Depok, October 28, 2025 — The Doctoral Program in Epidemiology (Clinical Epidemiology Concentration), Faculty of Public Health (FPH), Universitas Indonesia (UI), held an open doctoral promotion session for Yogi Puji Rachmawan. The session was chaired by Prof. Dr. Mondastri Korib Sudaryo, M.S., D.Sc., with Prof. Drg. Nurhayati A. Prihartono, M.P.H., M.Sc., Sc.D. as Promoter, and Prof. Dr. Dr. Bambang Budi Siswanto, SpJP(K) and Dr. Dr. Helda, M.Kes. as Co-Promoters. The examination board consisted of Prof. Dr. Dr. Sabarinah Prasetyo, M.Sc.; Prof. Dr. Dr. Ratna Djuwita, M.P.H.; Dr. Dr. Habibie Arifianto, SpJP(K), M.Kes.; and Dr. Anggoro Budi H., M.Sc., Sp.PD., Ph.D., Sp.JP. The open session, conducted in a hybrid format at the Doctoral Promotion Room, FPH UI, saw Yogi successfully defend his dissertation entitled “Predictive Model for Heart Failure in Young Adults: A Retrospective Cohort Study Across Four Hospitals in Indonesia.”
Yogi began his presentation by highlighting the background of his research. Heart failure is one of the leading causes of death worldwide, affecting more than 64 million people globally. In Indonesia, the prevalence of heart failure is approximately 5% and tends to occur at a younger age compared to cases in Europe and the United States. This condition leads to a decline in quality of life, increased mortality risk, frequent rehospitalizations, and a substantial economic burden. “Heart failure in young adults is a serious issue that has often been overlooked. Risk factors begin forming during productive age, so we need predictive approaches that allow clinicians to act earlier,” explained Yogi during his dissertation defense.
The study employed a retrospective cohort design involving patients aged 18–54 years treated at four cardiovascular referral hospitals in Indonesia: National Cardiovascular Center Harapan Kita (Jakarta), Dr. Hasan Sadikin General Hospital (Bandung), Sebelas Maret University Hospital (Solo), and H. Adam Malik General Hospital (Medan). A total of 321 patients without prior history of heart failure were followed longitudinally from 2021 to 2024. Data analysis was conducted using the Generalized Linear Model (GLM) Poisson approach to identify significant risk factors and develop a predictive model and risk scoring system for heart failure in young adults.
The results showed that over the four-year observation period, approximately 28.7% of patients developed heart failure, with survival probability declining from 0.988 to 0.713. The incidence rate was 9.58 cases per 100 person-years. Multivariate analysis identified three major risk factors significantly associated with early-onset heart failure: obesity (1.87 times higher risk), dyslipidemia (2.58 times higher risk), and Type 2 Diabetes Mellitus (T2DM) (2.79 times higher risk).
Based on these findings, Yogi developed the IDD (BMI–Dyslipidemia–T2DM) scoring system — a simple, practical, and reliable risk prediction tool with strong discriminatory ability (AUC = 0.827). The total score ranges from 0 to 13, corresponding to heart failure probabilities from 10.3% (score 0) to 76.8% (score 13). A cut-off score of ≥5 demonstrated 85.9% sensitivity and 75.1% specificity in predicting heart failure among young adults. Yogi recommended external validation of the IDD score in broader populations, integration of biomarkers and imaging parameters to enhance accuracy, and the development of a digital risk calculator application for use by general practitioners and patients in daily practice.
“These findings emphasize that metabolic factors such as obesity, dyslipidemia, and diabetes are key risk determinants of heart failure in young adults. Using the IDD scoring system, we can conduct early screening at the primary care level through simple BMI measurements, lipid profile tests, and diabetes assessments,” Yogi explained. The predictive model can also serve as a foundation for clinicians and public health professionals to initiate early preventive interventions, support national NCD (Non-Communicable Disease) programs in identifying high-risk populations, and assist researchers and policymakers in developing population-based early detection and prevention strategies for heart failure.
Based on his dissertation results, Yogi Puji Rachmawan was awarded the title of Doctor in Epidemiology with cum laude distinction. He became the 133rd doctoral graduate in Epidemiology and the 479th doctoral graduate of FPH UI. (Promovendus)