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Beyond Blood Pressure Control of ARB

Author : Antonia Anna Lukito
Upload Date : 19-04-2018

The goal of hypertension treatment is to reduce the risk of renal- and cerebro-cardiovascular (CV) disease. The risks associated with hypertension are modulated in the presence of other factors. This has prompted the search for agents that have benefits beyond blood pressure (BP) lowering. Antihypertensive agents that offer benefits that extend beyond those associated with BP reduction alone, to include tissue protective effects and effects on the vasculature, may be of benefit for many patients with increased cardiovascular risk due to comorbidities or prior history of CV events.

Analysis of data from seminal clinical studies and meta-analyses identify that, controlling for effects on BP control, Renin-angiotensin system (RAS) blockers may be more effective than calcium channel blockers (CCBs) in reducing risk of myocardial infarction and congestive heart failure; angiotensin II receptor blockers (ARBs) may be more effective than either angiotensin-converting enzyme inhibitors (ACEIs) or ? blockers in stroke prevention; CCBs may be more effective than RAS blockers in stroke prevention; and ARBs may be more effective than ? blockers in reducing left ventricular hypertrophy.

However, the renin-angiotensin-aldosterone system is considered to be the main mediator of the organ damage associated with hypertension. The angiotensin II receptor blocker represents a class of antihypertensive agents which has important addition to the therapeutic options for high blood pressure. Their ability to control BP is equivalent to other antihypertensive drugs and there is a mounting evidence-base for their ability to reduce hypertension-associated target organ damage and comorbidities. Studies show that ARBs have clinical benefits across the spectrum of disease severity. Furthermore, recent large studies have demonstrated that these benefits extend to patients with conditions predisposing to CV events, such as diabetes, left ventricular hypertrophy, micro-albuminuria, obesity and where risk factors coexist. Data from these studies suggest that the cardiovascular protective effects of ARBs are at least, in part, independent from the BP lowering action. In addition, ARBs are extremely well tolerated, and strong evidence suggests that compliance with therapy--a key factor in achieving adequate BP control--with ARBs is higher than with other antihypertensive agents. Furthermore, flexible dosing and good tolerability profile mean that, where necessary, ARBs can be combined with other classes of antihypertensive agents to achieve adequate BP control and reduce the risk of hypertension-associated morbidity. .

ARBs exert their BP-lowering action through different mechanisms at different levels of the RAS than ACEIs. Angiotensin-II (Ang-II) activates two major types of receptors, angiotensin II type one (AT1R) and type two (AT2R) receptors. While AT1R is widely expressed and mediates most inflammatory Ang-II effects, AT2R, is less expressed and has opposite effects, promoting vasodilation and anti-inflammatory effects. Physiologically, AT2R actions are usually masked by the more abundant AT1R. It has been suggested that ARBs can mediate their action through increasing angiotensin II (Ang II) availability to bind to the beneficial angiotensin type 2 receptor (AT2R), thus leading to unopposed AT2R stimulation.

Clinical and experimental evidence have documented the beneficial actions of ARBs beyond the blood pressure lowering effect. Ischemic diseases such as stroke and proliferative retinopathy are characterized by hypoxia-driven release of angiogenic growth factors. However, revascularization of the ischemic areas is inadequate, resulting in impaired neurovascular function. ARBs have been shown to exhibit vascular protective and pro- or anti-angiogenic effects depending on the tissue/cell type and disease condition under study. The vascular protective effects of ARBs has been demonstrated and candesartan, in particular, in models of ischemic stroke and retinopathy. The positive impact of candesartan was mainly via enhancing the pro-angiogenic state and stimulation of reparative angiogenesis.

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The Correlation of Polyunsaturated Fatty Acid-Monounsaturated Fatty Acid Plasma Ratio with Left Ventricular Ejection Fraction in Patients with Stabil Chronic Heart Failure (I. Puspita, M. R. Akbar, S. Hidayat)

Is Admission Hyperglycemia Associated with Reduced Ejection Fraction in ST elevation Myocardial Infarction without Diabetes?(S.P.I Nasruddin , A.A Nursidiq, N. Purwaningtyas. A. Sukmawarti, G. S. Putri)

Cardiovascular Complication in Preeclampsia: Can it be Predicted Electrocardiographically?(R.A. Raharjo, D. E. Wismiyarso, A. P. Mangkoesoebroto, A. Perdana, U. Bahrudin, A.Y.A.B. Mochtar, Y)

Association between Left Ventricular Global Longitudinal Strain and Functional Capacity Measured with 6 MWT in Patients after Acute Myocardial Infarction(P. Wulandari, T. Wasyanto, N. Purwaningtyas)

Association Between Compliance and Therapeutic Target Achievement in Hypertension Outpatient Patient in Blitar Population(M. Q. A’yun, B. H. Kuncahyo)

A Study of Correlation between Carotid Intima-Media Thickness and Left Ventricular Hypertrophy in Obese Patients (G.P. Lumentut, A. L. Panda, J. Pangemanan, M. Rotty, T. J. Sumampouw, N. O. H. Rantung, H. Pribadi)

Atrial Fibrillation is as a Predictor of in-Hospital Mortality of Acute Stroke Patients(N. H. Karunawan, R.T. Pinzon)

Distributon of Multiple Vessels Coronary Artery Disease and Risk Factors in Patient with Acute Coronary Syndrome: Study From Sardjito General Hospital Registry(A. Pradhana, H.P. Bagaswoto, N. Taufiq, B.Y. Setianto)

Hemoglobine Level as Predictor of Inhospital Mortality in ACS Patients SCIENCE Registry Sub-Study(A. R. Gemilang, H. Purnasidha, N. Taufiq, B. Y. Setianto)

Correlation between Plasma Adiponectin Levels and Mean Pulmonary Artery Pressure Amongst Grown-Up Uncorrected Atrial Septal Defect(W. Himawan, D. W. Anggrahini, A. B. Hartopo, L.K. Dinarti)

Association of ß angle with Arrhythmic Events in Brugada Syndrome with ECG type 2 and 3(C. Candra, S. B. Raharjo, D. Yugo, D.A. Hanafy, Y. Yunadi)

Percutaneous Balloon Mitral Valvuloplasty in Pregnancy with Severe Mitral Stenosis: Case Series in dr Kariadi General Hospital Semarang(A.P. Mangkoesoebroto, R. A. Raharjo, A. Perdana, M.J. Satyo, S. B. Utami, Y. Herry, S. Rifqi)

Characteristic of Hypertensive Crisis Population in Rural Area: An insight from Atambua(S.D. Putra*, E.A. Pradipta*)

Comparison of Interleukin-6 Post Percutaneous Coronary Intervention between Patients with Acute Myocardial Infarction that Underwent Complete and Incomplete Revascularization(P. K. Dewi, S. Rifqi, N. Anggriyani, N. Wijayahadi)

Pattern of Rheumatic Heart Disease: An Echocardiographic Study (G. Aditya, T. N. P. Adityaputra, I. B. R.Wibhuti, K. B.Nadha)

Comparison of TIMI Flow Between Streptokinase and Alteplase in Patients with ST Elevation Myocardial Infarction After Successful Fibrinolytic at Haji Adam Malik General Hospital Medan(D. Ashrinda, R. Hasan, C. A. Andra, Z. Mukhtar, H. Hasan)

The Relationship of Congenital Heart Defects and Birthweight in Mataram City General Hospital, West Nusa Tenggara(A.P. Rahman)

The Comparison of Sensitivity and Specificity of Point of Care Testing Next Generation Troponin I and High Sensitive Troponin I in Acute Myocardial Infarction Patients(Kriswanto, M. Aminuddin, J. Nugraha )

Correlation of Pulmonary to Systemic Flow Ratio and Adiponection Level in Grown-Up Uncorrected Atrial Septal Defect Patients(K. Mawaris, W. Himawan, D.W. Anggrahini, A.B. Hartopo, L. Krisdinarti)

Correlation Between Educational Level and Medication Adherence Using Morisky Medication Self Adherence Scale (MMAS) in Hypertensive Patients: An Analytical Study(A. F. Khalid, D. Ilmasari, M. G. Suwandi)

Association between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarctions Patients(A. A. Nursidiq, N. Purwaningtyas, T. Wasyanto)

Betel Nut Chewing in Rural East Nusa Tenggara: Prevalence and Relationship to Hypertension(F. Wahyudi)

The New Mayo Clinic Risk Score Characteristics in Acute Coronary Syndrome Post Percutaneous Coronary Intervention Patients(L. Z. Amin, H. Z. Amin, S. A. Nasution, M. Panggabean, H. Shatri)

White Blood Cell Count to Mean Platelet Volume Ratio as a Novel Non-Invasive Marker Predicting Short-term Outcomes in Patients with Non-ST Elevation Myocardial Infarction(Y. Saragih, B. Napitupulu, A.N. Nasution, A.H. Raynaldo, H. Hasan)

Correlation of Left Ventricular Function and CardShock Risk Score with Altered Mental State in Cardiogenic Shock Patient Treated with Mechanical Ventilation(D.H. Karimullah, L.H. Adrian, F.W. Nugroho, S. Anjarwani)

Get With The Guideline (GWTG) Score has Better Prediction than Acute Decompensated Heart Failure National Registry (ADHERE) Score for Inhospital Mortality in Acute Heart Failure Patients(P. A. Kamila, S. Rohman)

Predictive Value of CHA2DS2-VASc-HSF Score for Contrast Induced Nephropathy After Percutaneous Coronary Intervention for Acute Myocardial Infarction(H.W. Parlindungan, R. Hasan, C. A. Andra, H. Hasan, A. A. Siregar, I. N. Kaoy, Z. Mukhtar, A.N. Nasu)

Resolution of ST-Segment Depression in Reciprocal Leads as a Predictor of Mayor Adverse Cardiac Event for ST-Segment Elevation Myocardial Infarction Treated by Fibrinolytic Therapy(A. S. Adhitya, H. Hasan, A. Sitepu, Z. Mukhtar)

The Benefit of Fractional Flow Reserve-Guided PCI Compared to Coronary Angiography-Guided PCI in Patients with Coronary Artery Disease, Including All its Four Subtypes Namely ST-Elevation Myocardial Infarction, Non ST-elevation Myocardial Infarction, Unst(A.I.S. Putra)

Correlation between Tpeak - Tend Interval and Myocardial Blush Grade Value in Anterior ST-Elevation Myocardial Infarct Patient(R.P. Kaneko, N. Taufiq, E. Maharani.)

Relationship Of Platelet Distribution Width And Mean Platelet Volume with ST Segmen Resolution After Fibrinolytics On ST Elevation Myocardial Infarction Patients at Haji Adam Malik General Hospital Medan(D. Ashrinda, H. Hasan, N. Z. Akbar, Z. Mukhtar)

Serum Neutrophil Gelatinase-Associated Lipocalin and Decreased Kidney Function as Predictor of Mortality and Major Adverse Cardiac Events during Acute Heart Failure Hospitalizations(R. Maliawan, B. Nadha, R. Widiana, P. Gunadhi, Ida S., W. Wita )

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction(J. Suganti, A. C. Lubis, A. A. Siregar, A. Sitepu, C. A. Andra, A. N. Nasution, H. Hasan)

Assessment of Coronary No-reflow in Patients with Acute Anterior STEMI Underwent Primary Percutaneous Coronary Intervention Using P Wave Peak Time Parameter(P. Andri, M. Meidianaser, Syaoqi, S. Masrul)

Cardiac Power Output Predicts In-Hospital Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction(Y. F. Siregar, K. K. Ilyas, A. A. Siregar, H. Hasan)

Predictors of Hospital Length of Stay Prolongation in Patients with ST-Segment Elevation Myocardial Infarction in Cardiovascular Care Unit Sardjito General Hospital(I.H. Sulistya , H. P. Bagaswoto , N. Taufiq , B. Y. Setianto )

Comparison of Radial Artery Occlussion Incidence Post Transradial Access Between Seldinger Technique with Modified Seldinger Technique(M. H. Gailani, M. Syukri, M. Fadil)

Can HbA1c Predict Major Adverse Events and Mortality in Coronary Artery Bypass Grafting? – A Systematic Review and Meta Analysis(A. Z. Barano, M. Abduh , E. N. Putri, M. F. Addai)

A Meta-analysis: Associations Between Polymorphisms Gene in Chromosome 9p21 and Risk Of Aortic Aneurysm(R. Mahardhika , M.F. Huda, R. Mahardina, R. M. Budiarto)

The Efficacy of Levosimendan Infusion on Hemodynamic Improvement in Patient Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP) : a Mini Systematic Review(M. D. Jalma, W. Rahmadhani, J. M. Siahaan)

Left Ventricle Abnormality Among Chronic Obstructive Pulmonary Disease Patients in Persahabatan National Respiratory Center Hospital(H. Putrawan, B. Antariksa , M. Basalamah , F. Yunus )

Reached Blood Pressure Target in Heart Failure Patients and Its Correlation with Early Hospital Readmission(E.P. Sidarta, D.B. Bening, D. Sargowo)

Correlation of Left Ventricular Mass Index with Functional Capacity, Diastolic Parameters Changes, and Global Longitudinal Strain Based on Diastolic Stress Echocardiogrpahy in Asymptomatic Hypertensive Heart Disease Patients(R. A. Fanani, A. M. Soesanto, B. Radi)

Selvester Score in Myocardial Infarction, Could It Predict Degree of Severity in Coronary Lesion?(H. Pribadi, J. A. Pangemanan, S. H. Rampengan, A. L. Panda, I. Adriana, Ronaldi, V. F. K. Candra, N)

Estimated Glomerular Filtration Rate And Length of Stay in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention(H. Haryadi, A. A. Asrial, L. Raharjoyo, N. Virginia, K. Rizky ,Y. Herry)

Double Product and Obesity in Batam: A Descriptive Study(A.M. Zahidin, A. Sutheno)

Pregnancy Outcomes in Women with Uncorrected Congenital Heart Disease: A Single-Centre Experience(A. Wardhani, A. Yudanto, M.B.A. Pramono, Y. Herry)

Supranormal ECG: Athlete’s Heart(Aprihati, E.D. Hargiyanto, D. Wijayanti, M.Y. Alsagaff)

Correlation between Level of Blood Pressure in Hypersensitive Patients with Ankle Brachial Index(N.M.D. Yogiswari, A.A.S.M. Meiswaryasti, Y. Indrayana)

Utilization Of Rotablator And Scoring Ballon In Heavily Calcified And Diffuse Coronary Artery Disease(M.Thein, G. Yoga, M. Munawar)

Comparison of Age Profiles with “Slow Deep Breathing” Technique in Essential Hypertensive.(Y. A. Irmansyah, Y. W. Ashari, Y. Pintaningrum, Kadek Dwi P)

Correlation between Age and Length of Hospital Stay in Acute Coronary Syndrome Patients Treated with PCI In Bumi Waras Hospital, Lampung, Indonesia.(B. Setiawan, T.C. Sinatra, E. Mulia)

Correlation Between Lipid Profile and Carotid Intimal Medial Thickness in Women Systemic Lupus Erythematous Patients in Hasan Sadikin General Hospital(A. Kusumaputri, E. Chandra, Mardlatillah, S. Hidayat, L. Hamijoyo, M. R. Akbar, A. Purnomowati, T. M)

The Relationship between the Degree of Active Smoking in Non AC Bus Drivers and Incidence of Primary Hypertension at PT. Mayasari Bakti May 2016 Term(C. A. Aprilia, A.C.S. Putra, A. Harsoyo)

Association Between the Length of Congestive Heart Failure and WHO-5 Well-being Index (Z. P. Murti, S. I. Sugiarto, D. A. Paramita)

Predictors of In-hospital Mortality Following Percutaneous Coronary Intervention for Coronary Artery Disease in BP Batam Hospital An Observational Single Center Study(H. Soraya, F. N Hosea, A. A. Hakim)

Obstructive Sleep Apnea Risk Factors of Patients with Coronary Heart Disease Coronary Angiography by NTB General Hospital(N.Y. Pintaningrum, I. Hunaifi)

Differences between Platelet Immature Levels in Diabetes Mellitus Compared to Non Diabetes Mellitus Patients with Stable Coronary Artery Disease(D.R. Balti, Andrianto, B. Baktijasa)

Which Hematological Parameters are Best Correlated with Troponin in NSTE-ACS?(I. E. Hermawati, A. Subagjo, I. Alfia )

Correlation Between Undiagnosed Depression, Anxiety Disorder, and Hypertension in Cililin Primary Health Center: An Analytical Study(A. Leisyah, A. F. Khalid)

Profile of Dippers and Non Dippers Hypertension Patient in General Hospital Doctor Mohamad Saleh Probolinggo(M. A. Pasha; T. Ardhana)

Characteristics of Hypertensive Patients in Singkawang, West Borneo: Insight from a Multi-Cultural Remote Area in Indonesia(R. Arifin, A. Christopher)

Triglyceride and Non High-Density Lipoprotein Cholesterol as Predictors of Cardiovascular Disease Risk Factors(A. A. Rauf R. A. Said, Y. A. Fitrah, B. Z. Herman)

Thrombocyte-to-Leukocyte Ratio is correlated with Length of Stay in Patients with ST-Elevation Myocardial Infarction Underwent Primary Percutaneous Coronary Intervention(Y.S. Pratama, R. Puspitoadhi, N.A. Tafriend, U. Bahrudin)

The Associtaion between Uric Acid Level with Multivessel Coronary Artery Disease on Patients who Underwent Coronary Angiography in Abdul Wahab Syahranie General Hospital Samarinda(M.D.Pratama, D. Budiono, O.M.S Nasution, D. Herdianto)

Association between Statin Use as Primary Prevention and Outcomes in Acute Coronary Syndrome Patients during 2016 in Cengkareng General Hospital, Jakarta(A. Priyana, A. F. Sunjaya, A. P. Sunjaya)

Association between Metabolic Panels Abnormalities and Findings During Coronary Angiography: A Cross-Sectional Observational Study (R. Pranata, E. Yonas, V. Chintya, V. Pratama, BA. Permana, B. Pamungkas)

Correlation of Lipid Profile with the Severity of Coronary Artery Disease(M.F. Rizky, P.C. Fianirazha, A.H. Rolando, M.W. Hadi, M.N. Afif, S.F. Liliana, S. Imran, U. Ferry )

Peripartum Cardiomyopathy: Big Hearted Moms A Single Institution Case Series in Tangerang(A. Christopher, I. M. Pardede)

Lipid Profile and Coronary Heart Disease Assessment among Adult in Makassar, Indonesia: A Cross Sectional Study(A. A. Rauf , R. A. Said, Y. A. Fitrah, B. Z. Herman)

Profile Patient with ST-Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention at Kariadi Hospital(Y.S. Pratama, S. Sungkar, A. Yudanto, S. Rifqi)

The Role of Primary Care Physician in Educating Hypertensive Patient(N.P.A. Laksmi, A. Hendrayana)

The Effect Of Gymnastyc Exercise In Elderly To Lowering Blood Pressure In Geriatric Social Institution Of Tresna Werdha Kendari(A.U. Ramdhani, A. Pratama, B. Bintoro, S.Soebijakto)

Association Between Glycated Hemoglobin with Severity of Coronary Artery Disease in Non-Diabetic Patients(I.M Raditya, M. Syafri, M. Yanni)

Correlation between Mean Carotid Intima-Media Thickness and Body Mass Index among Minahasa Adults (T. Sumampouw, G. P. Lumentut, N. Rantung, H. Pribadi, A. Panda, J. Pangemanan, M. Rotty)

Prevalencec of Cardiovascular Disease in Women at Sampang General Hospital During The Year 2017(A.Pramudya)

Reduced Left Ventricular Ejection Fraction as A Predictor In-Hospital Major Cardiovascular Event in Patients Admitted with Acute Myocardial Infarction at Sanglah General Hospital Bali(I. D. G. D. Sumajaya, L. O. S. Suastika, A. A. A. D. A. Yasmin, I. G. N. P. Gunadhi)

Resolution of ST-Segment, Pain Level, and Arrythmia as A Tool For Assessing The Efficacy of Reperfusion Therapy in STEMI Patient Hospital Kanjuruhan(A. N. Lukito, G. A. Pawintri , A. B. Santoso)

Clinical Profile of patients with Acute Coronary Syndrome in Public Hospital in Bekasi, West Java, Indonesia(B.A.Pratama, J.S. Purnama, K. Priyantoro)

Age, High Density Lipoprotein Cholesterol and Triglycerides are Correlated with Triple-Vessel Coronary Artery Disease(Y.S. Pratama, U. Bahrudin, S. Sungkar, I. Uddin)

The Difference on Strain and Strain Rate Parameter of Left Ventricle Function Between Controlled Hypertension and Uncontrolled Hypertension(M. Reza, B. R. M. A. Soeryo, R. Soerarso)

Difference in Prevalence of Atrial Fibrillation and Non Atrial Fibrillation in Non Valvular Heart Disease Stroke Patient (E. Pramana, K. Susila)

Profile of Cardiovascular Risk Factors of Army Personel Undergoing Medical Check-Up(R. Pranata, E. Yonas, V. Chintya, B. Pamungkas, V. Pratama, B.A. Permana, D.E. Syahlul)

Lipid Profile and It’s Association with Multivessel Coronary Artery Disease on Patients Who Underwent Coronary Angiography in Abdul Wahab Syahranie General Hospital Samarinda(D. Budiono, O.M.S Nasution, M.D.Pratama , D. Herdianto)

Relation between Serum Triglyceride Levels and Physical Activity in Army Personel Undergoing Medical Check-Up(E. Yonas, R. Pranata, V. Chintya, B. Pamungkas, V. Pratama, B. A. Permana, D. E. Syahlul)

The Role of Sildenafil towards Health Related Quality of Life in Adults with Pulmonary Arterial Hypertension Related Uncorrected Secundum Atrial Septal Defect(F. Hidayati*, P.P.R. Gharini*, A.B. Hartopo*, D.W. Anggrahini*, L.K. Dinarti* )

Left Ventricular Dimension and Ejection Fraction Values by Echocardiography in Adolescents: An Epidemiology Study in Bali, Indonesia(L. O. S. Suastika, I. B. R. Wibhuti, K. B. Nadha, M. Chowdhury, J. Chowdhury, K. Olejnik, E. Bouman,)

Predictors of Right Ventricle Function Improvement in Patients with Right Ventricle Dysfunction after Mitral Valve Surgery(W.M. Saragih, A.S. Kuncoro, R. Zahara, A. M. Soesanto)

Correlation of Blood Nitric Axide Level and Right Ventricular Systolic Function in Adult Patient with Uncorrected Secundum Atrial Septal Defect(F. S. A. Pradana, D.W. Anggrahini , A.B. Hartopo, L.K. Dinarti)

Correlation between Estimated Right Ventricular Systolic Pressure and Tricuspid Annular Plane Systolic Excursion to Perinatal Outcome in Pregnancy with Acyanotic Congenital Heart Disease(A. Pudjiastuti, A.A. Asrial, A. Sariningrum, L. Raharjoyo, Y.A.B.M. Aruman, M.A. Nugroho, Y. Herry)

Correlation between Tricuspid Anular Plane Systolic Exercusion (Tapse) and Peak Systolic Velocity on Anulus Tricuspid (S') with Mean Arterial Pulmonary Pressure (Mpap) on Atrial Septal Defect Patient(V. Rosalinda, D.W. Anggraini, B.A. Hartopo, L. Krisdinarti)

Association between Biomarkers and Plaque Vulnerability Detected by Optical Coherence Tomography in Patient with Coronary Artery Disease: a Meta-analysis(U. Bahrudin, R.A. Raharjo, S. Herminingsih, I. Uddin, Hardian, Y. Herry, S. Rifqi)

Cerebrovascular Thromboembolic Events in Periprocedural Bridging Therapy vs Uninterrupted Anticoagulation in Long-Term Anticoagulant User with Atrial Fibrillation: A Mini Systematic Review(Vidyawati, P. M. H Putri, T. Jatiman)

Outcomes of Partial Closure with Fenestrated Device in Atrial Septal Defect Accompanied by Severe Pulmonary Hypertension : A Literature Review(P. Prasetyo, R. Prakoso )

True Lumen Identification in Dissection: Role of IVUS(E.N. Aisyah, M.Y. Assegaf)

Diagnosing and Treating Left Bundle Branch Block ECG Finding as An Acute Coronary Syndrome Event in Rural Hospital of East Sumba: A Case Report(T.S.R. Sembiring)

Segmental ST-T changes in Hypokalemia Suggesting Subendocardial Injury: a Case Report(Ayu A.P., Hidayat I.R., Dewi T.T., Rakhmawati I., Pertiwi D.Y., Rostiati D.)

Succesfully Delivery by a Cesarian Section in a Parturient Woman with Unrepaired Tetralogy Fallot: Case Report(Vitryaturida, Martini, Heny)

Ventricular Septal Rupture as Complication of Acute Miocard Infarct in Adolescent Caused by Blunt Chest Trauma: A Case Report(F.M. Yusuf, S. Khairunnissa, M.F Rizky, M.N.Aditya, P.L.T. Mangiring)

Spontaneous Thrombolysis in Left Ventricular Thrombosis Post Dengue Myocarditis(H. Lim, I.B. Wibhuti, K.B. Nadha)

How to Deal with Complicated Pericardial Effusion?(G.M. Rahman, I.G.R. Suryawan)

Ventricular Tachycardia in Doubt : Usefulness of Brugada and R Wave Peak Time Criteria(Albertus , M. Setiawan )

Electrocardiographic Change Mimicking ST Elevation Myocardial infarction in Subdural Hemorrhage: Diagnostic Dilemma(P.I.N. Sigit, Y. Ahmad)

Successful Management of Severe Mitral Stenosis with the First Percutaneous Baloon Mitral Valvulotomy (PBMV) in Pregnant Woman at Sanglah Hospital Bali(G.A. P Astara, I.M.J.R. Artha)

Raynaud Phenomenon Resistant to the Initial Therapy in Patient with Systemic Lupus Erythematosus(H. Susilo, R.M. Budiarto, H. Anugrawan, R. Amalia)

Infective Endocarditis with Ischemic Stroke Complication: A Case Report(K.D. Krisnayanti, C.A. Shandy, G.A. Suryawati)

Pericarditis and Mediastinitis as a Result of Neglected Chronic Odontogenic Infection(G. A. P. Astara, W. Aryadana)

Isolated Posterior Myocardial Infarct: The Deadly Nightshade of the Electrocardiography(B.D.Guntoro, D.Ilmasari, M.G.Soewandi)

Dealing with Coronary Aneurysm(L.P.C. Dewi, Y.H. Oktaviono)

Percutaneous Transluminal Angioplasty in Thrombosed Arteriovenous Fistulae (D. Bestari, J. Nugroho)

Polycythemia Vera as the Main Risk Factor in ST Elevation Myocardial Reinfarction(W.D.S. Cyndiana, B. Kris, A. Wayan)

Peripartum Cardiomyopathy Complicated by Preeclampsia with Mitral Stenosis(T.T. Dewi, I. Rakhmawati, I. R. Hidayat, P. Aulia, D. Y. Pertiwi, D. Rostiati.)

Role of Transthoracal Echocardiography in Guiding Diagnosis and Management in Successful Reversal Of Acute Severe Heart Failure Due To Peripartum Cardiomyopathy (D. G. Widyawati, W. I. B. Rangga, N. K. Badjra)

A 48-years-old Female with Stabbing Chest Pain and Pericardial Effusion: A Case Report(A.K. Ratri*,M.Y. Alsagaff*, T.P. Asmarawati**)

The Role of Cardiac Catheterization for Patient with Restrictive Cardiomyopathy and Severe Mitral Insufficiency(I. Y. Suhartono, F. Basalamah)

Acute Left Main Coronary Artery Total Occlusion Without ST-Segment Elevation in Lead aVR(R. Putra, M. Limbong, Y.S. Pratama, A. Mustika, Y. Herry)

Difficulty to Recognizing Acute Total Occlusion of Coronary Artery in Non-ST Elevation Myocardial Infarction: A pitfall of ST-segment Elevation in Electrocardiogram(Y.S. Pratama, R. Puspitoadhi A. Yudanto, I. Uddin)

Left Main Stem Stenosis in Young Female without Significant Cardiovascular Risk Factor(V Kurniawati, S.Rohman)

Pseudonormalization ST-segment in ST-elevation Myocardial Infarction Patient(F.Fathini, R. A. Seriulina,A. Ginanjar, T. T. Dewi, I.A. Rakhmawulan, D. Rostiati)

Fever Induce Brugada Syndrome: Case Report(G. Swandita)

Early Diagnosis and Prompt Treatment of Severe Stenosis in The Proximal Left Anterior Descending Coronary Artery: Wellens’ Syndrome Case Report(H. R. S. Dhilion, Haikal, B. Pamungkas, A. Harsoyo, V. Pratama)

Case Report: A 65-Year Old Man with Ventricular Tachycardia with Some Pattern Similar to Supraventricular Tachycardia and The Management(H. Oktaviani, M. Hatta)

Peripartum Cardiomyopathy in Atrial Septal Defect and Eisenmenger Syndrome(Y.S. Pratama, M.A. Nugroho)

Successful Percutaneus Revascularization of Total Occlusion of the Ostial Left Main Coronary Artery: A Rare Case Report(D. Wardana, N.A. Tafriend, U. Bahrudin, Y. Herry)

Anterior Extensive ST-Elevation Myocard Infarction With High Thrombus Burden Given Intra-Coronary, Intra-Venous Eptifibatide and Plain Old Balloon Angioplasty : A Case With Satisfying Result(I.N.G.Sudiarta, I.W. Wita)

Localized ST Elevation in ECG: Acute Myopericarditis Mimicking ST Elevation Myocardial Infarction(T. N. P. Adityaputra, L. O. S. Suastika)

Recurrent Acute Myocardial Infarction in A-63 years old Man with Hypersensitivity to Aspirin Therapy: How to Deal with it?(M. Sanjiwani, N. Wiryawan)

Diuresis in Resistant Congestion, Desperate Measures Before Ultrafiltration(H. Susilo, M.Y. Alsagaff)

Infective Endocarditis with Peripheral Embolization (Case Study)(Jefri, E. Phangestu, V. H. Wahidji)

Situs Inversus Totalis with Dextrocardia Complicated by Left Cerebral Abcess(I. Pratiwi, C. Melka, A.A. Bashori)

Double Culprit Coronary Arteries in ST Elevation Myocardial Infarction Treated with Primary Percutaneous Intervention: A Case Report(H.H. Satoto, R. Puspitoadhi, R.A. Raharjo, S. Sungkar, I. Uddin)

Coronary Artery Bypass Grafting in ST-Segment Elevation Myocardial Infarction: Option of Reperfusion (Still)(M. Puspitasari, Y.E. Sembiring, M.Y. Alsagaff)

Peri-Infarction Pericarditis, Rare Complication of Myocardial Infarction(S.A. Hutomo, Andrianto)

Diagnostic and Management Approach of Patients with Coronary Artery Fistula: Case Series(N.I. Gayatri, O. Lilyasari, P.S. Roebiono, A.U. Rahayoe, I. Sakijan, R. Prakoso, Y. Kurniawati, G.M.)

Coronary Artery Fistula : Should We Close?(D.G. Arilaksono, N. Haryono, A.S. Soerianat, D. Firman, A.A. Alkatiri, )

A Case Report : Primary Cardiac Tumor In a 1-year old girl(N.A. Tafriend, R, Puspitoadi, A. Priyatno, A. Soetadji)

Congenital Coronary-Cameral Fistula from Right Coronary Artery to Right Ventricle : a Very Rare Case Report(R. Puspitoadhi, M.H. Cahyadi, P.S. Putri, N. Virginia, A. Priyatno)

Giant biphasic T wave electrocardiogram pattern (Z syndrome) in patient with Plasmodium Vivax malaria infection(P.R. Kusuma, E. Zuhri)

Management of Degenerative Aortic Bioprosthetic : First case TAVI valve-in-valve in Indonesia(A.T. Faizal, D. Firman, D.A. Juzar, A.M. Soesanto, N. Haryono, A.A. Alkatiri, S. Soerinata)

Successful Percutaneous Balloon Mitral Valvuloplasty in Pregnant Woman with Severe Mitral Stenosis(A.P. Mangkoesoebroto, R.A. Raharjo, A. Perdana, S.B. Utami, Y. Herry, S. Rifqi)

A 55-year-old Man with Ruptured of Standford Type B Aortic Dissection Presenting with Bilateral Hemothorax (I.Tania, R. Ashriyah)

Left Ventricular Ejection Fraction in correlation with In Hospital Mortality in ACS Patients: SCIENCE Registry Sub-Study (B.A. Prabowo, H.P. Bagaswoto, N. Taufiq, B.Y. Setianto)

Strategy of Early Revascularization with Percutaneous Catheter Directed Intra-Arterial Thrombolysis for Acute Upper Limb Ischemia : A Case Report(M.R. Ramadhan, M. Failasufi, N. Kurnianingsih, D. Sargowo)

Aortic Dissection Presenting With Septic Shock(A. Satria, S. Widito)

Non-ST Elevation Myocardial Infarction Induced by Sildenafil Consumption in a Patient with No Coronary Artery Disease History: A Case Report(I.M.E.A. Wardhana, P.G. Budiana*)

Recognizing ST-Elevation Myocardial Infarction in Bundle Branch Block(Y.S. Pratama *, R. Puspitoadhi *, P. Ardhianto**, Y. Herry**)

Atrial Incisional Tachycardia Following Three Decades of Cardiac Surgery(G. Yoga, M. Thein, E. Sen, M. Munawar, B. Hartono)

A Rare Case of Multiple Intracardiac Tumors in Pediatric(B. Saunders, I. Sulistyorini I. Mappangara, Y. Patimang, B. Iskandar)

Mycobacterium Tuberculosis Endocarditis Infective at Pulmonary Valve in a Pediatric Patient with Ventricular Septal Defect. (P. Suci, A. Priyatno)

Reversible Dilation of Chambers, Tricuspid Regurgitation and Pulmonary Hypertension in Patient with Hyperthyroidism: A Case Report(Sepriyana, Haryadi)

A Case Report: Management of Systemic RV Failure on Adult Congenitally Corrected Transposition of Great Arteries (ccTGA) Complicating Symptomatic Bradycardia with Atrial Fibrillation Slow Ventricular Response (AFSVR)(M.A. Sobirin, K. Rizky,U. Bahrudin, I. Uddin)

Secundum Atrial Septal Defect with Significant Pulmonary Arterial Hypertension: Treat And Repair Strategy(N.G. Liman, R. Prakoso)

Role of Supporting Examination in Investigating Non Specific Chest Pain to Diagnose Thoracic Aorta Aneurysm in Rural Setting: A Case Report(M. Abduh, H. Nainggolan, J. Endang)

Facial Cold Stimuli to Treat Supraventricular Tachycardia at Makasar Subdistrict Primary Health Care, Jakarta, Indonesia : A Case Report(Aisyah, E. A. Pratama, S. Nurwulan)

ST-Segment Elevation Myocardial Infarction (STEMI) Caused by Left Atrial Myxoma – How to Treat : A Case Report(D. Irawan, J. E. Saragih, B. Satrijo)

Succesful Retrieval Of Stent Dislodged In Distal Left Main Coronary Artery And Proximal Left Circumflex Artery During Percutaneous Coronary Intervention With Small Balloon Technique (D.G. Widyawati, W. Aryadana)

Challenges in the Diagnosis and Acute Management of Idiopathic Left Ventricular Tachycardia : A Case Report(D. A. S. Ratnasari, I. A. Kusuma)

Total Occlusion of Left Main Coronary Artery in NSTE-ACS Patient : A Case Report(D.U. Setyowati, A. Kailani, M. Silalahi, M. Zaini)

Vena Cava Filter on Patient with Deep Vein Thrombosis(I.F. Ramdhani, J.Nugroho)

Symptomatic Bradycardia in a Hyperkalemic Patient: A Case Report(A. Halimi, Y. Pintaningrum)

New ST-Segment Elevation After Coronary Artery Bypass: A Case Report(N. O. H. Rantung, L. A. Natalino, V. Sariowan, A. E. Haurissa, A. Tangkilisan, H. Abraham, J.A. Pang)

Role of Trans Thoracal Echocardiography (TTE) in Assessing Aortic Abnormalities in Patient with suspected Marfan Syndrome: A Case Report(A.W. Sari, B. Nadha, R. Wibhuti)

Extensive Anterior ST elevation Myocardial Infarction in Reproductive Woman Using Oral Contraceptive Pills (D.Ilmasari, A.F.Khalid, M.G.Soewandi)

Cardiorenal Syndrome in Peripartum Cardiomyopathy Patient: A Case Report(I.A. Rakhmawulan, F. Fathini, T.T Dewi, I.R. Hidayat, A.P. Ayu, D.Y Pertiwi, D. Rostiati,)

Converting Persistent Non-Valvular Atrial Fibrillation to Sinus Rhythm in Critical Stenosis of Left Circumflex (LCX) Artery: Is it Ischaemic-related?: A Case Report(F. Ratih, M.F. Rizky, K. Agoes)

Cardiomyopathy in Patient with Malignant Lymphoma: A Case Report(D.Y. Pertiwi, T.T. Dewi, I. Rakhmawati , I.R. Hidayat, A.P. Ayu, D. Rostiati)

The Problem of Systemic Lupus Erythematosus Diagnosis In A Pregnant Woman With Early Clinical Manifestations Suspected Pulmonary Embolism(A. Munandar, D. Rachmaniah, S. Widito)

Hemorrhagic Transformation Following Ischemic Stroke in Patient with Infective Endocarditis Complicated with Atrial Fibrilation and Rheumatic Heart Disease(P. Setiawan, L.O.S Suastika)

Infective Endocarditis with Suspicion of Superimposed Acute Rheumatic Fever(M.I. Amin, D.W. Anggrahini, B. Irawan)

Definite Sub Acute Stent Thrombosis after Primary Percutaneous Coronary Intervention(G.Aditya, W. Aryadana)

Transient Segment ST Elevation: Spontaneous Coronary Reperfusion(A.Jalaludinsyah, T.Wasyanto)

Post infarction ventricle septal rupture: it is not always a lethal condition.(N.E. Damaiati, R. A. Sukaton, H. Isnanijah)

Subacute Coronary Stent Thrombosis in Patient after Elective Percutaneous Coronary Intervention : Causes, Risk Factors and Management(A. Chairunnisa, A. Wardhani, Y. Herry, I. Uddin, Safir)

Acute Pericarditis : A case report(I.R. Hidayat, A. P. Ayu, T. T. Dewi, I. Rakhmawati, D. Y. Pertiwi, D. Rostiati)

Rheumatic Heart Disease with Coronary Artery Disease and Stroke: A Case Report(D.Y. Pertiwi, T.T. Dewi, I. Rakhmawati, I Sofyan , I.R. Hidayat, A.P. Ayu, D. Rostiati)

Double-Outlet Right Ventricle with Dextrocardia in a One-year-old girl: A Case Report(D. Hertriwibowo, K. N. Hapsara, F. S. Hasibuan)

Successful Simple Recanalization Technique of in Stent-Left Anterior Descending-Chronic Total Occlusion: A Case Report(A.D. Anggraeni and B. Baktijasa)

Acute Pulmonary Embolism Mimicking an Acute Myocardial Infarction : A Case Report(O. M. Siregar, Y. Sarastri, Z. Safri, H. Hasan, )

Triple Valve Replacement in Patient with Rheumatic Heart Disease: Case report(M.Limbong, A. Sariningrum A. Yudanto ,S. Fatah)

Silent Myocardial Ischemia in Hyperglycemia Patient with LBBB Finding: A Case Study(M.Q. A’yun, Muzaiwirin)

Pericardial Effusion: Acute Management and Therapy(A.A. Akis, C. M. Gultom, D. D. Miranti, M. A. P. Prabowo, N. R. Simatupang, A. F. Chandranegara, H.)

Myocardial Infarction with Non Obstructive Coronary Artery Associated with Myocardial Bridging: A Case Report(A.Sariningrum, Elen, C.Anantaria, M.Kasim)

Uncommon LAD Coronary T-Wave Inversion : Wellens’ Syndrome : A Case Report(M.R. Felani, M.N. Adhitya, S. Revan, M.F. Yusuf, M.W. Hadi, S. Khairunnisa, M.N. Afif, S.F. Liliana)

Truncus Arteriosus: Pulmonary Vascular Disease Screening(N.G. Liman, G.M. Harimurti)

The Features of Electrocardiography on Dextrocardia with Situs Inversus in Adult Patient(I.N. Shabrina, M.G. Soewandi)

Regional Pericarditis with Reciprocal ECG Changes Mimicking Inferior STEMI(G. M. Rahman, M.Y. Alsagaff)

Normalizing T-Wave Inversion after Exercise Stress Test (Treadmill) on a Cycling Race Athlete : A Case Report(E.D.Hargiyanto)

How To Manage Total Atrioventricular Block In Inferior-Posterior AMI; Is PCI More Superior Than Permanent Pacemaker?(N.D Nuarisa, Y.H Oktaviono)

Wellen’s Syndrome Like Pattern on a Healthy Roller Skate Athlete : A Case Report(E. D. Hargiyanto, D. Hertriwibowo. )

Huge Mediastinal Mass with Massive Pericardial Effusion: Role of Echocardiography-Guided Pericardiosintesis(D.P. Kartikasari, D. Soemantri)

Coronary Vasospasm in ST-Segment Elevation Myocardial Infarction with Non-Obstructive Coronary Arteries(H. Lim, W. Aryadana)

A Benign Case of Supraventricular Extra Systole in Acute Coronary Syndrome: Is It Harmful?(R. Pranata, W.Wiharja, V. A. Damay)

Peripartum Cardiomyopathy: A Devastating Sequlae of Uncontrolled Hypertension in Preganancy(W. Wiharja, R. Pranata, V. A. Damay)

Treatment of Choice for Nonreperfused Patient in Total Atrioventricular Block Complicates Inferior Wall Myocardial Infarction with Right Ventricular Infarction(P.F. Sitohang)

Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus: High Interarterial Course of Right Coronary Artery(D. A. Paramita, S. Suhendro, T. V. Yoshinta, E. Leonid)

Silent Until Twilight : A Case Report of Ebstein Anomaly in 63 Years Old Woman(A.E. Prasetia, D. W. Angrahini, R. K. Marsam, L. Krisdinarti)

A Case Report: Transient ST Elevation Myocardial Infarction After Initial Treatment in Emergency Department(R.R. Aryanti, Z. Choa, R.D. Tureno, S. H. Putra)

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