10:31, 03 September 2026 by admin | Paper

Ricki Yudhanata, Christyanita P. Ekasari and Subagjo

Abstract

Background: Chronic coronary artery disease (CAD) with triple-vessel involvement and diabetes mellitus is a high-risk condition that often leads to a recommendation for coronary artery bypass grafting (CABG). This report presents the course of a 67-year-old man with chronic CAD, old myocardial infarction, and controlled diabetes mellitus who declined CABG and underwent conservative management and Hydrogen Nanobubble Infusion Therapy.

Methods: This retrospective descriptive case report was compiled from history taking, physical examination, and review of medical records from 2012 to 2025.

Case Presentation: Coronary angiography demonstrated triple-vessel disease, and CABG was recommended, but the patient declined surgery. He was managed with medical therapy, lifestyle modification, Enhanced External Counterpulsation, laser therapy, chelation infusion, and follow-up. Serial echocardiography in 2025 showed mildly reduced to low-normal left ventricular systolic function, regional wall motion abnormalities, and impaired relaxation. After 12 sessions of Hydrogen Nanobubble Infusion Therapy, the patient reported symptomatic improvement, and a follow-up reevaluation reportedly documented an increase in left ventricular ejection fraction from approximately 52% to 62%.

Conclusion: The posttreatment symptomatic improvement and reported increase in systolic performance are interesting, but causality cannot be established from a single case. The findings should be interpreted as hypothesis-generating and warrant structured investigation.

Keywords: chronic coronary artery disease; triple-vessel disease; diabetes mellitus; hydrogen nanobubble infusion therapy; conservative management; case report

Article Link: https://www.preprints.org/manuscript/202609.0114/v1

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