To date, AMI is still an important global health problem because of relatively high morbidity and mortality rates. Diagnosis of AMI can be established if there are at least two of the three criteria to be met, namely chest pain (anamnesis), persistent changes in electrocardiographic (ECG), as well as cardiac biomarker creatine myocardial band (CK-MB), cardiac troponin T (cTnT), or cardiac troponin I (cTnI). Treatment for AMI patients consists of reperfusion therapy and pharmacological therapy. This study aimed to determine the role of troponin examination in the diagnosis and management of AMI. This was a literature review study with a total of 13 literature reviews. The results showed that diagnosis of AMI could be established by conducting a cardiac biomarker examination, the troponin. Troponin was almost specific and highly sensitive to detect the presence of AMI. Moreover, minor damage of myocardium could be demonstrated by checking troponin level. In addition, changes in troponin levels could also be used as predictors of side effects that could occur after treatment or even an increase in late mortality. However, increased troponin level sould also occur in other conditions, such as chronic kidney disease, pulmonary embolism, and sepsis. Therefore, the execution of its interpretation should fit the context of the clinical situation in the patient. In conclusion, troponin plays an important role in the diagnosis and management of AMI.Keywords: troponin; diagnosis and management; acute myocardial infarction Abstrak: Hingga saat ini IMA masih menjadi suatu masalah kesehatan penting dunia dikarenakan angka morbiditas dan mortalitas yang relatif tinggi. Diagnosis IMA dapat ditegakkan jika terdapat minimal dua dari tiga kriteria yang harus dipenuhi, yaitu nyeri dada (anamnesis), gambaran elektrokardiografi (EKG) yang berubah secara persisten, serta pelepasan biomarker jantung yaitu Creatine Kinase Myocardial Band (CK-MB), Cardiac Specific Troponin T (cTnT), atau Cardiac Specific Troponin I (cTnI). Penanganan IMA berupa terapi reperfusi dan terapi farmakologik. Penelitian ini bertujuan untuk mengetahui peran pemeriksaan troponin pada diagnosis dan penanganan IMA. Jenis penelitian ialah suatu literature review, dengan jumlah literatur yang diteliti sebanyak 13 literatur. Hasil penelitian mendapatkan bahwa diagnosis IMA dapat ditegakkan salah satunya dengan melakukan pemeriksaan biomarker jantung, dalam hal ini kadar troponin. Troponin sendiri berperan penting dalam diagnosis IMA dikarenakan hampir spesifik dan sangat sensitif dalam mendeteksi adanya IMA. Kerusakan kecil pada miokard dapat ditunjukkan melalui pemeriksaan kadar troponin. Perubahan kadar troponin juga dapat digunakan sebagai prediktor efek samping yang dapat terjadi setelah penanganan atau bahkan peningkatan mortalitas lanjut. Peningkatan kadar troponin tidak hanya terjadi pada IMA, tetapi juga dapat terjadi pada kondisi lain sehingga dalam pelaksanaan interpretasi nilainya harus sesuai dengan konteks situasi klinis yang terjadi pada pasien. Simpulan penelitian ini ialah pemeriksaan troponin berperan penting dalam diagnosis dan penatalaksanaan IMA.Kata kunci: troponin; diagnosis dan penanganan; infark miokard akut

Background: Revascularization in patients with stable coronary artery disease (SCAD) can reduce myocardial ischemia and improves the autonomic nervous system, which can be measured by heart rate variability (HRV) and signal-averaged electrocardiogram (SAECG). This study aimed to investigate the effect of revascularization on HRV and SAECG in patients with SCAD. Methods: This is a single-center prospective cohort study. Revascularization refers to percutaneous coronary intervention (PCI). The primary outcome of this study is the change in short-term HRV and SAECG from before revascularization to after revascularization. HRV and SAECG measurement was performed for 10 minutes before PCI and one-month post-PCI. Data were analyzed using SPSS version 23 for Windows. Results: There are 30 patients included in this study, and 46.7% underwent incomplete PCI. There was no significant difference in HRV parameters in the time domain method. In the frequency domain, only the LF/HF ratio changed significantly from 3.5±2.6 before PCI to 2.16±1.9 after PCI, with a 1.33 decrease in LF/HF (p=0.007). Subgroup analysis was performed for patients receiving complete and incomplete revascularization. In patients who received complete revascularization, there was a significant difference in LF/HF ratio change of 1.6±2.28 (p=0.013). In patients that receive incomplete revascularization, there is a significant increase in HF 37.8±57.3 (p=0,028). In terms of SAECG parameters, there is no significant difference between before and after PCI in both primary and subgroup analysis. Conclusion: Revascularization resulted in a significant reduction in LF/HF ratio assessed by short-term HRV. There was no benefit of revascularization in terms of SAECG parameters.

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Background: The ischemic process in stable Coronary Artery Disease (CAD) causes cardiac remodeling and dysfunction, signaling the progress towards irreversible heart failure. Early identification for the presence of Left ventricular (LV) remodeling and dysfunction is important. Several methods can be used to assess LV dysfunction using echocardiography, including peak Global Longitudinal Strain (GLS) and ejection fraction measurements. Short-term Heart Rate Variability (HRV) and QT interval are considered practical parameters in electrocardiography identifying LV dysfunction. This study aimed to determine the relationship between short-term HRV and QT interval with LV systolic function in stable angina pectoris patients.Methods: This cross-sectional study was conducted in Prof. Dr. R. D. Kandou Hospital, Manado, from March to September 2021. All study subjects who met the inclusion criteria underwent a clinical history and further examinations, including electrocardiography, laboratory, and echocardiography examinations. The relationship of HRV variables and QT interval with LV systolic function were analyzed using Pearson correlation and linear regression models by SPSS version 21 for Windows.Results: A total of 33 subjects were included with a mean age of 62.3±8.9 years. Non-parametric correlation analysis between HRV variables and left ventricular systolic function showed no significant correlation. There was a significant correlation between QTc interval by Fridericia and LV peak GLS, but not with ejection fraction (r=0.426; p=0.013). The univariate regression analysis showed a relationship between QTc interval by Bazett and Fridericia with peak GLS (Bazett B=0.036; ?=0.35; R2=0.122; p=0.046; Fridericia B=0.052; ?=0.426; R2=0.181; p=0.013).Conclusion: There was a weak and moderate positive correlation between the QTc interval by Bazett and Fridericia formula with left ventricular systolic function. There was no statistically significant correlation between the short-term HRV variable and left ventricular systolic function.