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Congenital heart disease screening program in elementary schools: a research-based policy Dinarti, Lucia Kris; Hartopo, Anggoro Budi; Hadwiono, Muhammad Reyhan; Wiradhika, Abdul Majid Halim; Meliala, Andreasta; Putri, Likke Prawidya; Fajarwati, Prahesti; Anggrahini, Dyah Wulan
BKM Public Health and Community Medicine Vol 39 No 01 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v39i01.5783

Abstract

Purpose: CHD is a condition where heart abnormalities develop before birth and can lead to severe complications such as heart failure and premature death, especially among younger adults. Delayed diagnosis and treatment worsen the situation for CHD patients. Early screening can prevent CHD and ensure timely interventions. This study discusses the latest advancements in CHD screening for primary school children and the valuable insights gained from the program. Method: The CHD screening program in Yogyakarta province involved three stages: consolidation, implementation, and incorporation. During the consolidation stage, key decision-makers in the province and local health offices were involved. Primary healthcare workers and primary school teachers were trained to deliver the screening during the implementation stage. Stakeholders, health workers, and teachers were invited to discuss the results, and the Provincial Governor's office was engaged during the incorporation stage. Results: In 2018–2019, 18 CHDs were identified from 6,116 school-age children in 4 districts in Indonesia. The screening program was led by academics in the Universitas Gadjah Mada through 3 stages: consolidation, implementation, and incorporation. Strong collaboration with local stakeholders has contributed to the program's success in engaging 130 schools, 60 community health centers, and 190 health workers. Several opportunities for improvement are: strengthening the capacity and number of health providers at health centers to screen CHDs using 12-lead electrocardiography, addressing patients' reluctance to visit the health facility due to the COVID-19 pandemic, and motivating parents to have their children checked. Conclusion: CHD screening using 12-lead electrocardiography and auscultation should be part of primary school health screenings. Academics can train health workers, and local governments can provide funding and prepare health facilities for follow-up treatment.
Association between serum endothelin-1 level and major adverse cardiovascular events following percutaneous coronary intervention in stable coronary artery disease Rahayu, Dian Herlusiatri; Anggrahini, Dyah Wulan; Hartopo, Anggoro Budi
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.20513

Abstract

Coronary artery disease (CAD) affects greatly the global population, exhibits high mortality and morbidity rates. Major adverse cardiovascular events (MACE), such as stroke, myocardial infarction, heart failure, and death, are the focus of research due to their significant contribution to morbidity and mortality in patients with CAD. Endothelin-1 is identified as a CAD prognostic indicator, especially for heart failure outcome. This study aimed to investigate the association between serum endothelin-1 level and MACE within 1 yr observation in patients with CAD underwent percutaneous coronary intervention (PCI). It was a retrospective cohort study where conducted at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Subjects were patients with stable CAD who underwent elective PCI. Baseline serum endothelin-1 level was measured by ELISA at the time of elective PCI procedure. The outcome was MACE, which consisted of heart failure, acute coronary syndrome, stroke, and cardiac death, occurred within 1 yr after elective PCI. The ROC curve was designed to determine serum endothelin-1 cut-off value to predict MACE. Sixty-three subjects were enrolled and the endothelin-1 level in serum samples was analyzed. Out of these, 11 (17.5%) experienced MACE within 1 yr post elective PCI. Serum endothelin-1 cut-off value was 1.932 pg/mL, which determined based on ROC curve. There was no significant association between serum endothelin-1 and MACE. There was a trend of higher incidence of MACE, in subjects with above-cut-off endothelin-1 level (≥1.932 pg/mL) (MACE incidence: 23.1% vs. 8.3%; p=0.181). Above-cut-off endothelin-1 level significantly associated with incidence of heart failure (100% vs. 0%; p=0.039) for 1 yr follow-up after elective PCI. Higher serum endothelin-1 level had a trend of higher incidence of 1-yr MACE in patients with stable CAD undergone elective PCI. Among 1-yr MACE, higher serum endothelin-1 associated with increased incidence of heart failure.