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All Journal Medical Journal of Indonesia Indonesian Journal of Cardiology
Desandri, Dwita Rian
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Health Professions Medicine & Pharmacology

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Consensus Statements on the Use of High-Sensitivity Troponin I as the Assessment of Cardiac Risk in Apparently Healthy Population in Indonesia Ambari, Ade Meidian; Ng, Sunanto; Rejeki, Vidya Gilang; Rina Artha, I Made Junior; Raynaldo, Abdul Halim; Alsagaff, Mochamad Yusuf; Wicaksono, Sony Hilal; Dwiputra, Bambang; Desandri, Dwita Rian
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1544

Abstract

Cardiovascular disease (CVD) is a growing burden in Indonesia, making primary prevention of utmost importance. High sensitivity cardiac troponin I (hsTnI) has been known as one of the biomarkers of choice for diagnosing acute myocardial infarction. Nonetheless, recent studies indicate that hsTnI assay has potential as a predictor of cardiac risk in asymptomatic individuals. An advisory board consisting of renowned cardiologists from the Indonesian Heart Association was convened in Jakarta in March 2023. The meeting aimed to explore the appropriate use of hsTnI for cardiovascular (CV) risk stratification in apparently healthy adults in Indonesia. The board reviewed relevant literature and developed key consensus statements, including hsTnI cut-off for identifying high-risk asymptomatic patients, the proposed algorithm, and monitoring after aggressive risk factor control. This article presents the resulting consensus statements to provide clinicians with a practical tool for planning primary prevention strategies. Furthermore, it is expected to raise awareness and advocacy among stakeholders in the healthcare infrastructure regarding the use of hsTnI as a guide for assessing CV risk in Indonesia.
Protokol Latihan BEST yang Disesuaikan dalam Rehabilitasi Gagal Jantung Triangto, Kevin; Radi, Basuni; Siswanto, Bambang Budi; Tambunan, Tresia Fransiska Ulianna; Heriansyah, Teuku; Harahap, Alida Rosita; Kekalih, Aria; Ambari, Ade Meidian; Dwiputra, Bambang; Desandri, Dwita Rian; Katsukawa, Hajime; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1738

Abstract

Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Dyslipidemia management among patients with high and very high cardiovascular risk in Indonesia: a multi-center registry Ng, Sunanto; Santoso, Anwar; Sukmawan, Renan; Erwinanto, Erwinanto; Adam, Erika; Desandri, Dwita Rian; Zahra, Rita; Wicaksono, Sony Hilal; Putra, Magma Purnawan; Heriansyah, Teuku; Tiksnadi, Badai Bhatara; Pintaningrum, Yusra
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1880

Abstract

Background Indonesia, the world's largest archipelago, faces significant challenges in equitable healthcare delivery due to its geographical and infrastructural disparities. Atherosclerotic Cardiovascular Disease (ASCVD) remains the leading cause of mortality, with over 659,000 deaths recorded in 2019. Effective dyslipidemia management is crucial for preventing adverse ASCVD events. Unfortunately, the lack of implementation of an updated national lipid management registry might hinder optimal strategy for the adverse events. This study evaluated dyslipidemia cholesterol management practices among high- and very high-risk patients across the country. Methods The study recruited 322 patients from eight centers across six provinces in Indonesia between May 2022 and March 2023. Patients were stratified based on the ASCVD risk and followed over three visits. Baseline clinical characteristics, lipid profiles, and treatment regimens were analyzed. Descriptive statistics summarized continuous and categorical variables, and low-density lipoprotein cholesterol (LDL-C) achievement was assessed. Results Of the 322 patients, 98.8% were very high-risk, with only 4.9% achieving <55 mg/dL and 21.2% achieving <70 mg/dL. Moderate-intensity statins were the most prescribed (51.2%), followed by high-intensity (36.6%). LDL-C reduction was most pronounced in private insurance patients, achieving a mean LDL-C of 69.8 mg/dL at the third visit compared to 98.9 mg/dL in National Health Insurance (Jaminan Kesehatan Nasional/JKN) participants. Missed visit rates increased over time, with 57.5% of patients missing the third visit, predominantly among JKN participants and low-income groups. Conclusion Majority of the population failed to achieve the recommended target of LDL-C levels. Dyslipidemia management in Indonesia remains suboptimal, with disparities driven by socioeconomic factors. Improved policies addressing medication availability, national lipid registry establishment, and equitable healthcare access are essential to enhance lipid management and reduce the burden of ASCVD in Indonesia.
Co-Authors Adam, Erika Alsagaff, Mochamad Yusuf Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Anwar Santoso Aria Kekalih Arityanti, Dean Badai Bhatara Tiksnadi Bambang Budi Siswanto Basuni Radi Cholid Tri Tjahjono Dwiputra, Bambang Erwan, Nabila Erina Erwinanto, Erwinanto Febrianora, Mega Fitra, Maha Harahap, Alida Rosita Hasan, Harris Hergaf, Indah Widyasari Irsad Andi Arso, Irsad Andi Katsukawa, Hajime Krevani, Citra Kiki Makes, Indira Kalyana Muhammad Ridwan Pintaningrum, Yusra Putra, Magma Purnawan Qhabibi, Faqrizal Ria Raynaldo, Abdul Halim Rejeki, Vidya Gilang Renan Sukmawan Rina Artha, I Made Junior Rita Hamdani Sunanto Ng Susilowati, Eliana Syaoqi, Muhammad Tambunan, Tresia Fransiska Ulianna Tarsidin, Najmi Fauzan Teuku Heriansyah, Teuku Triangto, Kevin Wicaksono, Sony Hilal Yasmine Fitrina Siregar ZAHRA, RITA