PENGARUH RESISTIN TERHADAP KEJADIAN KARDIOVASKULAR PADA PASIEN SINDROM KORONER AKUT DENGAN SKOR GRACE RISIKO SEDANG DI RSUP DR SARDJITO YOGYAKARTA
RIZKI AMALIA GUMILANG, Dr. Nahar Taufiq, Sp.JP (K)
2014 | Tesis | SP KARDIOLOGI DAN KEDOKTERAN VASKULARPada penelitian sebelumnya dipaparkan tentang peran penanda inflamasi pada prediksi kejadian kardiovaskular pada SKA berdasarkan Skor GRACE. Resistin sebagai salah satu penanda inflamasi memiliki keterkaitan dengan kejadian kardiovaskular pada SKA namun perannya terhadap kejadian kardiovaskular berdasarkan Skor GRACE belum pernah diteliti. Skor GRACE memiliki tiga stratifikasi risiko rendah, sedang dan tinggi, telah ada penelitian mengenai peran penanda inflamasi pada stratifikasi rendah namun belum didapatkan studi tentang peran penanda inflamasi seperti resistin pada Skor GRACE risiko sedang. Berdasarkan hal tersebut maka penelitian ini bertujuan untuk mengetahui peran resistin sebagai salah satu penanda inflamasi, terhadap kejadian kardiovaskular pada SKA dengan Skor GRACE risiko sedang. Penelitian potong lintang ini melibatkan sebanyak 63 subyek SKA yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pengambilan sampel darah untuk pengukuran kadar resistin dalam 24 jam pasca awitan serangan dan kadar resistin tersebut dikelompokkan berdasarkan median. Kejadian kardiovaskular didefinisikan sebagai kematian, kejadian iskemik, gagal jantung akut dan aritmia yang terjadi pertama kali dalam observasi selama perawatan di rumah sakit. Kejadian kardiovaskular lebih tinggi secara bermakna pada kelompok kadar resistin di atas median 23,8% dibandingkan kelompok kadar resistin dari median ke bawah 11,1% (RO 3,348, 95% IK 1,125-10,007 p=0,027). Simpulan: Kadar resistin tinggi memiliki pengaruh terhadap kejadian kardiovaskular yang tinggi pada populasi SKA dengan Skor GRACE risiko sedang.
Previous study revealed that there were role of inflammatory biomarkers in clinical outcome of acute coronary syndrome and also for prediction of cardiovascular events by GRACE Score. Resistin belongs to inflammatory biomarker also had a role in clinical outcome of acute coronary syndrome but its role in clinical outcome regarding GRACE Score risk stratification is unknown. There are three risk stratification of acute coronary syndrome based on GRACE Score, low, intermediate and high. There were study stated that inflammatory biomarker had a role in cardiovascular events predicted by low risk score, but the role of that biomarker in intermediate risk still need to be elucidated. Thus, the aim of this study is to know the role of resistin as inflammatory biomarker, towards cardiovascular events of acute coronary syndrome patiets with intermediate risk GRACE Score. A cross sectional study was designed for this study. A-sixty-three acute coronary syndrome whom fulfilled the inclusion criteria participated on this study. Blood sample was drawn at 24 hours after onset and resistin level was analyzed and classified according to median. A cardiovascular event was defined as death, ischemic events, acute heart failure or aritmia which were firstly occurred in observation time during hospitalization. Cardiovascular events was significantly higher in resistin level higher than median 23,8% compared to resistin level from median up to the lowest 11,1 % (OR 3,348, 95%CI 1,125-10,007 p=0,027).Conclusion : High resistin level had role towards high cardiovascular events of acute coronary syndrome with intermediate risk GRACE Score.
Kata Kunci : resistin, kejadian kardiovaskular, sindrom koroner akut, skor GRACE
