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All Journal Jurnal Kedokteran Brawijaya Medical Journal of Indonesia Berkala Kedokteran JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Journal of Issues in Midwifery Heart Science Journal CRJIM (Clinical and Research Journal in Internal Medicine) Caring : Jurnal Pengabdian Masyarakat Journal of Nursing Science Update Journal of Community Health and Preventive Medicine (JOCHAPM)
Cholid Tri Tjahjono
Brawijaya Cardiovascular Research Center Department Of Cardiology And Vascular Medicine Faculty Of Medicine, Universitas Brawijaya Malang
Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Optimizing Cardiac Rehabilitation for Patients with Complex Coronary Disease without Revascularization Afifuddin, Mokhammad; Tjahjono, Cholid Tri; Mayangsari, Veny
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.10

Abstract

Patients with complex coronary artery disease (CAD) ineligible for revascularization present considerable management challenges and a high ischemic burden. Cardiac rehabilitation (CR), a comprehensive, multidisciplinary intervention, emerges as an essential non-pharmacological therapy. This review synthesizes the principles of CR, focusing on its profound pathophysiological benefits in this specific cohort. Mechanistically, CR confers pleiotropic effects: it enhances endothelial function via the eNOS/NO pathway, mitigates systemic inflammation through myokine regulation, promotes coronary collateralization (HIF-1α/VEGF pathway), and restores autonomic balance (HRV). Furthermore, CR integrates essential psychosocial support to address the high prevalence of depression and anxiety, which are independent risk factors. A primary objective, the improvement of quality of life (QoL), is consistently achieved through reduced anginal symptoms and enhanced functional status. Despite robust clinical and economic evidence demonstrating CR's efficacy in reducing MACE, mortality, and healthcare utilization, significant barriers to referral and adherence persist. Vigilant supervision and protocol adaptations are mandated for high-risk anatomical subsets, such as those with chronic total occlusions or severe left ventricular dysfunction
Correlation Analysis of Mortality and Length of Stay in Sepsis Cases Among Heart Failure Patients with Low Ejection Fraction at Dr. Saiful Anwar General Hospital, East Java, Indonesia Sakti, Pradhika Perdana; Anjarwani, Setyasih; Rohman, Mohammad Saifur; Prasetya, Indra; Tjahjono, Cholid Tri
Berkala Kedokteran Vol 21, No 2 (2025)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v21i2.24597

Abstract

In Indonesia, heart failure (HF) prevalence reaches 5%, contributing to over 1.8 million annual hospitalizations, accompanied by a 29% readmission rate and a 30-day mortality rate of 17%. The burden of infectious diseases, notably sepsis, further complicates the clinical landscape. Patients with sepsis residing in tropical regions often exhibit mortality rates surpassing global averages. Sepsis-associated coagulopathy (SAC) serves as a significant complication in this context. This study investigates the correlation between SAC, indicated by international normalized ratio (INR) levels, and outcomes in patients with heart failure with reduced ejection fraction (HFrEF) who develop sepsis. Utilizing a retrospective cohort approach, we analyzed medical records from Saiful Anwar Regional General Hospital, Malang, East Java, involving adult HFrEF patients who underwent INR testing. Purposive sampling was applied. Statistical analyses, including the Mann-Whitney Test, Kaplan-Meier Analysis, Log-Rank Test, Cox Proportional Hazards Regression, and Multiple Linear Regression, were conducted employing SPSS software. Results revealed a mean survival of 7.69 days in the Non-SAC group compared to 6.78 days in the SAC group, though the difference was not statistically significant (p=0.080). Notably, additional clinical complications predominantly influenced survival outcomes. This study elucidates that elevated INR levels, indicative of SAC, correlate with increased mortality and decreased survival in HFrEF patients with sepsis. Furthermore, the exacerbating effect of clinical complications on mortality highlights the imperative for early SAC detection and management of cardiovascular implications to enhance patient prognosis.
BEYOND TRADITIONAL RISK FACTORS : A REVIEW OF ENVIRONMENTAL EXPOSURES IN CARDIOVASCULAR DISEASE Tjahjono, Cholid Tri; Arthamin, Maimun Zulhaidah; Prakosa, Ardani Galih; Insanitaqwa, Aleyda Zahratunany
Journal of Community Health and Preventive Medicine Vol. 5 No. 2 (2025): JOCHAPM Vol. 5 No. 2 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jochapm.2025.005.02.5

Abstract

  Traditional cardiovascular disease (CVD) risk models frequently overlook environmental factors, despite increasing evidence that exposures such as air pollution, toxic chemicals, noise, and extreme temperatures markedly elevate CVD risk via common biological mechanisms. This review integrates contemporary evidence regarding the impact of environmental exposures on cardiovascular risk, exploring mechanistic insights, preventive strategies, and prospective research opportunities within the fields of environmental cardiology. We performed a narrative review of recent studies to assess environmental factors influencing cardiovascular health. Environmental exposures increases cardiovascular risk through oxidative stress, inflammation, autonomic imbalance, and endothelial dysfunction. Fine particulate matter (PM2.5), ozone, heavy metals, PFAS, noise pollution, and extreme temperatures are consistently linked to hypertension, arrhythmias, myocardial infarction, and stroke. People who work outside and older adults are more at risk than others. Urban redesign, monitoring of exposure, protective workplace interventions, and regulatory policies are all examples of preventive strategies. The exposome provides an effective framework for comprehensive exposure assessment. There are still big gaps in research, especially in low- and middle-income countries. This review underscore the imperative to underscore environmental risk factors in the prevention of CVD. Combining long-term research, data-driven policies, and personalized strategies is necessary to reduce the global burden of CVD and promote health equity.
Effect of decaffeinated green tea and green coffee combination on improving blood glucose levels in metabolic syndrome patients Nugroho, Ira Vori; Rohman, Mohammad Saifur; Karolina, Wella; Tjahjono, Cholid Tri; Kurnianingsih, Novi
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.12

Abstract

Background: Metabolic syndrome (MS) contributes to high mortality and morbidity not only in developing countries but also in developed countries, with central obesity and insulin resistance as primary risk factors. Our previous study demonstrated that combined decaffeinated green tea and green coffee extracts more effectively improved lipid and glucose profiles in an MS rat model. Objective: This study evaluates the efficacy of the extracts on top guideline-directed medical treatment optimal therapy in metabolic syndrome patients. Methods: The study was a randomized controlled trial (RCT) involving 90 patients diagnosed with metabolic syndrome, ages 45-70. Participants were randomly sorted into three groups: the first group received 2x2.5 g, the second group received 1x5 g, and the third one received a placebo. Researchers measured baseline and final values for fasting blood glucose (FBG), post-meal glucose levels (PPBG), and glycated hemoglobin (HbA1C) to evaluate treatment effects. Result: After 90 days of treatment with decaffeinated green tea and green coffee combination, both experimental groups (Groups 1 and 2) revealed significant decreases in PPBG and HbA1c compared to the control group. (-14.10 ± 2.00 vs. -28.63 ± 4.61 vs. -5.03 ± 0.74 mg/dL and -0.23 ± 0.01 vs. -0.22 ± 0.03 vs. -0.13 ± 0.01; p = < 0.05). FBG decreased across all groups but was not statistically significant. Conclusion: After 90 days, the combination of decaffeinated green tea and green coffee significantly reduced PPBG and HbA1C levels in patients with metabolic syndrome compared to the placebo. These findings suggest that this combination may serve as an effective adjunctive therapy for glucose management in metabolic syndrome, translating efficacious preclinical dosages to clinical application.
Co-Authors Adhika Prastya Wikananda Aditya Reza Pratama Adriyawan Widya Nugraha Afifah, Yuri Afifuddin, Mokhammad Alfata, Fandy Hazzy Amanda, Febrina Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Anjarwani, Setyasih Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardani Galih Ardani Galih Prakosa, Ardani Galih Ardhani Galih Ardhani Galih Ardhia, Jessica Fio Ardian Rizal Ardian Rizal Arif Wicaksono Arif Wicaksono Arifah, Medisa Roro Putri Nur Aris Munandar ZI Arityanti, Dean Aryanugraha, Teguh Ashari, Yordan Wicaksono Astiawati, Tri Ayu Asri Devi Adityawati Ayu Asri Devi Adityawati Badai Bhatara Tiksnadi Bambang Rahardjo Budi Satrijo Budi Satrijo Dadang Hendrawan David Rubiyaktho Dedy Irawan Desandri, Dwita Rian Diah Ivana Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Dwiputra, Bambang Elvira Sari Dewi Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Erwan, Nabila Erina Evit Ruspiono Evit Ruspiono Fahmy Rusnanta Fandy Hazzi Alfata Fathurohim, Zainal Febrianora, Mega Firdaus, Achmad Jauhar Fitra, Maha Galih Prakosa, Ardani Hasan, Harris Hayati, Yati Sri Hendrawati Hendrawati Heny Martini Heny Martini Hergaf, Indah Widyasari Hidayanti, Puji Astuti Nur Idris Idham Ikeningrum, Dyah Ayu Imelda Krisnasari Indhiarti, Tantri Refa Indra Prasetya Indra Prasetya Indra Prasetya Indriani, Anin Indriyani, Damayanti Insanitaqwa, Aleyda Zahratunany Irsad Andi Arso, Irsad Andi Iskandar Iskandar Jannah, Riska Raudhatul Karolina, Wella Kartika, Annisa Wuri Krevani, Citra Kiki Kurnianingsih, Novi Lestari, Defyna Dwi Liemena Harold Adrian Machfud, Savinka Salsabiela Iriana Maimun Zulhaidah Arthamin, Maimun Zulhaidah Makes, Indira Kalyana Martini, Heny Mayangsari, Veny Mifetika Lukitasari Mohammad Ryan Ramadhan Mohammad Saifur Rohman Mohammad Saifur Rohman Monika Sitio Muchammad Dzikrul Haq Karimullah Muhammad Abusari Muhammad Firdaus Muhammad Munawar Muhammad Ridwan Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Rizki Fadlan Ni Putu Frida Baskarani Novi Kurnianingsih Novi Kurniningsih Nugroho, Ira Vori Oktafin Srywati Pamuna Olivia Handayani Pawik Supriadi Pratiwi, Irma Kamelia Puji Astuti Nur Hidayanti Putri, Valerina Yogibuana Swastika Qhabibi, Faqrizal Ria Rahimah, Anna Fuji Ratna Pancasari Raynaldo, Abdul Halim Rita Hamdani Rizal, Ardian RWM Kaligis Sakti, Pradhika Perdana Saskia Dyah Handari Sasmojo Widito Sasmojo Widito Satrijo, Budi Satwikajati, Sawitri sawitri satwikajati Seprian Widasmara Setyasih Anjarwani Setyowati, Danti Utami Susilowati, Eliana Swastika Putri, Valerinna Yogibuana Swastikaputri, Valerina Yogibuana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Titin Andri Wihastuti Tonny Adriyanto Vori, Ira Widiani, Luh Widito, Sasmojo Wira Kimahesa Anggoro Wulandari, Ayu Pramitha Yasmine Fitrina Siregar Yoga Waranugraha Yogibuana, Valerinna Yudha, Tria Yusuf Arifin Zulhaidah A, Maimun