{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T20:13:56Z","timestamp":1783800836611,"version":"3.55.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100015689","name":"institut teknologi bandung","doi-asserted-by":"publisher","award":["31\/IT1.C10\/SK-KU\/2024"],"award-info":[{"award-number":["31\/IT1.C10\/SK-KU\/2024"]}],"id":[{"id":"10.13039\/501100015689","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Doxorubicin, as part of the chemotherapy regimen for breast cancer, has long been associated with cardiotoxicity, primarily manifested by a reduction in left ventricular ejection fraction (LVEF). Early detection of cardiac dysfunction is essential to prevent the progression of heart failure and ensure patient safety. This study aimed to analyze trends in LVEF reduction, the incidence of cardiotoxicity, and associated risk factors in breast cancer patients receiving doxorubicin-based chemotherapy at Dr. Hasan Sadikin General Hospital, Bandung.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of 130 patients and further reviewed the medical records. The LVEF values were obtained from echocardiographic assessments performed before and after each chemotherapy cycle. The Mann-Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test and Wilcoxon Signed Rank test were used to assess LVEF trends, while bivariate analysis was applied to evaluate the association between clinical variables and cardiotoxicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The results showed a statistically significant reduction in LVEF beginning after the third chemotherapy cycle and continuing through the sixth (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05), with a median decline of approximately 4% to 5%. The incidence of cardiotoxicity was 4.62%, with an additional 3.85% of patients classified as having borderline low LVEF. The age factor (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.047) and a history of hypertensive heart disease (HHD) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.034) showed a statistically significant association with the incidence of left ventricular dysfunction, but no factors showed a statistically significant association with the incidence of cardiotoxicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The early onset of LVEF reduction highlights the critical role of routine cardiac monitoring during chemotherapy as a preventive strategy against cardiotoxicity progression. Identification of risk factors such as older age and preexisting cardiovascular conditions is essential for risk stratification and the implementation of safer and individualized treatment approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00185787251408701","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:38:59Z","timestamp":1769060339000},"page":"386-394","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence and Predictors of Doxorubicin-Induced Cardiotoxicity in Breast Cancer Patients at a Tertiary Academic Hospital in Indonesia: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"61","author":[{"given":"Annisa Eka","family":"Fitrianti","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astri","family":"Astuti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irianti Bahana Maulida","family":"Reyaan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology - Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomi","family":"Hendrayana","sequence":"additional","affiliation":[{"name":"Department of Pharmacology - Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7486-1894","authenticated-orcid":false,"given":"Silma Aulia","family":"Rahmah","sequence":"additional","affiliation":[{"name":"Department of Pharmacology - Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kusnandar","family":"Anggadiredja","sequence":"additional","affiliation":[{"name":"Department of Pharmacology - Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-9558","authenticated-orcid":false,"given":"Zulfan","family":"Zazuli","sequence":"additional","affiliation":[{"name":"Department of Pharmacology - Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Indonesia"},{"name":"Center of Excellence for Innovative Cosmeceuticals and Natural Medicines for Degenerative Disease, Center for Pharma Valorisation, School of Pharmacy, Institut Teknologi Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Ferlay J Ervik M Lam F et al. 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