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All Journal Indonesian Journal of Cardiology CRJIM (Clinical and Research Journal in Internal Medicine)
Aditya, Muhammad Reva
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Could Cardiac Shockwave Therapy be the Breakthrough Solution for Refractory Angina? A Systematic Review and Meta-Analysis Pramesuari, Florentina Dewi; Aditya, Muhammad Reva; Mahbubi, Mustika
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1851

Abstract

Background: Refractory angina (RA) is a chronic condition unresponsive to standard treatments like PCI or CABG, leaving limited options for many patients. Cardiac shockwave therapy (CSWT) is a novel, noninvasive approach that enhances myocardial perfusion through microvascular regeneration. This systematic review and meta-analysis evaluate the effectiveness of CSWT in managing RA. Methods: A comprehensive literature search was conducted using electronic databases (Cochrane, PubMed, and ScienceDirect), including comparative studies with controls that evaluated CSWT in RA patients between 2010 and 2024. Studies not in English, with irrelevant outcomes, or lacking full-text access, were excluded. Data were extracted and analyzed using a random-effects model to address heterogeneity. Results: Seven studies, including 3 randomized controlled trials (RCTs) and 4 observational studies, with a total of 417 patients were analyzed. CSWT demonstrated significant improvements in multiple clinical outcomes. CSWT reduces angina severity in CSWT reduces angina severity in CCS grade (MD -0.76, 95% CI -0.97, -0.55, P < 0.00001) and in NYHA class (MD -0.62, 95% CI -0.95, -0.30, P = 0.0002), increased the 6- Minute Walk Test (6MWT) distance by 57.63 meters (MD 57.63, 95% CI 16.71, 98.54, P = 0.006), increased SAQ scores by 10.96 points (MD 10.96, 95% CI 1.66, 20.26, P = 0.02), improved LVEF by 4.43% (MD 4.43, 95% CI: 2.66 to 6.21, P< 0.01), and decreased nitroglycerin usage by 1.62 intake per week (MD -1.62, 95% CI -2.61, -0.62, P = 0.001). However, there was no significant difference in LVEDD between the two groups. Conclusion: CSWT appears to be a promising therapeutic option for patients with RA, demonstrating improvement in CCS angina class, NYHA class, 6-min walk test distances, SAQ score, LVEF, and reduces nitroglycerin usage. Keyword: Cardiac Shockwave Therapy, Refractory Angina, Non-invasive Cardiac Therapy, Chronic Angina Treatment, Innovative Angina Therapies
Pellagra Syndrome in Geriatric Patient: Insights from Pathogenesis and Diagnosis Raharjo, Fajar Maulana; Soenarti, Sri; Winoto, Eden Suryoiman; Adriansyah, Vito; Aditya, Muhammad Reva
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.14

Abstract

Pellagra syndrome is a chronic niacin deficiency disease that is often underdiagnosed. We report a case of an 83-year-old woman presenting with the four classic symptoms (4D) of pellagra: dermatitis (Casal’s necklace), diarrhea, dementia, and a risk of death if left untreated. The patient also had severe malnutrition, multiple infections, and a history of stroke for five years. The diagnosis was established based on clinical findings and a history of inadequate nutritional intake. Management included fluid therapy, antibiotics, medical rehabilitation, enteral and parenteral nutrition, as well as niacin supplementation. Following treatment, the patient showed clinical improvement, including stabilization of hemoglobin levels. This case highlights the importance of early detection and understanding the pathogenesis of Pellagra syndrome to improve patient outcomes and quality of life. Keywords: Casal’s Necklace, Dementia, Malnutrition, Niacin, Pellagra syndrome
Co-Authors Adriansyah, Vito Mahbubi, Mustika Pramesuari, Florentina Dewi Raharjo, Fajar Maulana Sri Soenarti Winoto, Eden Suryoiman