Cardiovascular disease remains a significant health problem in the Asia Pacific region. Several studies have found that dyslipidemia is a cause of morbidity and mortality and requires high medical costs. Dyslipidemia is a risk factor for atherosclerosis. The most widely used therapy for dyslipidemia is statins. Statins often cause muscle disorders such as myalgia, myopathy, and rhabdomyolysis, which can cause death. A prospective cohort study design was carried out at Airlangga University Hospital, Surabaya, from April to November 2019. A total of 26 sample pairs containing 13 samples were treated with Atorvastatin, and 13 samples were treated with Simvastatin. The subjects were examined for the creatinine kinase activity level using enzymatic methods. The mean creatinine kinase levels in the atorvastatin group before and after treatment was 105.71 IU/L and 100.03 IU/L, respectively, because the subjects were diagnosed with acute coronary syndromes and blood was collected during acute conditions. Median creatinine kinase levels in the Simvastatin group were 85.5 IU/L before therapy and 118.1 IU/L after therapy, indicating significant differences in creatinine kinase levels before and after treatment. Simvastatin is very susceptible to certain drug interactions that can increase the concentration of statins in the serum. There were differences in levels of creatinine kinase activity before and after Simvastatin therapy but not Atorvastatin.

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Cardiovascular disease is still a serious problem in the world of health. Life expectancy after being diagnosed with heartfailure is 50% and 10% for 5 and 10 years. Steroid hormones such as Dehydroepiandrosterone (DHEAS) havecardioprotective effects by inhibiting the formation of atherosclerotic plaque, pulmonary artery vasodilators, and protectingcardiomyocytes. DHEAS levels decrease with age. Decreased DHEAS levels are associated with an increased risk ofcardiovascular disease. This study aimed to know the relationship between DHEAS levels in serum and ejection fractions inheart failure patients. This cross-sectional study used a sample of 34 people aged > 30 years who had been diagnosed withheart failure by a specialist in the Department of Cardiology and Vascular Medicine. The diagnosis of heart failure usesEchocardiography to determine the ejection heart fraction. DHEAS levels were taken from venous blood and examinedusing the CLEIA method with an IMMULITE device (Siemens Healthineers, Germany). Statistical analysis was performed bySpearman correlation test, with a significance level of p < 0.05. Thirty-four research subjects found that 13 patients had anejection fraction of 40% (Heart Failure with Reduced Ejection Fraction/HFrEF), 12 patients had an ejection fraction of 41-49%(borderline) and 9 patients had an ejection fraction of ≥ 50% (Heart Failure with Preserved Ejection Fraction/HFpEF).Spearman correlation test results obtained a correlation coefficient or r=0.357 with a value of p=0.038, which meant therewas a significant relationship between DHEAS with ejection fraction (p < 0.05). The lower the DHEAS level, the ejectionfraction would also be lower. Further with age, DHEAS levels get lower. The lower the DHEAS level, the lower the ejectionfraction.

Endothelial dysfunction is a key mechanism in the pathogenesis of complications of cardiovascular disease in Diabetes Mellitus (DM) patients. One of the new biomarkers for inflammatory conditions and endothelial dysfunction is endocan. This study aimed to determine the correlation between endocan levels and HbA1c in type 1 DM patients. This study was an analytical observational study with a cross-sectional approach performed at the Dr. Saiful Anwar Hospital, Malang from May to August 2019. The research subjects were children aged 10-18 years with a diagnosis of type 1 DM who met the inclusion criteria. Students who underwent routine health checks participated as the control group. In both groups, serum endocan levels were measured using the ELISA method and HbA1c levels were measured by the HPLC method. Independent T-test analysis was used to determine the differences between both groups and the Pearson test was used to determine the correlation between serum endocan and HbA1c with SPSS version 23. In this study, there were 40 type 1 DM patients and 40 healthy controls with a mean age of 14.5 (3.16) years in the type 1 DM group and 14.7 (0.99) years in the healthy control group. There was a higher number of female subjects in both the type 1 DM group (57.5%) and the healthy control group (65%). The mean endocan level in the type 1 DM group was higher than the control group and was statistically significant with 1090.61 (150.84) pg/mL vs. 775.56 (8.91) pg/mL, p=0.000). The mean value for HbA1c levels in the type 1 DM group was also significantly higher compared to the control group 9.63 (2.22%) vs. 4.69 (0.251%), p <0.001), respectively. There was a significant positive correlation between endocan levels and HbA1c in DM patients (p=0.025, r=0.354). This study showed a correlation between serum endocan levels and HbA1c in patients with type 1 DM.