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Introduction: Atherosclerosis plays an important role in the pathogenesis of acute coronary syndrome (ACS). Inflammation plays a causal role in atherosclerosis. There are many inflammatory markers related to ACS, including C-reactive protein (CRP), homocysteine, matrix metal loproteinases, interleukin (IL)-6, IL-8, and IL-27. IL-6 is the sign of synthesis of acute phase proteins. Recently, the clinical trials related to ACS showed that IL-6 may be an indicator of increased risk for ACS. An Interleukin-6 (IL-6) examination is can be used to assess risk factors for acute coronary syndrome (ACS). Interleukin-6 is a marker of local inflammation of coronary plaque and peripheral blood circulation which increases the occurrence of coronary heart disease causing plaque instability and rupture. The SYNTAX scoring system has correlation assessed through angiography assessing the complexity of the severity of coronary artery stenosis. This study aims to determine the between Interleukin-6 (IL-6) levels and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome (ACS). Methods: This is a cross-sectional study of 45 patients with acute coronary syndrome (ACS) who were treated at H. Adam Malik General Hospital, Medan (February 2023 - May 2023). IL-6 levels were examined using the Electrochemiluminescent Immunoassay (ECLIA) method using Cobas e 411. The extent of the coronary lesion was calculated based on the SYNTAX score from coronary angiography which was calculated by two invasive cardiologist as suggested before using an online calculator. We used the Spearman correlation test and Mann Whitney test to analyze the data. Results: There were 39 male subjects (86.7%) total. The mean age of the subjects was 54.89 ± 10.3 years old. Most of the subjects experienced STEMI in total 28 people (62.2%). The Median IL-6 levels was 19.22 pg/mL while the median of SYNTAX score level was 13.00. By using cross-sectional study and the spearman correlationa test, there is a significant correlation between IL-6 and the SYNTAX score with the correlation value obtained r = 0.343 (p = 0.021). Conclusion: There is a significant relationship between IL-6 and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Aim To study the anti-inflammatory effect of bay leaf on C-reactive protein (CRP) and myeloperoxidase (MPO) level in the heart of rat model with myocardial infarction. Methods In the first phase, results of pathological examination and biochemical assay were compared between rats with and without induction of myocardial infarction. In the second phase, the effect of bay leaf extract on CRP and MPO of rats with myocardial infarction was studied. Results C-reactive protein and MPO were higher in rats which had myocardial infarction. Administration of bay leaf extract reduced levels of CRP and MPO in the rats started from day 4 after the induction of myocardial infarction. Conclusion Anti-inflammatory effect of bay leaf is confirmed, reflected by decreasing of CRP and MPO levels of rat model with myocardial infarction. [ABSTRACT FROM AUTHOR]

Background - Hyponatremia is a common electrolyte disorder among patients with heart failure and associated with poor clinical outcomes. This study aims to assess the prevalence and clinical outcomes in hyponatremia compared to normonatremia patients hospitalized for heart failure. Methods - This was a cohort retrospective study using medical record of patients hospitalized for heart failure between January and December 2015 in Adam Malik Hospital, Medan, Indonesia. Patients were assigned to one of two groups; hyponatremia with admission serum sodium <135 mg/dl or normonatremia with admission serum sodium =135 mg/dl. Differences in variables between two groups were evaluated using chi-square test for categorical variables and independent samples t test or Mann Whitney U test for continuous variables. Furthermore, hyponatremia group was classified into mild, moderate and severe to analyses outcomes based on severity of hyponatremia. Results - Of 497 patients, hyponatremia was present in 230 patients (46.27%) with mean admissions serum sodium 129.16±5.17 mg/dl. Patients with hyponatremia had significantly higher in-hospital mortality (p=0.034, OR=1.999, 95% CI 1.044-3.828) and longer hospital stays (p=0.023) compared to normonatremia but no difference in readmission rate was observed between groups (p=0.414). Among hyponatremia groups, severe hyponatremia had worse clinical outcomes, with highest in-hospital mortality (19.35%) and longest length of stays (11.16±8.04 days). Conclusions - Hyponatremia was a relatively common condition found in patients hospitalized for heart failure and associated with higher in-hospital mortality and longer hospital stays. Poorer clinical outcomes were observed in severe hyponatremia group. [ABSTRACT FROM AUTHOR]

Background: Lower limb peripheral artery disease (PAD) is the main risk of diabetes mellitus which result to high mortality rate. Approximately, 50% of patients who receive several treatments have passed away or lost limbs at a year's follow-up. Secretome of hypoxia mesenchymal stem cells (S-MSCs) contains several active soluble molecules from hypoxia MSCs (H-MSCs) that capable inducing anti-inflammatory and vascular regeneration in PAD., Objective: In this study, we investigated the therapeutic potential of S-MSCs in improving dynamic function and angiogenesis of PAD diabetic rats., Methods: The PAD was established by the incision from the groin to the inner thigh and distal ligation of femoral arteries in rats with diabetes. Rats were administered with 200 µL and 400 µL S-MSCs that successfully filtrated using tangential flow filtration (TFF) system based on various molecular weight cut-off categories intravenously. ELISA assay was used to analyze the cytokines and growth factors contained in S-MSCs. Tarlov score were examined at day 1, 3, 5, 7, 10 and 14. The rats were sacrificed at day 14 and muscle tissues were collected for immunohistochemistry (IHC) and gene expression analysis., Results: ELISA assay showed that S-MSCs provides abundant level of VEGF, PDGF, bFGF, IL-10 and TGFβ. In vivo administration of S-MSCs remarkably enhanced the Tarlov score. S-MSCs improved angiogenesis through enhancing VEGF gene expression and significantly increasing CD31 positive area in muscle tissue of PAD diabetic rats., Conclusion: Our findings suggest that S-MSCs could improves dynamic function and angiogenesis in PAD diabetic rats., Competing Interests: There are no conflict of interest., (© 2023 Brama Ihsan Sazli, Dharma Lindarto, Refli Hasan, Agung Putra, Agung Pranoto, Rosita Juwita Sembiring, Syafruddin Ilyas, Santi Syafril.)

Background: In myocardial infarction (MI), inflammatory cytokine including tumor necrosis factor-α (TNF-α) plays pivotal role throughout worsening processes and recovery, whereas its cleavage is controlled by a disintegrin and metalloproteinases-17 (ADAM-17). Syzygium polyanthum (Wight) is widely used plant in Indonesia and Southeast Asian countries to treat various illnesses., Objective: This study aimed to analyze the effect of S. polyanthum extract towards TNF-α and ADAM17 expressions in MI rat model., Methods: Myocardial infarction were surgically induced in wistar rats by ligating left anterior descending coronary artery in both treatment and control group. Around 3.6 mg of S. polyanthum extract (SPE) was administered via nasogastric tube to treatment groups, while control group received only saline. Serum TNF-α level and expression of TNF-α and ADAM17 in blanching heart muscle was examined in both groups on day 1, day 4, day 7, and day 14 after treatment with SPE., Results: Reduction of serum TNF-α levels was markedly seen from day 4 in treatment group and was lower than in control group since day 4. Expression of ADAM17 was reduced and expression of TNF-α was only seen in myocardial membrane in group with SPE treatment., Conclusion: Syzygium polyanthum exerts its anti-inflammatory effect by decreasing ADAM17 expression subsequently lowering TNF-α regulation in MI rat model., Competing Interests: None declared., (© 2020 Refli Hasan, Gontar Alamsyah Siregar, Dharma Lindarto.)

Aim To investigate effect of bay leaf extract in endothelial integrity, observed by vascular endothelial growth factor (VEGF) level, VEGF and CD31 expression. Methods Thirty-two acute coronary syndrome surgery-induced Wistar Rats (Rattus novergicus) were divided into 16 bay leaf extract (treatment) groups and 16 control groups, sacrificed on day 1, 4, 7, and 14 after the induction. Serum VEGF level was determined by ELISA and expression of VEGFR-2 and CD31 were detected on immunohistochemistry. Results This study showed increased expression of serum VEGF level, and VEGFR-2 expression was found significantly on day 7 and 14 in the treatment group compared to the control group. CD31 expression was significantly different compared to the control groups on day 4, 7, and 14 of administration. Conclusion The potential effect of bay leaf extract on angiogenesis in acute coronary syndrome (ACS) as adjuvant for the treatment. Bay leaf extract has been shown to support angiogenesis and maintain endothelial integrity that leads to better prognosis for reperfusion on ischemic tissue., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)