Objectives Antioxidants can reduce oxidative radicals that affect the early phase of atherogenesis, that is endothelial dysfunction. Polysaccharide Peptide (PsP) derived from Ganoderma lucidum has an active substance in the form of β-glucan. Previous studies have proven the PsP of Ganoderma lucidum as an effective antioxidant in atherosclerotic rats and shows no toxicity in animal model. This study aims to prove the effect of PsP as potent antioxidant in high risk and stable angina patients. Method This is a clinical trial conducted to 37 high risk and 34 stable angina patients, which were determined based on ESC Stable CAD Guidelines and Framingham risk score, with pre and post test design without control group. The parameters are superoxide dimustase (SOD) and malondialdehyde (MDA) concentration, circulating endothelial cell (CEC) and endothelial progenitor cell (EPC) counts. The patients were given PsP 750 mg/day in 3 divided dose for 90 days. Paired t -test was performed for normally distributed data, and Wilcoxon test for not normally distributed data, and significant level of p ≤ 0,05. Results SOD level in high risk patients slightly increased but not statistically significant with p = 0,22. Level of SOD in stable angina group significantly increased with p = 0,001. MDA concentration significantly reduced in high risk and stable angina patients with p = 0.000. CEC significantly reduced both in high risk and stable angina patients, with p = 0.000 in both groups. EPC count significantly reduced in high risk and stable angina with p = 0.000. Conclusion PsP of Ganoderma lucidum is a potent antioxidant against pathogenesis of atherosclerosis in stable angina and high risk patients

Background Radiofrequency catheter ablation (RFCA) using the high‐power short duration (HPSD) results in better ablation lesion formation in the swine model. This systematic review and meta‐analysis purposed to investigate the safety and efficacy profile between HPSD and low‐power long‐duration (LPLD) ablation strategies to treat atrial fibrillation (AF) patients. Methods We completed the literature review after identifying the relevant articles comparing HPSD and LPLD ablation methods for AF recorded in ClinicalTrials.com, CENTRAL, PubMed, and ScienceDirect until February 2021. The overall effects were calculated using pooled risk ratio (RR) and mean difference (MD) for categorical and continuous data, respectively. We also estimated the 95% confidence interval (CI). Results The HPSD strategy took shorter procedure time (MD = −33.75 min; 95% CI = −44.54 to −22.97; P < .01), fluoroscopy time (MD = −5.73 min; 95% CI = −8.77 to −2.70; P < .001), and ablation time (MD = −17.71; 95% CI = −21.02 to −14.41) than LPLD strategy. The HPSD RFCA was correlated with lower risk of esophageal thermal injury (RR = 0.75; 95% CI = 0.59 to 0.94; P = .02). The HPSD method resulted in higher first‐pass pulmonary vein isolation (PVI) (RR = 1.36; 95% CI = 1.13 to 1.64; P < .01), lower PV reconnection (RR = 0.47; 95% CI = 0.34 to 0.64; P < .01), and lower recurrent AF (RR = 0.72; 95% CI = 0.54 to 0.96; P = .02) than LPLD strategy. Conclusion HPSD RFCA was superior to the conventional LPLD RFCA in terms of safety and efficacy in treating AF patients.

Obat Anti Inflamasi Non Steroid (OAINS) merupakan obat pilihan utama untuk osteoartritis. Penggunaan OAINS yang kurang tepat dapat menyebabkan gastropati. Penelitian ini bertujuan untuk mengetahui hubungan pola penggunaan OAINS dengan gejala klinis gastropati pada pasien reumatik Penelitian dilakukan dengan desain cross sectional pada 40 orang pasien dipilih dengan metode consecutive sampling. Penelitian ini menilai pola pengguaan OAINS (jenis, lama penggunaan, cara penggunaan, pemakaian obat sitoproteksi ) dan gejala klinis gastropati yang timbul. 55% pasien mengalami gejala klinis gastropati berupa sindrom dispepsia. Uji Kruskal Wallis gejala klinis gastropati antara penggunaan Na diclofenac, meloxicam, dengan ibuprofen menunjukkan p = 0,732. Uji regresi logistik lama penggunaan dengan gejala klinis gastropati menunjukkan p = 0,047. Uji Mann Whitney gejala klinis gastropati pada penggunaan OAINS secara periodik dengan berkelanjutan menunjukkan p > 0,05. Uji Mann Whitney gejala klinis gastropati pada penggunaan OAINS bersama obat sitoproteksi dengan penggunaan OAINS tanpa obat sitoproteksi menunjukkan p = 0,000. Penelitian ini membuktikan bahwa jenis OAINS tidak memberikan perbedaan gejala klinis gastropati, demikian juga penggunaan periodik dan berkelanjutan. Dibuktikan juga bahwa lama penggunaan OAINS berhubungan dengan gejala klinis gastropati dan penggunaan obat sitoproteksi bersama dengan OAINS mengurangi gejala klinis gastropati. Gastropati, OAINS, reumatik Non -Steroidal Anti -Inflammatory Drug (NSAID) is the drug of chice for rheumatic disease. However, NSAID which is used inappropriately will cause gastropathy. This research was conducted to identify the relationship of NSAID application model toward rheumatic patient with gastropathy symptoms in

Background: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Methods: A systematic review and meta-analysis study was conducted. The overall effects estimation was conducted using random effects models. The pooled effects were presented as the risk difference and standardised mean difference for dichotomous and continuous outcomes, respectively. Results: A total of 1,476 patients from four studies were included. The risk of atrial tachyarrhythmias following a successful catheter ablation procedure was greater in the pulmonary vein isolation + CTI ablation group than pulmonary vein isolation alone group (34.8% versus 28.2%; risk difference 0.08; 95% CI [0.00–0.17]; p=0.04). Prophylactic CTI ablation was associated with a higher recurrent AF rate (33.8% versus 27.1%; risk difference 0.07; 95% CI [0.01–0.13]; p=0.02). Additional prophylactic CTI ablation to pulmonary vein isolation significantly increased the radio frequency application time (standardised mean difference 0.52; 95% CI [0.04–1.01]; p=0.03). Conclusion: This study suggested that prophylactic CTI ablation was an ineffective and inefficient approach in AF without documented typical atrial flutter patients.

Background Non-paroxysmal atrial fibrillation (AF) has a complex pathophysiological process. The standard catheter ablation approach is pulmonary vein isolation (PVI). The additional value of complex fractionated electrogram (CFAE) ablation is still unclear. We aimed to investigate the additional value of CFAE ablation for non-paroxysmal AF. Methods We performed a systematic review and meta-analysis of randomized controlled studies up to May 2020. Articles comparing pulmonary vein isolation (PVI) plus CFAE ablation and PVI alone for AF were obtained from the electronic scientific databases. The pooled mean difference (MD) and pooled risk ratio (RR) were assessed. Results A total of 8 randomized controlled trials (RCTs) including 1034 patients were involved. Following a single catheter ablation procedure, the presence of any atrial tachyarrhythmia (ATA) with or without the use of antiarrhythmic drugs (AADs) between both groups were not significantly different (RR = 1.1; 95% confidence interval [CI] = 0.97–1.24; p = 0.13). Similar results were also obtained for the presence of any ATA without the use of AADs (RR = 1.08; 95% CI = 0.96–1.22; p = 0.2). The additional CFAE ablation took longer procedure times (MD = 46.95 min; 95% CI = 38.27–55.63; p = < 0.01) and fluoroscopy times (MD = 11.69 min; 95% CI = 8.54–14.83; p = < 0.01). Conclusion Additional CFAE ablation failed to improve the outcomes of non-paroxysmal AF patients. It also requires a longer duration of procedure times and fluoroscopy times.