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"Pendahuluan –Diabetes Mellitus tipe 2 (DMT2) merupakan sindrom inflamasi progresif dengan peningkatan risiko komplikasi kardiovaskular berupa Atherosclerotic Cardiovascular Disease (ASCVD). Proses thromboinflamasi pada DMT2 ASCVD dikaitkan dengan perubahan pada jumlah serta fungsi leukosit dan trombosit. Rasio leukosit (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) serta penanda biologis dari netrofil (Peptydil Arginine Deiminase-4), monosit/makrofag (Interleukin-6), dan trombosit (Platelet Glycoprotein 1b-α) dikenali sebagai penanda biologis yang dapat memprediksi perubahan plak stabil dan tidak stabil pada pasien DMT2 ASCVD. Studi ini dilakukan untuk menganalisis hubungan antara klasifikasi pasien DMT2 2 risiko sangat tinggi (Very High Risk / VHR) dan risiko tinggi (High Risk / HR) dan pada pasien DMT2 dengan Acute Coronary Syndrome (ACS) terhadap parameter inflamasi NLR, MLR, PLR, GPIbα, PAD4, dan IL-6. Metodologi – 75 pasien DMT2 ACSVD yang menjalani pengobatan di rawat jalan dan unit gawat darurat Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita dilibatkan dalam studi ini. Pasien dikategorikan sebagai DMT2 risiko tinggi, DMT2 risiko sangat tinggi, dan DMT2 ACS. Parameter metabolisme dan inflamasi diukur dan dianalisis pada ketiga kelompok DMT2 ASCVD tersebut. Hasil dan Diskusi – Nilai parameter metabolisme kolesterol total dan Low Density Lipoprotein (LDL) serta parameter inflamasi NLR, MLR, PLR, dan IL-6 ditemukan lebih tinggi dan signifikan pada kelompok DMT2 ACS. Nilai Gp1bα ektodomain (Glikokalisin) ditemukan lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan hubungan Gp1bα dan ADAM17 yang terkait dengan keseimbangan pembentukan dan pembersihan trombosit. Nilai PAD4 yang lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan proses perbaikan jaringan dan induksi polarisasi makrofag menjadi fenotip antiinflamasi yang berperan terhadap perbaikan fungsi kardiovaskular. Penelitian ini menunjukkan bahwa nilai NLR dan kolesterol total yang tinggi serta nilai PAD4 yang rendah merupakan prediktor terjadinya keadaan ACS (plak tidak stabil) pada pasien DMT2 ASCVD.

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Introduction – Diabetes Mellitus type 2 (T2DM) is a progressive inflammatory syndrome with an increased risk of cardiovascular complications in the form of Atherosclerotic Cardiovascular Disease (ASCVD). The thromboinflammatory process in T2DM ASCVD is associated with changes in the number and function of leukocytes and platelets. The leukocyte ratio (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) as well as biological markers of neutrophils (Peptydyl Arginine Deiminase-4), monocytes/macrophages (Interleukin-6), and platelets (Platelet Glycoprotein 1b-α) are recognized as a biological marker that can predict stable and unstable plaque changes in T2DM with ASCVD. This study was conducted to analyze the relationship between the classification of T2DM patients with very high risk (VHR), high risk (HR), and early onset ACS on the inflammatory parameters NLR, MLR, PLR, GPIbα, PAD4, and IL-6.

Methodology – This study included 75 ACSVD T2DM patients being treated at Harapan Kita Heart and Blood Vessel Center Hospital's outpatien and emergency unit. Patients were classified as having high risk T2DM, extremely high risk T2DM, or ACS T2DM. In the three T2DM ASCVD groups, metabolic and inflammatory parameters were evaluated and studied.

Results and Discussion – The metabolic indices total cholesterol and Low Density Lipoprotein (LDL), as well as the inflammatory markers NLR, MLR, PLR, and IL-6, were shown to be greater and significant in the T2DM ACS group. Gp1b ectodomain (Glycocalysin) values were found to be greater in the high risk T2DM and very high risk T2DM groups, demonstrating the relationship between Gp1b and ADAM17, which is associated to platelet production and clearance balance. Higher PAD4 values in the high risk T2DM and very high risk T2DM groups represent tissue repair and the activation of macrophage polarization into an anti-inflammatory phenotype, which contributes to improved cardiovascular function. According to this study, high NLR and total cholesterol levels, as well as low PAD4 levels, are predictors of ACS (unstable plaque) in ASCVD T2DM patients."

"This book describes the main enzymes regulating the turnover of each of the seven PIs in mammalian cells, some of their intracellular functions and some evidence of their involvement in human diseases. Due to the complex inter-relation between the distinct PIs and the plethora of functions that they can regulate inside a cell, this book is not meant to be a comprehensive coverage of all aspects of PIs signalling but rather an overview on the current state of the field and where it could go from here. Phosphoinositide and inositol phosphates interact with and modulate the recruitment and activation of key regulatory proteins and in doing so control diverse functions including cell growth and proliferation, apoptosis, cytoskeletal dynamics, insulin action, vesicle trafficking and nuclear function. Initially, inositide signaling was limited to the PLC pathway, however, it is now clear that all the seven phosphoinositides and more than 30 different inositol phosphates likely have specific signaling functions. Moreover there is a growing list of proteins that are regulated by inositol signaling. This has raised the question as to how inositol signaling can control diverse processes and yet maintain signaling specificity. Controlling the levels of inositol signaling molecules and their subcellular compartmentalisation is likely to be critical. This meeting will bring together scientists from different backgrounds to discuss how understanding inositol signaling may be used to target complex human diseases that manifest themselves when inositol signaling is deregulated."

"Helping you to apply scientific knowledge and clinical strategies, this resource for your everyday practice provides all of the knowledge you need to give your patients the most accurate diagnoses, the best possible heart disease treatment options, and the expert care they deserve."

"Tujuan: Menentukan hubungan antara volume lemak perikardial dengan derajat stenosis aterosklerosis arteri koronaria pada pasien yang menjalani pemeriksaan dual-source CT jantung di RSCM, sehingga dapat dilakukan penentuan titik potong volume lemak perikardial yang dapat digunakan untuk mendeteksi derajat stenosis aterosklerosis arteri koronaria hanya dengan menghitung volume lemak perikardial saja. Metode: Analisa retrospektif hasil CT jantung dari 53 pasien yang diambil secara consecutive, meliputi penilaian derajat stenosis aterosklerosis arteri koronaria dan penghitungan volume lemak perikardial. Derajat stenosis aterosklerosis arteri koronaria dikelompokkan menjadi tidak ada stenosis, ringan, sedang dan berat, berdasarkan metode indeks prognosis Duke. Volume lemak perikardial dihitung dalam satuan cm3 dengan menggunakan perangkat lunak analisa volume pada cardiac workstation (Siemens, Leonardo), lemak perikardial adalah gabungan antara lemak epikardial dengan lemak parakardial. Analisa statistik penelitian ini menggunakan uji Anova. Hasil: Terdapat hubungan positif antara volume lemak perikardial dengan stenosis arteri koronaria derajat sedang pada pasien di RSCM yang menjalani pemeriksaan DSCT jantung. Titik potong volume lemak perikardial untuk mendeteksi stenosis arteri koronaria derajat sedang adalah 185 cm3 (≥ 185 cm3 dan < 185 cm3), dengan nilai sensitifitas 81,8 %, spesifisitas 63,15 %, akurasi 70 % dan OR 7,71 pada 95 % interval kepercayaan 1,03 - 72,06. Kesimpulan: Volume lemak perikardial dapat digunakan untuk menentukan stenosis arteri koronaria derajat sedang, sehingga dapat dipakai sebagai suatu acuan deteksi dini stenosis arteri koronaria bagi pasien yang beresiko terhadap kejadian PJK.

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Purpose: to determine the correlation between pericardial fat volume and stenosis grade of atherosclerotic coronary artery in patients who underwent dual-source cardiac CT in Cipto Mangunkusumo hospital and cut off point of pericardial fat volume that can be used to determine stenosis grade of atherosclerotic coronary artery.

Methods : Retrospective analysis of 53 consecutive patients who underwent dualsource cardiac CT in Cipto Mangunkusumo hospital, the assessment was include stenosis grade of atherosclerotic coronary artery and pericardial fat volume. Stenosis grade were classified as no stenosis, mild, moderate and severe based on prognostic index Duke. Pericardial fat volume was measured in cm3 using the Volume Analysis software tool of our cardiac workstation (Siemens, Leonardo), pericardial fat defined as epicardial fat plus paracardial fat. Statisticall analysis were performed with Anova test.

Results : There was positive correlation between pericardial fat volume and moderate stenosis of atherosclerotic coronary artery in patients who underwent dual-source cardiac CT in Cipto Mangunkusumo hospital. A cut-off value of 185 cm3 (≥ 185 cm3 and <185 cm3) determined a sensitivity and specivicity to detect moderate stenosis of 81,8% and 63,15%, with accuracy of 70% and OR 7,71 in 95% confident interval 1,03 - 72,06.

Conclusions : Pericardial fat volume can be use to determine moderate stenosis of atherosclerotic coronary artery in patients who underwent dual-source cardiac CT in Cipto Mangunkusumo hospital due to early detection for coronary stenotic condition in patient who have higher risk for CAD."

"Latar belakang dan Tujuan: Penyakit jantung koroner adalah penyakit kardiovaskular yang paling banyak di dunia. Aterosklerosis arteri koronaria adalah penyebab terbanyak dari penyakit tersebut. Stenosis aterosklerosis arteri koronaria dapat dinilai dengan multislice computed tomography coronary angiography (MSCT angiografi koronaria). Permasalahan saat ini adalah modalitas tersebut tidak tersedia di semua institusi kesehatan. Beberapa penelitian telah banyak menghubungkan angka kejadian perlemakan hepar dengan stenosis aterosklerosis arteri koronaria. Pemeriksaan perlemakan hepar dapat dilakukan dengan berbagai modalitas radiologi, salah satunya dengan pemeriksaan CT non dengan mengukur densitas hepar yang memiliki tingkat sensitifitas dan spesifisitas yang baik. Pemeriksaan ini lebih sering dan mudah dilakukan daripada pemeriksaan MSCT angiografi koronaria. Mengetahui peranan pemeriksaan derajat perlemakan hepar diperlukan dalam memperkirakan derajat stenosis arteri koronaria. Metode : Penelitian potong lintang menggunakan data sekunder pada 32 pasien yang dilakukan pemeriksaan MSCT angiografi koronaria di RSPAD dalam rentang waktu Juni 2015 ? Desember 2015. Penilaian dilakukan dengan mengukur derajat perlemakan hepar pada CT Scan non kontras dan derajat stenosis aterosklerosis arteri koronaria pada MSCT angiografi koronaria. Hasil : Tidak terdapat hubungan yang bermakna antara derajat perlemakan hepar dengan derajat stenosis aterosklerosis arteri koronaria. Terdapat hubungan concordant yang cukup baik antara adanya perlemakan hepar dengan stenosis aterosklerosis arteri koronaria. Kesimpulan : Berat ringannya derajat perlemakan hepar tidak mempunyai hubungan dengan berat ringannya derajat stenosis arteri koronaria, tetapi adanya perlemakan hepar dapat menjadi prediktor adanya stenosis arteri koronaria.

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Background and Objective : Coronary heart disease is common cardiovascular disease in the world with the most common cause is coronary artery atherosclerosis. Stenosis of the coronary artery atherosclerosis assessed by multislice computed tomography coronary angiography. The problem is the modality is not available in all health institutions. Several studies have been associate between incidence of fatty liver with stenosis of coronary artery atherosclerosis. Examination of fatty liver can be done with various radiology modalities, one of them with non contrast CT by measured attenuation of the liver which have a good sensitivity and specificity. These examination are more frequent and easier to do than MSCT coronary angiography. Recognizing the importance of the degree of fatty liver examination is required in estimating the degree of coronary artery stenosis.

Methods : A cross-sectional study using secondary data on 32 patients who underwent coronary angiography MSCT at the army hospital within the period June 2015 - December 2015. The assessment was conducted by measuring the degree of fatty liver in non-contrast CT Scan and the degree of stenosis of coronary artery atherosclerosis in MSCT coronary angiography.

Results: There was no significant correlation between the degree of fatty liver with stenosis of coronary artery atherosclerosis. There is a pretty good concordant relationship between the presence of fatty liver with stenosis of coronary artery atherosclerosis.

Conclusion: Severity of fatty liver degree do not have a relationship with severity degree of coronary artery stenosis, but the presence of fatty liver can be a predictor of coronary artery stenosis."

"Latar belakang dan Tujuan: Penyakit jantung koroner adalah penyakit kardiovaskular yang paling banyak di dunia. Aterosklerosis arteri koronaria adalah penyebab terbanyak dari penyakit tersebut. Stenosis aterosklerosis arteri koronaria dapat dinilai dengan multislice computed tomography coronary angiography (MSCT angiografi koronaria). Permasalahan saat ini adalah modalitas tersebut tidak tersedia di semua institusi kesehatan. Beberapa penelitian telah banyak menghubungkan angka kejadian perlemakan hepar dengan stenosis aterosklerosis arteri koronaria. Pemeriksaan perlemakan hepar dapat dilakukan dengan berbagai modalitas radiologi, salah satunya dengan pemeriksaan CT non dengan mengukur densitas hepar yang memiliki tingkat sensitifitas dan spesifisitas yang baik. Pemeriksaan ini lebih sering dan mudah dilakukan daripada pemeriksaan MSCT angiografi koronaria. Mengetahui peranan pemeriksaan derajat perlemakan hepar diperlukan dalam memperkirakan derajat stenosis arteri koronaria. Metode : Penelitian potong lintang menggunakan data sekunder pada 32 pasien yang dilakukan pemeriksaan MSCT angiografi koronaria di RSPAD dalam rentang waktu Juni 2015 - Desember 2015. Penilaian dilakukan dengan mengukur derajat perlemakan hepar pada CT Scan non kontras dan derajat stenosis aterosklerosis arteri koronaria pada MSCT angiografi koronaria. Hasil : Tidak terdapat hubungan yang bermakna antara derajat perlemakan hepar dengan derajat stenosis aterosklerosis arteri koronaria. Terdapat hubungan concordant yang cukup baik antara adanya perlemakan hepar dengan stenosis aterosklerosis arteri koronaria. Kesimpulan : Berat ringannya derajat perlemakan hepar tidak mempunyai hubungan dengan berat ringannya derajat stenosis arteri koronaria, tetapi adanya perlemakan hepar dapat menjadi prediktor adanya stenosis arteri koronaria.

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Background and Objective : Coronary heart disease is common cardiovascular disease in the world with the most common cause is coronary artery atherosclerosis. Stenosis of the coronary artery atherosclerosis assessed by multislice computed tomography coronary angiography. The problem is the modality is not available in all health institutions. Several studies have been associate between incidence of fatty liver with stenosis of coronary artery atherosclerosis. Examination of fatty liver can be done with various radiology modalities, one of them with non contrast CT by measured attenuation of the liver which have a good sensitivity and specificity. These examination are more frequent and easier to do than MSCT coronary angiography. Recognizing the importance of the degree of fatty liver examination is required in estimating the degree of coronary artery stenosis.

Methods : A cross-sectional study using secondary data on 32 patients who underwent coronary angiography MSCT at the army hospital within the period June 2015 - December 2015. The assessment was conducted by measuring the degree of fatty liver in non-contrast CT Scan and the degree of stenosis of coronary artery atherosclerosis in MSCT coronary angiography.

Results: There was no significant correlation between the degree of fatty liver with stenosis of coronary artery atherosclerosis. There is a pretty good concordant relationship between the presence of fatty liver with stenosis of coronary artery atherosclerosis.

Conclusion: Severity of fatty liver degree do not have a relationship with severity degree of coronary artery stenosis, but the presence of fatty liver can be a predictor of coronary artery stenosis."