Perbedaan Kadar Serum Endothelin-1 pada Pasien Infark Miokard Akut Dengan dan Tanpa Hiperglikemia

ADITYA DONI PRADANA, DR. dr. Budi Yuli Setianto, Sp.PD-KKV, Sp.JP(K); dr. Anggoro Budi Hartopo, M.Sc., Sp.PD, Ph.D

2014 | Skripsi | PENDIDIKAN DOKTER

Latar belakang : Tingginya kadar glukosa darah sebanding dengan peningkatan kadar endothelin-1. Endothelin-1 merupakan suatu peptida yang berperan dalam terjadinya atherogenesis melalui mekanisme vasokonstriksi dan pertumbuhan sel-sel otot polos vaskular. Pada pasien IMA didapatkan peningkatan kadar endothelin-1. Penelitian ini bertujuan untuk mengevaluasi perbedaan kadar serum endothelin-1 pasien IMA dengan dan tanpa hiperglikemia. Metode : Desain penelitian adalah studi potong lintang. Pengambilan sampel dilakukan secara berurutan dari pasien IMA yang dirawat di bagian ICCU RSUP Dr. Sardjito, Yogyakarta. Pengukuran endothelin-1 dan glukosa darah sewaktu dilakukan satu kali sebelum dilakukan trombolisis dari darah vena. Uji kadar endothelin-1 dilakukan menggunakan metode ELISA. Perbedaan rerata kadar endothelin-1 diuji dengan menggunakan Mann Whitney. Angka kemaknaan yang diterima adalah p , 0,05. Hasil : Terdapat 84 subjek, yang terdiri dari 48 IMA dengan hiperglikemia dan 36 IMA tanpa hiperglikemia. Rerata kadar glukosa darah terdapat perbedaan bermakna antara kelompok IMA dengan hiperglikemia dan IMA tanpa hiperglikemia (242,65 + 102,16 vs. 114,36 + 14,89, p = 0,00). Rerata kadar endothelin-1 pada pasien IMA dengan hiperglikemia tidak terdapat perbedaan bermakna dibanding pasien IMA tanpa hiperglikemia (3,19 + 1,77 vs. 2,84 + 1,34, p = 0,59). Kesimpulan : Tidak terdapat perbedaan bermakna kadar endothelin-1 pada pasien IMA dengan hiperglikemia terhadap pasien IMA tanpa hiperglikemia.

Background : High blood glucose level are proportional to the increasing level of endothelin-1. Endothelin-1 is a peptide which plays a role in atherogenesis through vasoconstriction mechanism and vascular smooth muscle cell growth. In patients with AMI found elevated levels of endothelin-1. This study aimed to evaluate if there was any difference between the plasma endothelin-1 levels of AMI patients with and without hyperglycemia. Methods : This research design was cross-sectional. Sample was recruited in consecutive patients admitted to ICCU of Dr. Sardjito Hospital, Yogyakarta. The measurement of endothelin-1 and plasma glucose level from venous blood sample was done before thrombolysis. The serum level of endothelin-1 was measured with ELISA method. Mann Whitney test was used to compare endothelin-1 levels between AMI patients with and without hyperglycemia. A statistical significance was considered when p < 0,05. Results : There are 84 subjects, consist of 48 AMI patients with hyperglycemia and 36 AMI patients without hyperglycemia. Glucose plasma level was a mean of 242,65 + 102,16 and 114,36 + 14,89 in AMI patients with hyperglycemia and without hyperglycemia respectively. The difference between groups was significant (p < 0,05). The difference of endothelin-1 serum level was not significant between AMI patients with hyperglycemia and without hyperglycemia (3,19 + 1,77 vs. 2,84 + 1,34, p = 0,59). Conclusion : No significant differences in serum endothelin-1 levels between AMI patients with hyperglycemia and without hyperglycemia.

Kata Kunci : hyperglycemia, acute myocardial infarction, endothelin-1