HUBUNGAN KADAR VASCULAR ENDOTHELIAL GROWTH FACTOR A DENGAN TINGKAT KEPARAHAN CHRONIC LIMB THREATENING ISCHEMIA

Billy Aditya Pratama, dr. Muhamad Taufik Ismail, Sp.JP(K); Dr. dr. Hariadi Hariawan, Sp.PD(K), Sp.JP(K)

2023 | Tesis-Spesialis | ILMU PENYAKIT JANTUNG DAN PEMBULUH DARAH

Latar Belakang: Chronic limb threatening ischemia (CLTI) merupakan spektrum akhir dari penyakit arteri perifer (PAP) dan telah menjadi permasalahan kesehatan saat ini dengan tingginya angka amputasi dan kematian. Sampai saat ini belum adanya suatu biomarker yang dapat memprediksi keparahan hingga menentukan prognosis amputasi dan kematian.

Tujuan Penelitian: Mengetahui hubungan kadar Vascular Endothelial Growth Factor A dengan tingkat keparahann Chronic Limb Threatening Ischemia.

Metode Penelitian: Penelitian ini merupakan studi observasional analitik dengan desain cross sectional. Penelitian ini dilakukan pada pasien CLTI yang menjalani rawat inap di RSUP Dr. Sardjito Yogyakarta periode Juli 2021 – Februari 2023.

Hasil: Terdapat 42 subjek yang memenuhi kriteria inklusi dan eksklusi. Sebanyak 27 (64%) subjek merupakan laki-laki dengan rerata usia 65±13 tahun. Mayoritas subjek 24 (57%) memiliki tingkat keparahan CLTI pada derajat IV, derajat I sebanyak 6 (14%), derajat II sebanyak 4 (10%) dan derajat III sebanyak 8 (19%). Median kadar VEGF A pada derajat I sebesar 18,5 (4,9–35,3) pg/ml, derajat II sebesar 39 (24,7–60,3) pg/ml, derajat III sebesar 61,9 (49,8–76,7) pg/ml dan derajat IV sebesar 160 (68,4–644) pg/ml. Terdapat perbedaan bermakna antara kadar VEGF A dengan tingkat keparahan CLTI (p=0,000). Hasil uji menunjukkan korelasi kuat kadar VEGF A dengan tingkat keparahan CLTI (r=0,865).

Kesimpulan: Terdapat hubungan positif kadar Vascular Endothelial Growth Factor A dengan tingkat keparahan Chronic Limb Threatening Ischemia

Background: Chronic limb threatening ischemia (CLTI) is the end spectrum of peripheral arterial disease and has become a current health problem with high rates of amputation and death. However, there is no biomarker that can predict the severity and determine the prognosis of amputation and death.

Objective: To determine relationship between Vascular Endothelial Growth Factor A levels with the severity of Chronic Limb Threatening Ischemia.

Methods: It was an analytical observational study with a cross sectional design. The study was conducted on CLTI patients who hospitalized in Dr. Sardjito Yogyakarta Hospital from July 2021 to February 2023.

Results: There were 42 patients (mean age 65±13 years, 27 (64%) male who met the inclusion and exclusion criteria. The majority of subjects 24 (57%) had CLTI severity at grade IV, grade I was 6 (14%), grade II was 4 (10%) and grade III was 8 (19%). The median level of VEGF A in grade I was 18,5 (4,9–35,3) pg/ml, grade II was 39 (24,7–60,3) pg/ml, grade III was 61,9 (49,8–76,7) pg/ml and grade IV was 160 (68,4) –644) pg/ml. There was a significant difference between VEGF A levels and CLTI severity (p=0,000). The test results showed a strong correlation between VEGF A levels and the severity of CLTI (r=0,865).

Conclusion: There is a positive relationship between Vascular Endothelial Growth Factor A levels with the severity of Chronic Limb Threatening Ischemia

Kata Kunci : Vascular Endothelial Growth Factor A, Chronic Limb Threatening Ischemia, Penyakit Arteri Perifer