ACI (Acta Cardiologia Indonesiana)

Triglyceride-Glucose Index Associated with Multivessel Artery Coronary Disease (MVCD) Incidents in Patients With Coronary Artery Disease (CAD) at Sultan Agung Islamic Hospital Semarang

Muhammad Saugi Abduh — 2025-12-10

Background : Coronary artery disease (CAD) patients with multivessel coronary artery disease (MVCD) have higher incidence of major adverse cardiovascular events (MACEs) than patients with single vessel coronary artery disease (SVCD). The triglyceride-glucose index (TG) is a marker of insulin resistance (IR) which has been linked to cardiovascular diseases. However, evidence on the effect of TG index on the incidence of multivessel coronary artery disease (MVCD) in coronary artery disease (CAD) is still limited.

Aims : This study aims to investigate the association between the TG index and the incidence of MVCD in CAD patients at Sultan Agung Islamic Hospital.

Methods : Total of 198 subjects suffering from CAD at Sultan Agung Islamic Hospital Semarang for the period March 2022 to December 2023 were divided into 2 groups, the first group being the MVCD group if the stenosis was ≥ 50% in at least two blood vessels main coronary artery and the second group is the non-multivessel coronary artery disease (non-MVCD) if the stenosis is ≥ 50% in one main coronary artery. This research is an analytical observational study with a cross sectional design. Multivariate test was carried out with a logistic regression test.

Results : The study showed that the higher the TG index value (p=<0.001; PR = 4.117; 95% CI = 2.284-7.424) significantly increased the risk of MVCD in CAD patients.

Conclusions : The increase of TyG index is closely related to the risk of MVCD in CAD patients. This study revealed that the TG index can be a predictor of the severity in CAD patients.

Keywords: Coronary Artery Disease; Multivessel Coronary Artery Disease; Stenosis; Trigleserid-Glucose Index.

Examining the Dominant Factors Affecting Smoking Cessation in Patients with Coronary Heart Disease

Ahmad Handayani — 2025-12-10

Background: Smoking poses a significant public health issue and is a major risk factor for cardiovascular diseases, especially coronary heart disease (CHD). Effective smoking cessation strategies are crucial for improving health outcomes in patients with CHD. Objective: This study aims to identify factors influencing smoking cessation compliance in CHD patients, focusing on family support, environmental support, knowledge, and perception. A cross-sectional study was conducted at Mitra Medika Amplas Hospital, Medan, Indonesia, involving 100 participants from June to December 2022. Methods: Data were collected using structured questionnaires. Bivariate and multivariate statistical analyses, including logistic regression, assessed the relationships between the variables and smoking cessation compliance. Results: Family support significantly predicted smoking cessation compliance, with an odds ratio of 16.454 (P=0.044). While environmental support, knowledge, and perception showed significant associations in the bivariate analysis, multivariate analysis revealed these factors were not independent predictors when adjusted for other variables. Thus, family support remains the dominant factor influencing successful cessation. Conclussion: The findings underscore the critical role of family support in smoking cessation among CHD patients. Although environmental support, knowledge, and perception are related to compliance, they do not have the same level of impact. Enhancing family involvement may improve cessation rates, offering valuable insights for healthcare providers in Indonesia.

Keywords: Smoking Cessation, Coronary Heart Disease, Family Support

The Role of Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as Predictors of Reduced Left Ventricular Ejection Fraction (LVEF) in Heart Failure Patients

Muhammad Ainul Yaqin — 2025-12-10

Background: Heart failure can be called as an emerging epidemic due to increasing cases along with the increasing population. The pathogenesis of heart failure is closely related to inflammation. Some of the biomarkers that can be used to assess the severity of inflammation in patients is neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR).

Objectives: The purpose of this study was to determine the relationship between NLR and PLR with left ventricular ejection fraction (LVEF) and to determine the role of NLR and PLR as predictors of reduced LVEF.

Methods: This study is an observational analytical study with a cross-sectional design in heart failure patients at Dr. H. Abdul Moeloek Hospital, Lampung Province throughout 2023. In total, 88 heart failure patients were included in this study. This study used the Spearman Rank correlation test and receiver operating characteristics (ROC) analysis test to find the cut-off point of NLR and PLR as predictors of reduced left ventricular ejection fraction. In this study, left ventricular ejection fraction was divided into 2 groups (≤40% and >40%).

Result: NLR has a significant relationship with LVEF (r: -0.290, p value: 0.006) and PLR also has a significant relationship with LVEF (r: -0.297, p value: 0.005). NLR> 2.67 can be used as a predictor of reduced left ventricular ejection fraction with a sensitivity of 70.7% and a specificity of 70% (AUC: 0.747, p value: <0.001). PLR> 119.69 can be used as a predictor of reduced left ventricular ejection fraction with a sensitivity of 62.1% and a specificity of 63.3% (AUC: 707, p value: 0.001).

Conclusion: NLR and PLR are associated with LVEF in patients with heart failure. NLR >2.67 and PLR >119.69 can be used as a cheap, simple, and fast predictor in predicting reduced LVEF in heart failure patients.

Keywords: neutrophil lymphocyte ratio; platelet lymphocyte ratio; left ventricular ejection fraction; heart failure

Anatomy, Functional Assessment, Management of Peripheral Artery Disease with Calcification

Mohammad Reza Juniery Pasciolly — 2025-12-10

Abstract :

Peripheral artery disease (PAD) encompasses distinct phenotypes, such as atherosclerotic plaque and calcification, which arise from vascular calcification (VC). 30-50% of individuals may exhibit varying degrees of vascular compromise from vascular beds. Peripheral artery disease (PAD) continues to exhibit significant discrepancies, as numerous patients and general practitioners (GPs) often overlook early signs. Early identification of patients in the etiology of PAD continues to pose a challenge, although its increasing global prevalence and severe repercussions. Given that revascularization decisions are patient-centered and involve a multidisciplinary approach, early recognition of anatomic and functional data is essential for determining appropriate management for all symptomatic patients. This management encompasses lifestyle modifications, antithrombotic therapy, lipid-lowering interventions, and treatment for comorbidities beyond revascularization.

Keywords :

peripheral arterial disease — physical assessment — functional asssessment - vascular calcification - management

Cardiovascular Protection by Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor: How to Optimize the Agent for Patients?

Budi Yuli Setianto — 2025-12-08

Sodium-glucose co-transporter 2 (SGLT2) inhibitor such as empagliflozin and canagliflozin have been shown to decrease atherosclerotic cardiovascular morbidity and mortality in patients with type 2 diabetes and overt cardiovascular disease (CVD). In the primary analysis, dapagliflozin did not appear to reduce atherosclerotic cardiovascular morbidity or cardiovascular mortality. However, it decreased cardiovascular outcomes in a sub-analysis of the primary trial. The cardiovascular trials to date have been carried out in very high-risk populations to increase the hazard rate for major CVD events and complete the studies in a relatively brief period of time. Compared with the empagliflozin and canagliflozin trials, the dapagliflozin trial had a lower fraction of participants with established CVD and a greater proportion of patients with multiple risk factors for CVD (multiple risk factors in 60 percent compared with 0 and 34 percent in the empagliflozin and canagliflozin trials, respectively). This difference in patient population may explain, in part, the differences in atherosclerotic CVD outcomes. However, the ertugliflozin cardiovascular trial only included patients with established CVD and did not show superior benefit in the composite outcome (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke). In patients with type 2 diabetes and heart failure, all SGLT2 inhibitors have shown salutary effects.