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Journal : Majalah Kedokteran Bandung

Association between Neutrophil-Lymphocyte Count Ratio and Matrix Metalloproteinase-9 in Patients with Acute Myocard Infarction Tiksnadi, Badai Bhatara; Akbar, Muhammad Rizki; Yahya, Achmad Fauzi; Hidayat, Syarief; Purnomowati, Augustine; Aprami, Toni Mustahsani
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (614.44 KB) | DOI: 10.15395/mkb.v51n1.1405

Abstract

The correlation between metalloproteinase-9 (MMP-9) level and neutrophil-lymphocyte count ratio (NLCR) in AMI patients has not been studied despite the fact that they are both known to predict ventricular remodeling. This study aimed to evaluate the correlation between the MMP-9 level and NLCR in patients with acute myocardial infarction. A cross-sectional study was conducted by recruiting acute coronary syndrome patients (onset within 24 hours) who were admitted to the emergency department in several hospitals around Bandung during October-December 2012. The relationship between the MMP-9 level and NLCR was analyzed using Pearson correlation test. Linear regression analysis was used to measure the strength of NLCR in MMP-9 level prediction. Thirty seven patients aged 55.8 + 11 years old were included in this study with mostly male patients (78%). Seventy-six percents of the sample were ST-elevation myocardial infarct (STEMI) patients with the onset of symptoms of 6 (3-14) hours. The mean lymphocyte-neutrophil ratio was 5.24 (1σ±2.4) and the MMP-9 plasma concentration was 370 (240-530) ng/mL. One-sided Pearson correlation showed a positive correlation between the two variables (r=0.44, p=0.003). The linear regression analysis conceived the formula of MMP-9 = 40.87 (NLCR) + 211.3 which was used to show the relationship between the MMP-9 level and lymphocyte-neutrophil ratio. There was a positive moderate correlation between the MMP-9 level and NLCR in patients with AMI. Linear regression analysis shows that NLCR is the only independent variable to predict the MMP-9 plasma level.Key words: Acute myocardial infarct, left ventricular remodeling, matrix metalloproteinase (MMP)-9, neutrophyl-lymphocyte count Ratio (NLCR) Korelasi Rasio Neutrofil-Limfosit (NLCR) dengan Kadar Matriks Metaloproteinase-9 pada Penderita Infark Miokardium AkutKorelasi antara matriks metaloproteinase-9 (MMP-9) dan rasio netrofil-limfosit masih belum pernah dipelajari, meskipun kedua variable tersebut diketahui dapat memprediksi remodeling ventrikel kiri. Studi ini bertujuan mengevaluasi korelasi antara kadar MMP-9 dan rasio netrofil-limfosit pada penderita infark miokardium akut. Penelitian dilakukan secara potong lintang menggunakan sampel darah pasien dengan diagnosis kerja infark miokardium akut (IMA) (onset nyeri dada <24 jam) yang diambil dari beberapa rumah sakit di sekitar Kota Bandung dari periode Bulan Oktober–Desember 2012. Hubungan antara kadar MMP-9 dan rasio neutrofil leukosit dianalisis menggunakan uji korelasi Pearson. Analisis regresi linier digunakan untuk mengukur kekuatan pengaruh konsentrasi rasio neutrofil-limfosit pada kadar MMP-9. Sebanyak 37 pasien berusia 55,8 +11 tahun, dan 78% di antaranya adalah pria menjadi subjek dalam penelitian ini. Tujuh puluh enam persen sampel diantaranya merupakan pasien infark miokardium dengan elevasi ST dengan onset gejala 6 (3–14) jam.  Rerata rasio limfosit-neutrofil adalah 5,24 (1σ ±2,4), dan kadar konsentrasi MMP-9 sebesar 370 (240–530) ng/ml. Uji Korelasi Pearson menunjukkan hubungan positif antara kedua variabel tersebut dengan nilai r=0,44 (p=0,003).  Dari analisis regresi linier didapatkan rumus MMP-9= 40,87 (NLCR) + 211,3, yang digunakan untuk menunjukkan hubungan antara kadar MMP-9 dan rasio limfosit-netrofil. Terdapat hubungan positif antara kadar MMP-9 dan rasio neutrofil-limfosit pada pasien penderita IMA. Analisis regresi linier menunjukkan bahwa hanya rasio neutrofil-limfosit yang menjadi variabel prediktor independen kadar MMP-9.Kata kunci: Infark neutrofil akut, matriks-metaloproteinase 9 (MMP-9), rasio limfosit-neutrofil, remodeling ventrikel kiri
HUBUNGAN KADAR LEPTIN SERUM DENGAN KOMPLEKSITAS LESI KORONER BERDASARKAN SKOR SYNTAX PADA PENDERITA PENYAKIT ARTERI KORONER STABIL Ashari, Fajar; Aprami, Toni Mustahsani; Akbar, Muhammad Rizki; Purnomowati, Augustine; Martha, Januar Wibawa; Achmad, Chaerul; Martanto, Erwan
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (165.975 KB) | DOI: 10.15395/mkb.v48n1.730

Abstract

Leptin memiliki peran penting dalam pembentukan plak ateroskleosis dengan mengaktifkan respons sel imun dan respons inflamasi ataupun peran langsung terhadap dinding pembuluh darah koroner. Penelitian terdahulu mengenai hubungan antara kadar leptin serum dan kompleksitas lesi koroner masih menunjukkan kontroversi. Penelitian ini bertujuan mengetahui hubungan antara kadar leptin serum dan kompleksitas lesi koroner berdasarkan skor SYNTAX pada penderita penyakit arteri koroner stabil. Metode penelitian berupa observasional, deskriptif, dan analisis korelasi dengan rancangan potong lintang. Subjek penelitian sebanyak 44 orang penderita penyakit arteri koroner (PAK) stabil yang memenuhi kriteria inklusi, menjalani pemeriksaan angiografi koroner di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Januari?Mei 2014. Pengambilan sampel darah untuk pemeriksaan kadar leptin serum dilakukan sebelum tindakan angiografi. Kompleksitas lesi arteri koroner dinilai menggunakan skor SYNTAX. Hasil penelitian didapatkan subjek penelitian 84% laki-laki dengan usia rata-rata 54,68 (+10,24) tahun. Indeks massa tubuh rata-rata 24,71 (+ 3,05) kg/m2. Faktor risiko terbanyak adalah dislipidemia (84%), merokok (72%), hipertensi (38,4%), diabetes melitus (22,7%), dan obesitas (4,5%). Median kadar leptin serum 7.242 (780?36.929) pq/mL, nilai rata-rata skor SYNTAX sebesar 19,52 (+9,93). Analisis menggunakan uji korelasi rank-Spearman tidak didapatkan hubungan (p=0,61; r= 0,078). Perbedaan hasil penelitian ini dengan penelitian sebelumnya disebabkan oleh perbedaan subjek dan kriteria penilaian kompleksitas lesi arteri koroner. Simpulan, tidak terdapat hubungan antara kadar leptin serum dan kompleksitas lesi koroner berdasarkan skor SYNTAX pada penderita penyakit arteri koroner stabil. [MKB. 2016;48(1):26?31]Kata kunci: Kompleksitas lesi koroner, leptin serum, penyakit arteri koroner stabil, skor SYNTAXCorrelation between Serum Leptin Levels and Complexity of Coronary Artery Lesion based on SYNTAX Score in Patients with Stable Coronary Artery DiseaseAbstractLeptin has been shown to play a potential role in the atherosclerotic plaque formation by activating immune and inflammatory cells or directly acting on the vessel wall. Earlier reports of the correlation of serum leptin levels with the degree of coronary lesion stated are still controversial. This study determined the correlation between serum leptin levels and complexity of coronary artery lesion in patients with stable coronary artery disease (SCAD). This is an observational cross-sectional study. Data were collected from January to May 2014 in Dr. Hasan Sadikin Central General Hospital Bandung. Blood samples were collected before angiography procedures. The complexity of coronary artery lesion was assessed using SYNTAX score. There were 44 patients who met inclusion criteria, male 84%, median age 54.68 (+10.24) years. Mean body mass index 24.71 (+ 3.05) kg/m2. Dyslipidemia was the most common risk factor (84%), followed by smoking (72%), hypertension (38.4%), diabetes mellitus (22.7%), and obesity (4.5%). Median leptin level was 7,242 (780-36,929) pq/mL. Mean SYNTAX score was 19.52 (+9.93). Leptin level had no correlation with the complexity of coronary artery lesion (p=0.61, r=0.078). The difference between this study from prior studies might be caused by differences in subject selection and criteria used for complexity of coronary artery lesion. In conclusion, there is no correlation between serum leptin levels and complexity of coronary artery lesion in patients with stable coronary artery disease. [MKB. 2016;48(1):26?31]Key words: Complexity of coronary artery lesion, leptin, stable coronary artery disease, SYNTAX score