Profil serum amyloid a pada pasien unstable angina pectoris dan infakr miokard akut di RSUP Dr. Sardjito Yogyakarta

YUSNITASARI, dr. Setyawati; Sp.PK(K)

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Sindrom koroner akut merupakan masalah kesehatan utama, dan salah satu penyebab kematian didunia. Hampir sepertiga dari seluruh kematian di dunia tahun 2001 adalah penyakit kardiovaskuler. Diperkirakan pada tahun 2020, setiap tahunnya akan terdapat 25 juta kematian akibat penyakit kardiovaskuler dan hampir separuhnya akibat penyakit jantung koroner Protein serum amyloid A (SAA) merupakan protein fase akut yang dihasilkan hepar, sebagai respon terhadap stimuli inflamatorik akut dan kronis dan kadarnya meningkat hingga mencapai 1000 kali lipat. Serum Amyloid A menurunkan kinerja HDL dengan berperan sebagai protein utama HDL menggantikan Apo A-1. Serum Amyloid A menghambat esterifikasi kolesterol dan menurunkan kemampuan antiaterogenik HDL. Tujuan penelitian ini adalah perbedaan kadar serum amyloid A pada pasien unstable angina pectoris dan infark miokard akut di RSUP Dr. Sardjito Yogyakarta. Metode penelitian adalah cross sectional, subyek penelitian 60 yang diambil secara konsekutif di RSUP. DR. Sardjito, Yogyakarta yaitu penderita unstable angina pectoris dan infark miokard akut di bangsal ICCU bagian Kardiologi yang terbukti secara elektrokardiografi dan pemeriksaan enzim jantung di RSUP. DR. Sardjito, Yogyakarta. sedangkan SAA diukur dengan metode sandwich ELISA. Data karakteristik subyek penelitian ditampilkan secara deskritif. Dilakukan uji rerata kadar SAA pada kelompok unstable angina dan infark miokard akut. Uji beda rerata dilakukan dgn menggunakan t-test atau Mann-Whitney test dan ANOVA test atau Kruskall Wallis test. Perhitungan statistik menggunakan batas kemaknaan p<0,05 dengan interval kepercayaan 95%. Hasil penelitian ini diharapkan bahwa terdapat perbedaan kadar serum amyloid A antara pasien unstable angina pectoris dan infark miokard akut di RSUP Dr Sardjito Yogyakarta. Pada pasien infark miokard akut kadar serum amyloid A lebih tinggi dibandingkan dengan unstable angina pectoris.

Acute coronary syndrome is a major health problem, and one of the most common cause of mortality worldwide, as approximately one third of all death in 2001 was caused by cardiovascular disease. It is estimated that in 2020, there will be 25 millions of death annually as the result of cardiovascular disease and almost half of will be caused by coronary heart disease. Serum amyloid A (SAA) protein is an acute phase protein that is produced by the liver, in response to acute and chronic inflammatory stimuli and its level can reach as high as 1000 fold. Serum Amyloid A attenuate HDL performance by replacing Apo A-1 as the major protein of HDL. Serum Amyloid A inhibits the cholesterol esterification and lowers the HDL antiatherogenic ability. The objective of this study is to assess the level of serum amyloid A level in patients with unstable angina pectoris and acute myocardial infarction in Dr. Sardjito Hospital Yogyakarta. This is a cross sectional study, with as many as 60 subjects will be entered in the study from Dr. Sardjito Hospital, Yogyakarta. These subjects are the patients with unstable angina pectoris and acute myocardial infarction who is treated in ICCU, department of cardiology, with documented electrocardiography and cardiac enzyme measurement in DR. Sardjito Hospital, Yogyakarta. Meanwhile, SAA will be measured with sandwich ELISA method. The subject’s characteristic data will be presented as the result from descriptive analysis. The mean of SAA level in unstable angina and acute myocardial infarction will be compared. The difference of means will tested with t-test or Mann-Whitney test and ANOVA test or Kruskall Wallis test with significance level of p<0,05 and 95% confidence interval. It is expected that the study would indicate a difference of serum amyloid A level between patients with unstable angina pectoris and acute myocardial infarction in Dr Sardjito Hospital, Yogyakarta. Patients with acute myocardioal infarction may be higher in SAA level compared with patients with unstable angina pectoris.

Kata Kunci : Nyeri dada,Infark miokard akut,STEMI,NSTEMI,Serum amyloid A,Unstable angina pectoris