Budi Yuli Setianto
Faculty of Medicine, Gadjah Mada University/ dr.Sardjito Hospital, Jogjakarta

Published : 45 Documents
Articles

Corelation Between Matrix Metalloproteinase-9 (MMP-9) With Complications of Acute Heart Failure In Myocardial Infarction With ST-Elevation (STEMI) And Acute Coronary Syndromes Without STElevation (NSTEACS) Setianto, Budi Yuli; Mubarika, Sofia; Irawan, Bambang
Jurnal Kardiologi Indonesia Vol 32, No 4 (2011)
Publisher : Indonesian Heart Association

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Background. Acute coronary syndrome (ACS) often leads tocomplications of acute heart failure. These complications will increasethe morbidity and mortality of patients with ACS.Objective. To determine differences in levels of MMP-9 betweenSTEMI and NSTEACS and the correlation between MMP-9 with acuteheart failure between the two groups.Methods. Examination of the samples performed in 79 patientswith ACS (38 STEMI and 41 NSTEACS) prior to the action ofintravenous thrombolytic or coronary intervention. Differences inlevels of MMP-9 in the ACS are experiencing acute heart failure andwithout heart failure, and differences in levels of MMP-9 in the STEMI andNSTEACS groups were tested with Chi-square, Fisher’s exact test or theIndependent t-test.Results. STEMI groups had significantly higher levels of MMP-9 thanNSTEACS group 1629.12 ± 719.60 compared to 1033.42 ± 777.12(p = 0.001). However, STEMI groups who have acuteheart failureare higher but not significant compared with NSTEACS group 14(36.84) and 11 (26.82) (p = 0.339). There are differences in levelsof MMP-9 in ACS with acute heart failure than those who did not:1698 ± 867.95 ng/mL and 1144.61 ± 713.60 ng/mL (p = 0.004).Conclusion. MMP-9 levels are significantly higher in STEMI groupscompared with NSTEACS groups, and MMP-9 associated with the incidenceofacute heart failure in ACS. STEMI groups have tended to have acute heartfailure are higher than NSTEACS groups.
Corelation Between Matrix Metalloproteinase-9 (MMP-9) With Complications of Acute Heart Failure In Myocardial Infarction With ST-Elevation (STEMI) And Acute Coronary Syndromes Without STElevation (NSTEACS) Setianto, Budi Yuli; Mubarika, Sofia; Astuti, Indwiani; Irawan, Bambang
Jurnal Kardiologi Indonesia Vol 34, No 4 (2011): Vol 32, No 4 (2011): Oktober-Desember 2011
Publisher : Indonesian Heart Association

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Background. Acute coronary syndrome (ACS) often leads to complications of acute heart failure. These complications will increase the morbidity and mortality of patients with ACS.Objective. To determine differences in levels of MMP-9 between STEMI and NSTEACS and the correlation between MMP-9 with acute heart failure between the two groups.Methods. Examination of the samples performed in 79 patients with ACS (38 STEMI and 41 NSTEACS) prior to the action of intravenous thrombolytic or coronary intervention. Differences in levels of MMP-9 in the ACS are experiencing acute heart failure and without heart failure, and differences in levels of MMP-9 in the STEMI and NSTEACS groups were tested with Chi-square, Fisher’s exact test or the Independent t-test.Results. STEMI groups had significantly higher levels of MMP-9 than NSTEACS group 1629.12 ± 719.60 compared to 1033.42 ± 777.12 (p = 0.001). However, STEMI groups who have acuteheart failure are higher but not significant compared with NSTEACS group 14(36.84) and 11 (26.82) (p = 0.339). There are differences in levels of MMP-9 in ACS with acute heart failure than those who did not: 1698 ± 867.95 ng/mL and 1144.61 ± 713.60 ng/mL (p = 0.004).Conclusion. MMP-9 levels are significantly higher in STEMI groups compared with NSTEACS groups, and MMP-9 associated with the incidence of acute heart failure in ACS. STEMI groups have tended to have acute heart failure are higher than NSTEACS groups.
Corelation Between Matrix Metalloproteinase-9 (mmp-9) And Troponin-I (cTn-I) in ST- Elevation Myocardial Infarction (STEMI) and Non St-Elevation Acute Coronary Syndrome (NSTEACS) Setianto, Budi Yuli; Astuti, Indwiani; Irawan, Bambang; Mubarika, Sofia
Jurnal Kardiologi Indonesia Vol. 32 No.1 Jan-Mar 2011
Publisher : Indonesian Heart Association

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Background: Acute coronary syndrome (ACS) is due to plaque rupture or erosion. Plaque rupture or erosion occurs because of the extra-cellular matrix destruction by an MMP (matrix metalloproteinase). Troponin I(cTn-I) is a biomarker that will increase in ACS with myocardial necrosis.Objective: To determine levels of MMP-9 difference between STEMI and NSTEACS and the relationship between levels of MMP-9 and cTn-I levels between the two groups.Methods: The sample examination performed in 80 patients with ACS (39 STEMI and 41 with NSTE-ACS) prior to the act of intravenous thrombolysis or coronary intervention.Analysis of MMP-9 levels relationship and cTn-I using Spearman test, and analysis of the cut-off relationship MMP-9 in the STEMI and NSTEACS groups were tested by Chi square.Results: Group STEMI had higher levels of MMP-9 and significantly higher compared with NSTE-ACS group (p = 0.002). Spearman correlation test showed a significant and positive correlation between MMP-9 and troponin-Ibetween the two groups (p = 0.003 and r = 0.33).Conclusion: Increased levels of MMP-9 were significantly higher in STEMI compared with NSTE-ACS and its association with elevated levels of troponin-I, provide information about the role of MMP-9 against the severity of heart muscle damage that occurred.Keywords: MMP-9, Troponin-I, STEMI, NSTEACSPendahuluan: Sindrom koroner akut (SKA) terjadi karena adanya ruptur atau erosi plak. Ruptur atau erosi plak terjadi karena adanya destruksi matriks ekstra selular oleh suatu MMP (matriks metaloproteinase). Troponin I (cTn-I) merupakan biomarker yang akan meningkat pada SKA dengan nekrosis miokard.Tujuan: Untuk mengetahui perbedaan kadar MMP-9 antara STEMI dan NSTEACS serta hubungan antara kadar MMP-9 dan kadar cTn-I diantara kedua kelompok.Metode: Pemeriksaan sampel dilakukan pada 80 pasien SKA (39 STEMI dan 41 NSTEACS) sebelum dilakukan tindakantrombolisis intravena atau intervensi koroner. Analisis hubungan kadar MMP-9 dan cTn-I menggunakan uji Spearman, dan analisis hubungan cut-off MMP-9 pada kelompok STEMI dan NSTEACS diuji dengan chi square.Hasil: Kelompok STEMI memiliki kadar MMP-9 yang lebih tinggi dan bermakna dibandingkan kelompok NSTEACS (p=0.002). Uji korelasi Spearman menunjukkan hubungan yang signifikan dan korelasi positif antara MMP-9 dan troponin-I diantara kedua kelompok (p=0.003 dan r=0.33).Kesimpulan: Peningkatan kadar MMP-9 yang lebih tinggi secara bermakna pada STEMI dibandingkan dengan NSTEACS dan hubungannya dengan peningkatan kadar troponin-I, memberikan informasi tentang peran MMP-9 terhadap beratnya kerusakan otot jantung yang terjadi.Kata kunci: MMP-9, Troponin-I, STEMI, NSTEACS
Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital Setianto, Budi Yuli; Sari, Julia; Hartopo, Anggoro Budi; Gharini, Putrika Prastuti Ra
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

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ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently.Several studies reported that young patients have distinct clinical characteristics as compare with olderpatients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronarysyndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensivecardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admittedwith acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS(age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrumsfrom both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was consideredsignifi cantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Mostyoung ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not differentfrom that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50%vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did notdiffer from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. Theyoung ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15%vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65).Thirty percent of young ACS patients presented with Killip class II or higher, however there were nosignifi cant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinicalpresentation and spectrums between young ACS and older ACS patients. The need for preventionprogram in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.
Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital Setianto, Budi Yuli; Sari, Julia; Hartopo, Anggoro Budi; Ra Gharini, Putrika Prastuti
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.
CORRELATIONS BETWEEN SERUM LEVEL OF MATRIX METALLOPROTEINASE-9 (MMP-9) AND SERUM LEVEL OF TROPONIN-I IN PATIENT WITH ACUTE CORONARY SYNDROME (ACS) Ruchanihadi, Ruchanihadi; Setianto, Budi Yuli; Hariawan, Hariadi
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground. The pathophysiology of acute coronary syndromes (ACS) is now accepted as the rupture or erosion of an atherosclerotic plaque, initially occurs at the shoulder of the plaque and is followed by intra-plaque thrombosis then spread to the vascular lumen and cause total partial vascular occlusion. MMP-9 is an extracellular matrix degrading enzyme that plays a crucial role in the breakdown of the fibrous cap of plaque and subsequent rupture in the pathogenesis of ACS. Cardiac troponins are currently the most sensitive and specific biochemical markers of myocytes necrosis.Objective. To know the correlation between serum level MMP-9 and serum level of Troponin-I in patients with ACSMethod. Study design was cross sectional. Data were collected by consecutive sampling from patients in ICCU board of RSUP Dr. Sardjito Yogyakarta, in June 2008-August 2010. A questionnaire was used to collect information from patient. After admission, peripheral venous blood was drawn once and measuring concentration of serum level of MMP-9 and Troponin-I before definitive thrombolysis. Data are expressed as means ± standard deviation (SD). Correlation between serum level of MMP-9 and serum level of Troponin-I were assessed using Spearman’s rank correlations test. A value of p<0.05 was considered statistically significant.Result. There were 139 patients with ACS and comprising 63 patients with STEMI, 27 patients with NSTEMI, and 49 patients with UAP. Means±SD of Troponin-I from all of samples was 9.49±10.47 ng/dL. Mean±SD of MMP-9 from all of samples was 1296.06±729.97 ng/dL. There were significant correlations between MMP-9 and Troponin-I in patients with ACS (r=0.34, p=0.000).Conclusion. There were significant correlations between MMP-9 and Troponin-I in ACS patients in ICCU RSUP Dr. Sardjito Yogyakarta. Keywords: ACS, MMP-9, Troponin-I
29-Years Old Woman Presenting with ST Elevation Myocardial Infarction Anggrahini, Dyah Wulan; Setianto, Budi Yuli
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1167.062 KB) | DOI: 10.22146/aci.17795

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Myocardial infarction in young female is rare condition, but carries significant morbidity and mortality. The recognition management for MI in young female is challenging due to its unspecific clinical presentation and lack of guidance in the current guidelines. We reported a 29-years old woman presenting with infarction type chest pain, showing ST- elevation in the inferior leads with total AVblock as complication. The risk factors in this patient were smoking, family history, cardiomyopathy, and preeclampsia history. The cause for myocardial infarction in this patient was atherosclerotic plaque rupture, but we did not manage to performed coronary intervention due to her low ventricular function and unavailability data for myocardial viability at the time of hospitalization.
Correlation of Serum Levels of Matrix Metalloproteinase-9 to Acute Heart Failure Event as a Complication af Acute Coronary Syndrome Purnomo, Sasongko Hadi; Setianto, Budi Yuli; Krisdinarti, Lucia
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.313 KB) | DOI: 10.22146/aci.17791

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Background: Acute heart failure (AHF) after acute coronary syndrome (ACS) is the biggest complication with a poor prognosis in a long term. The infl uence of MMP-9 as proteolytic enzyme that degrades extracellular matrix in remodeling left ventricle was recognized. However, according to researcher’s knowledge, evaluation of the MMP-9 as a predictor of AHF after ACS was never reported. Objective: To fi nd out the serum level of MMP-9 in ACS with AHF higher than that without it, as well as to fi nd out the level of MMP-9 with risk of AHF after ACS. Method: The study used a cross-sectional study. Samples were collected by using a consecutive sampling technique among patients with ACS treated in ICCU of Public Hospital Dr Sardjito Yogyakarta, since June 2008 to August 2010. Questionnaires were used to collect sample raw data. The level of MMP-9was examined a time at admission in ICCU before trombolysis was done. The heart failure had Killip II- IV scores. Factors infl uencing the incidence was analyzed by using multivariate analysis technique. A signifi cance level was at p< 0.05. The relative risk of acute heart failure at a certain level of MMP-9 (from cut-off value) was obtained after it was adjusted. Result: Among 122 subjects, 75 was without AHF and 47 with AHF. Median of the level of MMP-9 in the whole sample of ACS was 1248.55 ng/mL with a minimum of 170.50 ng/mL and maximum of 3058.40 ng/mL. Moreover, the level of MMP-9 in ACS with AHF (1700.81±740.43 ng/mL) was signifi cantly higher than ACS without AHF (1189.55±654.60 ng/mL) with p value = 0.000. Independent risk factor after the multivariate analysis was done indicates the level of MMP-9 above 1444 ng/mL (RR= 4.2) and the location of anterior infarction (RR= 2.9). Conclusion: In patients with ACS treated in ICCU of RSUP Dr Sardjito, the level of MMP-9 with AHF was higher than that without it. If the level of MMP-9 above 1444 ng/mL, the possibility of AHF was 4.2 times.Keywords: acute coronary syndrome, MMP-9, acute heart failure after acute coronary syndrome
Surgical and Non Surgical Interventions in Adult Congenital Heart Disease: Our Experience from COHARD registry Setianto, Budi Yuli; Anggrahini, Dyah Wulan
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2(S) (2017): Supplement, Abstracts of Jogja INternational CARdiovascular TOpic Series (JI
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (104.067 KB) | DOI: 10.22146/aci.28012

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Surgical and Non Surgical Interventions in Adult Congenital Heart Disease:Our Experience from COHARD registry
The Prevalence and Impact of Body Mass Index Category in Patients with Acute Myocardial Infarction Hartopo, Anggoro Budi; Susanti, Vina Yanti; Setianto, Budi Yuli
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (274.878 KB) | DOI: 10.22146/aci.22604

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Background: Body mass index is widely recognized as a tool to classify obesity and adiposity. In Asian population, body mass index category can be divided as underweight, normal, overweight and obese. The prevalence of this categorisation is varied among patients with acute myocardial infarction. Furthermore, there is a J and U curve relationship between body mass index category with outcome in acute myocardial infarction. This research aims to investigate the prevalence of body mass index category and its impact on patients with acute myocardial infarction.Methods: The research design is a cross sectional study. The subjects of this research are patients hospitalised with acute myocardial infarction. Subjects are categorised as underweight, normal, overweight and obese, based on Asian body mass index categorisation. The demography, clinical and laboratory data is compared among categories and statistically analysed. The major adverse cardiac events occuring during hospitalisation are recorded and its incidence is compared among group. A p value < 0.05 is statistics limit for significance.Results: We analyse 375 subjects hospitalised with acute myocardial infarction. The most prevalence BMI category is overweight (47.7 %), the second most common category is normal (33.1 %), followed by obese (15.5 %) and the least common category is underweight (3.7 %). No significant difference is observed in respect of gender and cardiovascular risk factors. The underweight subject is significantly older as compared to other categories. The glucose level and atherogenic lipid tend to be higher in underweight subject as compared with normal subject. There is no difference in the incidence of major adverse cardiac events among body mass index categorisation.Conclusion: The overweight is the most common body mass index category in acute myocardial infarction. The underweight subject is significantly older and tend to have worse biochemical parameters as compared to other categories. The incidence of MACE is not associated with the body mass index category.Keywords: body mass index; overweight; underweight; acute myocardial infarction