ABSTRAKLatar Belakang:
Kadar hsCRP berhubungan dengan mayor adverse cardiac events. Pada PJK stabil,
hubungan antara kadar hsCRP dengan skor SYNTAX sebagai gambaran derajat
aterosklerosis koroner belum jelas.
Tujuan :
Mengetahui hubungan antara kadar hsCRP dengan skor SYNTAX pada penderita
PJK stabil, dan mengetahui titik-potong kadar hsCRP yang dapat membedakan
antara kelompok skor SYNTAX rendah dengan yang tinggi.
Metode:
Observasional potong-lintang pada consecutive 93 subjek penderita PJK stabil
dewasa yang menjalani angiografi koroner di RSUPNCM pada bulan Mei sampai
September 2018, untuk memperoleh skor SYNTAX. Diambil darah dari arteri
perifer sebelum tindakan angiografi untuk pemeriksaan hsCRP dan laboratorium
dasar. Dieksklusi penderita infeksi berat, trauma, PGK, sirosis hati, keganasan,
pengobatan steroid. Selanjutnya data dikumpulkan dan dianalisis. Skor SYNTAX
dikelompokkan tinggi bila > 27, dan rendah bila nilai < 27. Untuk menilai titikpotong
kadar hsCRP dipakai uji Sperman karena distribusi data tidak normal.
Hasil:
Ditemukan rerata umur 60,23 tahun (SB 8,984), IMT 26,30 Kg/m2 (SB 3,903), kol-LDL
117,74 mg/dL (SB 36,31). Kadar hsCRP dan skor SYNTAX tidak dipengaruhi oleh
IMT atau kol-LDL (hsCRP-IMT: r:0,032; p:0,772; skor SYNTAX-IMT: r:-0,021;
p:0,849; hsCRP-kol LDL: r:-0,149; p:0,266; skor SYNTAX-kol LDL: r:0,159;
p:0,234). Ditemukan korelasi positif lemah hsCRP dengan skorSYNTAX (r:0,270;
p:0,009) dan Titik-potong pada kadar hsCRP 2,35 mg/L (sensitifitas 0,69;
spesifisitas 0,53). Nilai AUC 0,554, IK 95%, p: 0,472, merupakan diskriminasi
yang kurang baik.
Simpulan:
Pada penderita PJK stabil, kadar hsCRP berkorelasi positif lemah dengan skor SYNTAX
sebagai gambaran derajat aterosklerosis. Kadar hsCRP dengan titik-potong > 2,35 mg/L
dapat membedakan kelompok yang mempunyai skor SYNTAX rendah dengan kelompok
skor SYNTAX tinggi, namun nilai prediksinya relatif rendah.
ABSTRACTackground:
High sensitivity C-reactive protein levels are associated with mayor adverse cardiac events.
In stable CAD, the association of baseline hcCRP level with coronary atherosclerosis
severity assessed by SYNTAX score were not clear.
Objective:
To investigate the association between hsCRP level and SYNTAX score in patients with
stable CAD, and to know cut-off point of hsCRP level which can differentiated between
the group of low SYNTAX score and of high SYNTAX score.
Methods:
Cross-sectional observation to the consecutive 93 subject adult patients of stable CAD,
undergoing coronary angiography in Cipto Mangunkusumo General Hospital on May to
September 2018 to obtain SYNTAX score. The blood tests were taking from pheripheral
artery prior to carrying out of coronary angiography to obtain level of hsCRP and laboratory
data base. The exclusion were severe infection, trauma, CKD, cirrhosis hepatis,
malignancy, and steroid therapy. The SYNTAX score will be differentiated between the
group of high if the value > 27, and the group of low if the value < 27. Sperman analysis
will be used to evaluate hsCRP cut-off point.
Results:
Average age was 60,23 year (SD 8,984), BMI 26,30 Kg/m2 (SD 3,903), and LDL-chol
117,74 (SD 36,31). The Level of hsCRP and SYNTAX score were not influenced by BMI
or LDL-chol (hsCRP - BMI: r:0,032; p:0,772; SYNTAX score - BMI: r:-0,021; p:0,849;
hsCRP- LDL-chol: r:-0,149; p:0,266; SYNTAX score - LDL-chol: r:0,159; p:0,234). We
found positif corelation (weak) between hsCRP and SYNTAX Score (r:0,270; p:0,009).
Cut-off point was found in the hsCRP level 2,35 mg/L (sensitivity 0,69; spesivisity 0,53).
AUC 0,554, CI 95%, p: 0,472, were the poor discrimination.
Conclusions:
There were positif (weak) correlation between hsCRP level and SYNTAX score in
stable CAD patients. Cut-off point in the hsCRP level > 2,35 mg/L can
differentiated between the group of low SYNTAX score and of high SYNTAX
score, but the prediction value is low-grade
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