Hubungan antara peningkatan kadar homosistein dengan kadar malondialdehid pada infark miokard akut

TJAHJONO, Warih, dr. Bambang Irawan, SpPD-KKV

2006 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar Belakang. Peningkatan kadar homosistein berhubungan dengan risiko infark miokard akut (IMA), kejadian reinfark dan ratio kematian kardiovaskuler. Hiperhomosistein meningkatkan peroksidasi lipid yang kan menghasilkan aldehid seperti malondialdehid (MDA). Beberapa penelitian sebelumnya masih memperdebatkan hubungan antara hiperhomosistein dan MDA ini sehingga masih menjadi pertanyaaan tentang pengaruh hiperhomosisteinemia terhadap terjadinya peroksidasi lipid pada IMA. Tujuan Penelitian. Penelitian ini bertujuan untuk mengetahui hubungan antara peningkatan kadar homosistein total dengan kadar malondialdehid pada penderita infark miokard akut. Metode dan Rancangan Penelitian. Penelitian dilakukan secara potong lintang, terhadap pasien infark miokard akut yang dirawat di bangsal ICCU RS Dr. Sardjito. Subyek penelitian penderita infark miokard akut dengan manifestasi serangan yang pertama kali. Pengambilan sampel secara berurutan dan menggunakan sampel darah puasa. Uji U dan uji t untuk analisa univariat. Hasil. Subyek penelitian 35 orang IMA dengan 34 orang hiperhomosisteinemia dan 1 orang homosistein normal. Didapatkan rata-rata usia 61,83 ± 10,89 tahun. Analisis bivariat terhadap MDA menggunakan nilai cut-off homosistein berdasarkan distribusi sampel. Didapatkan median beda kadar MDA sebesar 1,08 pada homosistein cut-off 37,32 μmol/L ( men + 1 SD) dan 47,65 μmol/L (mean+2SD), P = 0,035. analisis bivariat terhadap faktor pengganggu tidak menunjukkan kemaknaan. Simpulan. Kadar MDA dalam kondisi hiperhomosisteinemia (cut off = > 37,32 μmol/l dan >47,65 μmol/l) lebih tinggi dibanding kadar MDA yang kurang dari nilai cut off di atas pada infark miokard akut namun tidak ada hubungan antara hiperhomosisteinemia dengan MDA.

Background. Increasing of homocysteine levels is related to acute myocardial infarction (AMI), reinfarction and cardiovascular death ratio. Hyperhomocysteine increases lipid peroxidation that will result in aldehyde such as malondialdehyde (MDA). Some previously researches are still debating on relationship between hyperhomocysteine and MDA, so there is a question on influence of hyperhomocysteine to the lipid peroxidation in AMI. Objective. This Study aimed to know relationship between increasing of total homocysteine to MDA levels in AMI patients. Methods and Design. This is a cross-sectional study, in AMI patients in ICCU wards Dr. Sardjito Hospital, Jogjakarta. Subjects were AMI patients with first attack events. We took consecutive samples and used fasting blood sampling. U test and t test were used for univariate analysis. Results. There were 35 AMI patients, 34 with hyperhomocysteinemia and 1 normal homocysteine levels. We found mean age 61.83±10,89 years. Bivariate analysis to MDA levels used cut-off point for homocysteine based on sampling distribution. There were median different of MDA levels by 1.08 for homocysteine cut-off 37,32 μmol/l (mean±1SD) and 47,65 μmol/l (mean±2SD), (p=0.035). There was no relationship between hyperhomocysteine and malondialdehyde levels in AMI patients. Conclusion. MDA levels in hyperhomocysteinemia (cut-off >37.32 μmol/l and >47,65 μmol/l) was higher than MDA levels in homocysteine condition less than above cut-off point in AMI patients, but there was no relationship between hyperhomocysteine and malondialdehyde levels.

Kata Kunci : Infark Miokard AKut,Kadar Homosistein dan Malondialdehid, Hyperhomocysteinemia, malondialdehyde, acute myocardial infarction