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All Journal Medical Journal of Indonesia Narra J
Fitra, Maha
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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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.
Global longitudinal strain and left ventricular ejection fraction for early detection of chemotherapy-related cardiac dysfunction in breast cancer: A prospective comparison of doxorubicin-based and paclitaxel–carboplatin regimens Faradilla, Rizka; Heriansyah, Teuku; Novita, Novita; Munirwan, Haris; Fitra, Maha
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.3095

Abstract

Left ventricular ejection fraction (LVEF) is widely used in routine practice to assess cardiotoxicity; however, reductions in LVEF often reflect relatively advanced myocardial damage. Global longitudinal strain (GLS) quantifies myocardial deformation and has demonstrated greater sensitivity for identifying early systolic dysfunction, yet comparative evidence on myocardial strain changes between doxorubicin-based regimens and non-anthracycline chemotherapy in breast cancer patients remains limited. The aim of this study was to compare changes in left ventricular GLS and LVEF between breast cancer patients receiving doxorubicin-based chemotherapy and those treated with paclitaxel–carboplatin regimens. A prospective cohort study was conducted among 106 women with histopathologically confirmed breast cancer, who were allocated to receive either a doxorubicin-based regimen (n=53) or a paclitaxel–carboplatin regimen (n=53). Transthoracic echocardiography was performed within seven days before chemotherapy initiation and repeated after four months. Left ventricular GLS was measured using two-dimensional speckle-tracking echocardiography from apical views and analyzed offline using the 17-segment model. Baseline GLS values did not differ significantly between the doxorubicin and paclitaxel–carboplatin groups (−20.47±0.45 vs −20.38±0.53; p=0.410). After four months, GLS was significantly reduced in the doxorubicin group compared with the paclitaxel–carboplatin group (−15.04±0.35 vs −19.54±0.50; p<0.001). The change in GLS (ΔGLS) was also greater in the doxorubicin group (5.43±0.12 vs 0.84±0.11; p<0.001). No significant differences were observed in LVEF before chemotherapy (55.26±1.78 vs 55.39±1.99; p=0.720), after chemotherapy (51.32±1.51 vs 51.60±1.64; p=0.359), or in ΔLVEF (p=0.484). In conclusion, doxorubicin-based chemotherapy was associated with early subclinical systolic dysfunction detectable by GLS before measurable LVEF decline, whereas paclitaxel–carboplatin was associated with relatively preserved myocardial deformation. These findings support the incorporation of strain imaging into routine cardiac surveillance for earlier identification and management of chemotherapy-related myocardial injury.
Co-Authors Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Arityanti, Dean Badai Bhatara Tiksnadi Cholid Tri Tjahjono Desandri, Dwita Rian Dwiputra, Bambang Erwan, Nabila Erina Faradilla, Rizka Febrianora, Mega Hasan, Harris Hergaf, Indah Widyasari Irsad Andi Arso, Irsad Andi Krevani, Citra Kiki Makes, Indira Kalyana Muhammad Ridwan Munirwan, Haris Novita Novita Qhabibi, Faqrizal Ria Raynaldo, Abdul Halim Rita Hamdani Susilowati, Eliana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Teuku Heriansyah, Teuku Yasmine Fitrina Siregar