fitness so that labor productivity has also increased. From some of the benefits it could be concluded that exercise can improve heart function, lung, circulatory system and other organ functions that exercise is one of the best ways to prevent coronaryheartdisease.
46. Wheeler JG, Juzwishin KD, Eiriksdottir G, Gudnason V, Danesh J, Wheeler JG, et al. Serum uric acid and coronaryheartdisease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS Medicine / Public Library of Science. 2005;2(3):e76.
pressure. Thus, it can prevent the oxygen to reach the artery. Thus, women also include in the diagnosis patient having coronaryheartdisease. It happened because of the occurrences in the body that cannot work in a normal condition. The basic feature of the coronaryheartdisease is the pain in the chest, this normal sign of the person is infected by the disease. It is because of uncomfortable feeling the chest that likely occurs in few minutes. Thus, the people also feel the shortness of the breath. It is because the heart cannot pump enough blood together with the body needs.
Postmortem studies of accident victims and military casualties in Western countries have shown that coronary atherosclerosis often begins to develop before age 20 and is widespread even among adults who were asymptomatic during life. Exercise stress tests in asymptomatic persons may show evidence of silent myocardial ischemia, i.e., exercise-induced ECG changes not accompanied by angina pectoris; coronary angiographic studies of such persons may reveal coronary artery plaques and previously unrecognized obstructions (Chap. 230). Postmortem examination of patients with such obstructions without a history of clinical manifestations of myocardial ischemia often shows macroscopic scars secondary to myocardial infarction in regions supplied by diseased coronary arteries, with or without collateral circulation. According to population studies, ~25% of patients who survive acute myocardial infarction may not come to medical attention, and these patients have the same adverse prognosis as do those who present with the classic clinical picture of acute myocardial infarction (Chap. 245). Sudden death may be unheralded and is a common presenting manifestation of IHD (Chap. 273).
Epicardial coronary arteries are the major site of atherosclerotic disease. The major risk factors for atherosclerosis [high levels of plasma low-density lipoprotein (LDL), low plasma high-density lipoprotein (HDL), cigarette smoking, hypertension, and diabetes mellitus (Chap. 241)] disturb the normal functions of the vascular endothelium. These functions include local control of vascular tone, maintenance of an antithrombotic surface, and control of inflammatory cell adhesion and diapedesis. The loss of these defenses leads to inappropriate constriction, luminal thrombus formation, and abnormal interactions between blood cells, especially monocytes and platelets, and the activated vascular endothelium. Functional changes in the vascular milieu ultimately result in the subintimal collections of fat, smooth muscle cells, fibroblasts, and intercellular matrix that define the atherosclerotic plaque. This process develops at irregular rates in different segments of the epicardial coronary tree and leads eventually to segmental reductions in cross-sectional area, i.e., plaque formation.
karoten dan sangat efektif melawan radikal bebas. Kandungan likopen pada tomat juga dapat mencegah kanker prostat, coronaryheartdisease (CHD) dan stroke (Vanket, et al., 2002) Melihat kemampuan buah tomat yang demikian kuat dalam melawan radikal bebas maka perlu dilakukan penelitian untuk membandingkan kemampuan wedang tomat dibanding zegavit 500 mg (multivitamin) dalam mencegah penurunan kadar eritrosit pada mahasiswa yang latihan aerobik tipe high impact.
Rheumatic heartdisease (RHD) is mediated by an abnormal immunological response following a Streptococcus pyogenes infection that induces a disturbance of oxidants and antioxidants balances. Mannose-binding lectin (MBL) binds to N-acetylglucosamine, a molecule present on the Streptococcus cell wall and human heart valves. There is a disturbance of oxidant and antioxidant balance in rheumatic disease. Myeloperoxidase (MPO) is a marker of oxidative stress and inflammation. This study was aimed to determine the correlation of MBL and MPO levels and severity of valvular regurgitation and heart failure (HF) in RHD patients. A case-control study was conduct using human peripheral blood samples from 32 children aged 6 to 14 years old. The subjects were divided into two groups: 16 RHD patients included in the case group and 16 healthy children as a control group. The level of MBL and MPO was investigated using ELISA method. There were significant differences on MBL and MPO level between patient and control group. The level of MBL and MPO were significantly increased in RHD group, especially on severe valvular regurgitation. There was a strong correlation between MBL and MPO levels and the severity of valvular regurgitation (r = 0.94 and r = 0.88). The least significant diff- erence (LSD) analysis showed that significant difference occurs in the severe heart failure group. Our research revealed that the MBL and MPO levels in pediatric RHD patients were significantly higher than in healthy children. The MBL and MPO levels were signifi - cantly correlated with the severity of valvular regurgitation and heart failure.
Nordestgaard G. Børge, dkk, 2013, Familial Hypercholestrolemia is Underdiagnosed and Undertrated in the General Population: Guidance for Clinicala to Prevent CoronaryHeartDisease, European Heart Journal, Tersedia dalam: doi:10.1093/eurheartj/eht273, Dikutip tanggal 23 Juni 2015.
Abstract—The 2010 impact goal of the American Heart Association is to reduce death rates from heartdisease and stroke by 25% and to lower the prevalence of the leading risk factors by the same proportion. Much of the burden of acute heartdisease is initially experienced out of hospital and can be reduced by timely delivery of effective prehospital emergency care. Many patients with an acute myocardial infarction die from cardiac arrest before they reach the hospital. A small proportion of those with cardiac arrest who reach the hospital survive to discharge. Current health surveillance systems cannot determine the burden of acute cardiovascular illness in the prehospital setting nor make progress toward reducing that burden without improved surveillance mechanisms. Accordingly, the goals of this article provide a brief overview of strategies for managing out-of-hospital cardiac arrest. We review existing surveillance systems for monitoring progress in reducing the burden of out-of-hospital cardiac arrest in the United States and make recommendations for filling significant gaps in these systems, including the following: 1. Out-of-hospital cardiac arrests and their outcomes through hospital discharge should be classified as reportable events as part of a heartdisease and stroke surveillance system. 2. Data collected on patients’ encounters with emergency medical services systems should include descriptions of the performance of cardiopulmonary resuscitation by bystanders and defibrillation by lay responders. 3. National annual reports on key indicators of progress in managing acute cardiovascular events in the out-of-hospital setting should be developed and made publicly available. Potential barriers to action on cardiac arrest include concerns about privacy, methodological challenges, and costs associated with designating cardiac arrest as a reportable event. (Circulation. 2008;117:2299-2308.)
When comparing coronarydisease and stroke, we found that incidence and short-term case fatality of coronarydisease were considerably higher than that of stroke, especially for men. Incidence of coronarydisease decreased especially for men, and mortality declined for both men and women during 1987–2001. For stroke, there was a less marked decline regarding incidence and there were slight declines in mortality. Out-of-hospital mortality during the first 28 days from occurrence was higher than in-hospital mortality for coronary events, whereas for stroke, in-hospital mor- tality was higher (in men) or the same (in women) as out-of-hospital mortality. The 28 days of case fatality from coronarydisease was nearly three times higher for men and at least two times higher for women compared with case fatality of stroke during that period. It is known that a substantial proportion of these early coronary deaths are instantaneous and are caused by fatal cardiac arrhythmias. Longer-term (29 days to 5 years) case fatality was higher for stroke than for coronarydisease.