Objective: Coronary computed tomographic angiography (CCTA) is a modality used to aid in the diagnosis of patients suspected of having coronary artery disease (CAD). This study describes patients with chronic coronary syndrome in whom CCTA evaluations were indicated at the Siloam Diagram Heart Hospital. Materials and Methods: This study is descriptive research that was conducted at Siloam Diagram Heart Hospital between January 2021 and December 2022. The samples were taken from patients who were diagnosed with chronic coronary syndrome and indicated to have CCTA examinations. The obtained data include the computed tomography calcium score (CAC), Coronary Artery Disease Reporting and Data System 2.0 (CAD-RADS) categorization, and the individual results for each coronary artery. Data collection, compilation, and processing occurred between June 2023 and December 2023. Results: CCTA was performed on 593 outpatients with suspected CAD in Siloam Diagram Heart Hospital, Indonesia. The average patient age was 51 years old. The ratio of male patients to female patients was 1.3:1. Nine patients had a history of stenting. A total of 286 (48.2%) patients had CAC=0 (very low risk of CAD), while 60 (10.1%) patients had CAC ≥300 (moderate-severely increased risk). Three hundred twenty-two (54.3%) patients were categorized as CAD-RADS 0, while 4 (0.7%) patients were on CAD-RADS 5. The most common stenosis occurred in the left anterior descending (LAD), which was identified in 250 (42.2%) patients, and 163 (27.5%) patients were also found to have myocardial bridging in the LAD. The most frequently affected area is the proximal part of the LAD. Conclusion CCTA is very useful for assessing the anatomical condition of the coronary blood vessels. Using the results of a CCTA examination, physicians can assess a patient’s prognosis as well as determine the appropriate therapy. CAD-RADS is another tool that can be used to help determine optimal therapies, but it should still be based on the clinical findings.

REV-ERBα MITIGATES HEART FAILURE BY EXERTING TRANSCRIPTIONAL REPRESSION: A LITERATURE REVIEW Heart failure (HF) is a major cause of mortality, affecting millions of people in the United States. Current treatments focus on minimizing stress and improving hemodynamics, but there is still a need for an effective strategy that can selectively inhibit the abnormal gene program associated with HF. Rev-erb, a member of the nuclear receptor superfamily, has been identified as a potential therapeutic target for HF due to its role in regulating circadian rhythm, glucose and lipid metabolism, and inflammation. Synthetic Rev-erb agonists have shown promise in preclinical studies, improving metabolic and inflammatory pathways while also enhancing mitochondrial function. Long-term therapy with these agonists has also been shown to reduce atherosclerotic plaque. While more research is needed to fully understand Rev-erb’s functions in HF development, it represents a potentially exciting new avenue for treatment. This literature review explores the potential use of Rev-erb agonists as a therapeutic target for HF patients.

Background: Heart failure (HF) is a complex clinical syndrome with signs and symptoms resulting from any structural dysfunction of ventricular filling or blood ejection. miRNAs were known as essential regulators and tissue-specifically expressed. MicroRNA-155 (miR-155) expression in macrophages is already well known to promote hypertrophy, cardiac inflammation, and failure due to pressure overload. In this study, we aim to identify the role of expression miR-155 as a potential biomarker for HF. Method: We incorporated search engines from Google Scholar, PubMed, EBSCO Host, and ProQuest to search the articles. Newcastle Ottawa Scale (NOS) was used to evaluate the bias risk in the case-control research. A systematic database search reveals 6 relevant studies. Results: This research found that miR-155 levels were significantly higher in heart failure patients than in the MI and control groups. MiR-155's plasma levels in heart failure are higher than the control group, with a cut-off value of 0.8591, a sensitivity value of 98.5%, and a specificity value of 64.6%. However, miRNA expression patterns do not appear to differ significantly between pf and cf LVAD. Most cardiac changes and clinical outcomes specific to each device are independent of differences in miRNA expression levels. According to one study, miR-155, a diagnostic biomarker for heart failure, had a specificity of 92.14% and a cutoff value of 1.77%. Conclusion Our systematic review showed that miR-155 could be a potential new diagnostic biomarker in HF patients.
MicroRNAs

Cardiogenic shock (CS) is a complex condition causing end-organ hypoperfusion and high mortality rates especially in patients with acute myocardial infarction. It remains a challenge for clinician to provide good outcomes despite the development of evidence-based therapeutic strategies, especially for interventional management. Although there has been an improvement in survival, the mortality remains high. There are still many uncertainties regarding the best treatment, as clinicians need to weigh the risks and benefits. This review aims to elaborate the latest updates in the field of CS. To enhance contractility and systemic vascular resistance and hence avoid organ damage, inotropic and vasopressin agents are often administered in the therapy of CS. Despite their usefulness and widespread use, administration of these medicines requires close monitoring and the lowest effective dosage administered in the shortest amount of time possible to prevent adverse effects including increased oxygen demand, arrhythmia, and impaired microcirculation of the tissue. When pharmacological agents fail to provide an adequate response, mechanical circulatory support (MCS) devices like the intraaortic balloon pump (IABP), left ventricular assist devices (LVAD), venoarterial extracorporeal membrane oxygenation (VA-ECMO), and revascularization become an option to provide haemodynamic support.
Shock, Cardiogenic