Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 60710 dokumen yang sesuai dengan query
cover
Noor Asyiqah Sofia
Pengaruh fluoxetine terhadap peningkatan kadar penderita depresi pasca sindrom koroner akut = The Influence of fluoxetine in nitric oxide level in patients with post acute coronary syndrome depression
"ABSTRAK
Latar Belakang. Depresi sering terjadi pada penderita sindroma koroner akut
(SKA) dan berhubungan dengan peningkatan mortalitas penderita SKA. Obat
selective serotonin reuptake inhibitor (SSRI) telah diketahui efikasinya pada
depresi pasca SKA. Nitric oxide (NO) merupakan salah satu penanda fungsi
endotel. Studi menunjukkan kemampuan SSRI citalopram dalam memperbaiki
fungsi endotel melalui peningkatan kadar nitric oxide (NO). Fluoxetine
merupakan obat SSRI yang tersedia dengan baik di Indonesia belum pernah
diteliti pengaruhnya pada peningkatan kadar NO.
Tujuan. Mengetahui pengaruh pemberian fluoxetine 20 mg/hari selama 8 minggu
terhadap peningkatan kadar NO pasien depresi pasca SKA, serta Mengetahui
korelasi antara perbaikan simtom depresi dengan peningkatan kadar NO pasien
depresi pasca SKA yang mendapatkan fluoxetine 20 mg/hari selama 8 minggu.
Metode. Penelitian uji klinik tersamar acak ganda yang dilakukan pada JanuariSeptember
2015
di
poklinik
Jantung
RSUP
Dr.Sardjito
Yogyakarta.
Subjek
adalah
penderita
pasca SKA usia 40-60 tahun yang memenuhi kriteria depresi. Subjek
dirandomisasi untuk mendapatkan fluoxetine dosis 20 mg/hari selama 8 minggu
atau plasebo. Simtom depresi yang diukur dengan kuesioner BDI dan kadar NO
diambil pada awal dan akhir minggu ke 8 penelitian.
Hasil. Dari 44 subjek yang mengikuti penelitian, 24 subjek mendapatkan
fluoxetine dan 20 subjek mendapatkan plasebo. Analisis dilakukan pada 19 subjek
kelompok fluoxetine dan 19 subjek kelompok plasebo. Rerata kadar NO sebelum
dan sesudah pemberian fluoxetine adalah berturut-turut 31,86(2,4) μm dan
29,7(2,7) μm. Rerata kadar NO sebelum dan sesudah pemberian plasebo adalah
berturut-turut 32,44(2,48) μm dan 30,09(2,87) μm. Tidak terdapat korelasi antara
perbaikan simtom depresi dan peningkatan kadar NO pada pasien depresi pasca
SKA yang mendapatkan fluoxetine dibandingkan kelompok plasebo (r -0,206; p
0,215).
Simpulan. Fluoxetine dosis 20 mg/hari selama 8 minggu pada pasien depresi
pasca SKA tidak meningkatkan kadar NO. Penurunan skor BDI pasien depresi
pasca SKA yang mendapatkan fluoxetine 20 mg/hari selama 8 minggu tidak berkorelasi dengan peningkatan kadar NO.
ABSTRACT
Background. Depression was prevalent in post acute coronary syndrome (ACS)
patients and this condition was related with increasing morbidity and mortality.
selective serotonin reuptake inhibitor has established as a treatment choice for
depression in post ACS patients. Nitric oxide (NO) was a well known marker of
endothelial function. Study on SSRI Citalopram showed an increasing level of NO
after administration of citalopram. Fluoxetine was available in Indonesia, but its
function in improving endothelial function through the increasing of NO level
remains unknown.
Purpose. To evaluate the influence of fluoxetine 20 mg daily for 8 weeks in
increasing NO level in patients post ACS with depression, and to evaluate the
correlation between improvement in depressive symptoms and increment of NO
level in post ACS depression patients who receive fluoxetine 20 mg daily for 8
weeks.
Method. It was a randomized double blind clinical trial counducted in JanuarySeptember
2015 whic held in Sardjito General Hospital Yogyakarta. Eligible
subjects were post ACS age 40-60 years who fulfilled depression criteria. Subjects
were randomized to receive fluoxetine 20 mg daily or plasebo for 8 weeks.
Depressive symtoms were evaluate using BDI inventory. Nitric oxide level were
taken at baseline and the end of week 8.
Results. From 44 subjects, 24 subjects received fluoxetine, while 20 subjectcs
received placebo. Analysis was done in 19 subjects of fluoxetine group and 19
subjects of plasebo group. Means of NO level before and after treatment in
fluoxetine group were 31,86(2,4) μm and 29,7(2,7) μm respectively. We found no
correlation between improvement of depressive symptoms and increment of NO
level (r -0,206; p 0,215).
Conclusions. The NO level was not increased in post ACS depression patients
who recieve fluoxetine 20 mg daily for 8 weeks. The improvement of depressive
symptoms was not correlated with increment of NO level in post ACS patients depression patients who recieve fluoxetine 20 mg daily for 8 weeks."
2015
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Yaldiera Utami
Uji Keandalan dan Kesahihan Kuesioner Cardiac Depression Scale untuk mendeteksi Depresi Pasca Sindrom Koroner Akut di Indonesia = Reliability and Validity Study of Cardiac Depression Scale to Detect Post Acute Coronary Syndrome Depression in Indonesia
"Latar Belakang. Depresi pasca SKA memiliki prevalensi sebesar 20-37 , yaitu sekitar tiga kali lipat lebih tinggi dibandingkan pada populasi umum. Pasien pasca SKA yang mengalami depresi dalam waktu 2 tahun pertama memiliki risiko mortalitas sebesar 2.5 kali lipat lebih tinggi dibandingkan dengan pasien yang tidak mengalami depresi. Meskipun prevalensinya cukup tinggi, namun kondisi ini seringkali tidak terdeteksi sehingga sulit untuk ditatalaksana. Kuesioner CDS telah terbukti andal dan sahih untuk mendeteksi depresi pasca SKA di beberapa negara, namun belum ada penelitian yang menguji keandalan dan kesahihan kuesioner tersebut di Indonesia. Penelitian ini bertujuan untuk menguji keandalan dan kesahihan kuesioner CDS berbahasa Indonesia sebagai alat ukur untuk mendeteksi depresi pasca SKA di Indonesia. Metode. Penelitian ini merupakan studi potong lintang yang dilakukan dalam dua tahap, yaitu tahap adaptasi lintas bahasa dan budaya serta tahap uji keandalan dan kesahihan. Subjek penelitian terdiri atas pasien rawat jalan pasca SKA yang berobat di Polikilinik Kardiologi PJT RSCM pada bulan Juli-September 2017. Uji keandalan dilakukan dengan menilai Intraclass Correlation Coefficient ICC melalui metode test-retest dan menilai Cronbach-alpha untuk mengetahui konsistensi internal. Uji kesahihan dilakukan dengan menilai kesahihan konstruksi melalui multitrait multimethod analysis dan kesahihan eksternal dengan cara membandingkan CDS dengan kuesioner BDI-II sebagai alat ukur standar untuk menilai depresi. Hasil. Penelitian ini diikuti oleh 56 subjek dengan rerata usia 58.39 8.38 tahun. Sebagian besar subjek berjenis kelamin laki-laki 64.3 dan sudah menikah 80.4 . Uji keandalan memberikan hasil yang baik, terbukti dengan nilai ICC r 0.944; p
Background. Prevalence of post Acute Coronary Syndrome ACS depression reached 20 37 which is three times higher than in general population. Depressed post ACS patients have 2.5 times higher risk of mortality within 2 years after ACS compared with non depressed patients. Despite the high prevalence, this condition often go unrecognized and untreated. Cardiac Depression Scale CDS has been demonstrated to be valid and reliable in detecting post ACS depression in other countries. However it has not been validated in Indonesian population. This study was designed to evaluate the validity and reliability of Indonesian version CDS as a screening tool for post ACS depression in Indonesia. Method. A cross sectional study was conducted in two phases a the language and cultural adaptation phase and b the validity and reliability test. The study participants were recruited from post ACS outpatients attending Cardiology Clinic in PJT RSCM between July September 2017. Reliability of the CDS was evaluated by calculating Intraclass Correlation Coefficient ICC using test retest method and by calculating Cronbach alpha to determine internal consistency.Validity of the CDS was evaluated by examining construct validity using multitrait multimethod analysis and by comparing CDS with BDI II as gold standard measurement to determine external validity. Result. Fifty six patients were included in this study. The mean age was 58.39 8.38 years. Of these patients, 64.3 were male and 80.4 were married. Indonesian CDS demonstrated good result for test retest reliability r 0.944 p"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Eka Widya Khorinal
Pengaruh kadar Glukosa Darah saat perawatan pada mortalitas penderita Sindrom Koroner Akut = The impact of Blood Glucose during admission in mortality rate of Acute Coronary Syndrome patients / Eka Widya Khorinal
"ABSTRAK
Latar Belakang. Hiperglikemia yang terjadi selama masa perawatan di rumah sakit pada pasien dengan penyakit kritis telah diketahui akan memberikan luaran klinis yang buruk bahkan dapat berujung pada kematian. Hiperglikemia yang terjadi pada pasien sindrom koroner akut (SKA) akan berakibat pada gangguan regenerasi sel endotel dan pembentukan pembuluh darah kolateral (revaskularisasi). Sayangnya, manajemen hiperglikemia sampai saat ini masih belum dicapai kata sepakat terutama perbedaan dalam menentuksn nilai potong dalam evaluasi glukosa lanjutan.
Tujuan. Untuk mengetahui pengaruh hiperglikemia selama perawatan terhadap kesintasan
(mortalitas) enam bulan pasien SKA dan mencari nilai potong ideal jntuk evaluasi lanjutan dan target kendali selama perawatan
Metodologi. Penelitian dilakukan secara kohort retrospestif pada pasien SKA di dirawat di instalasi ICCU RSUPN Cipto Mangunkusumo Jakarta, dengan melibatkan pasien yang dirawat sampai dengan Desember 2011. Pengambilan data subjek penelitian dilakukan melalui data sekunder dengan pendaraan rekam medis dan dilakukan secara konsekutif.
Hasil. Kami mendapatkan 807 pasien SKA selama periode Januari tahun 2000 sampai dengan Desember tahun 2011 yang memenuhi kriteria inklusi dan ekslusi. Hiperglikemia selama perawatan terjadi 242 (30 %) subjek penelitian. Hiperglikemia yang memberikan pengaruh pada kesintasan enam bulan dengan meningkatkan resiko kematian (HR 2,16 dengan IK 95% 1,77 sampai 2,63). Nilai potong glukosa darah yang memberikan kemaknaan pada kesintasan berada pada nilai 142,5 mg/dL.
Kesimpulan. Pasien dengan hiperglikemia memiliki kesintasan yang lebih buruk dibandingkan pasien tanpa hiperglikemia. Nilai glukosa darah 142,5 mg/dL dapat dipergunakan sebagai nilai potong untuk evaluasi glukosa darah lanjutan selama masa perawatan.
ABSTRACT
Background. Hyperglicemia during hospitalization especially on critically ill patients has worse clinical outcome and deadly. Patient with hyperglicemiain in acute coronary syndrome (ACS) will hamper endotelial regeneration and revascularization of coronary blood vessels. Unforrtunately, up until now rate of blood glucose cut off in hyperglycemia management had not reached any consession although we undoubtfully agree that this concept is very important in evaluation and choosing goal treatment.
Aim. To determine the impact of hyperglicemia during admission in six month mortality rate of ACS patients and the best blood glucose cut off for evaluation and goal treatment.
Method. This research used retrospective cohort on ACS patients admitted in ICCU, Cipto Mangukusumo Hospital, Jakarta, untill December 2011. Subjects' data were collected through medical records consecutively.
Results. This research found that there were 807 ACS patients admitted during Januari 2000 to December 2011 that met inclusion and exclusion criterias. Hyperglicemia during admission was found on 242 (30 %) subjects. This condition statistically proven to increase six month mortality rate (HR 2, 16 with CI 95% 1,77 till 2,63). The best rate of Blood Glucose cut of for evaluation and management was 142,5mg/dL.
Conclussion. There was significant difference mortality rate between hyperglicemia patients and non hyperglicemia.Blood glucose level on 142, 5 mg/dL could be used as cut off evaluation during admission."
Fakultas Kedokteran Universitas Indonesia, 2013
T32144
UI - Tesis Membership  Universitas Indonesia Library
cover
Irman Firmansyah
Perbedaan Serotonin Plasma dan Kortisol Saliva terhadap Gejala Depresi pada Pasien pasca Sindroma Koroner Akut = Difference between Plasma Serotonin and Salivary Cortisol with Depressive Symptoms in Post-Acute Coronary Syndrome Patients
"Latar Belakang: Penyakit kardio-serebrovaskular dengan kematian tertinggi sebagian besar diakibatkan Sindroma Koroner Akut (SKA). Dalam perjalanan penyakit tersebut dapat timbul gangguan psikis berupa depresi. Dilaporkan bahwa depresi sering terjadi dan menetap, dengan prevalensi sekitar 20% pada pasien dengan penyakit jantung. Gangguan psikis memiliki hubungan yang erat dengan pengaruh hormonal seperti kortisol dan serotonin. Pada pasien SKA dapat terjadi disfungsi otonom dan disregulasi aksis HPA yang menyebabkan peningkatan kortisol yang dapat memperburuk prognosispasien SKA. Sehingga penting untuk mengetahui pengaruh hormonal yaitu kadar kortisoldan serotonin dalam mengurangi gejala depresi yang akan ditelaah pada penelitian ini. Metode: Penelitian ini merupakan penelitian cross sectional untuk mengetahui peran kortisol dan serotonin terhadap kejadian depresi pada pasien SKA pasca perawatan. Penelitian dilakukan di ICCU RSUPN dr. Cipto Mangunkusumo Jakarta Pusat, Divisi Kardiologi Departemen Ilmu Penyakit Dalam FKUI/RSCM dan Divisi Psikosomatik danPaliatif Departemen Ilmu Penyakit Dalam FKUI/RSCM pada 73 orang responden yang memenuhi kriteria inklusi dengan menggunakan wawancara, pengisian kuesioner HADS,pemeriksaan fisik, dan pemeriksaan laboratorium. Hasil: Sebanyak 15,1% pasien SKA mengalami depresi pasca perawatan. Hasil uji statistik antara serotonin plasma terhadapdepresi tidak bermakna secara statistik dengan p value 0,482, demikian pula dengan kortisol saliva dengan p value 0,275. Namun ditemukan bahwa, kadar rerata hormon serotonin pada pasien SKA dalam penelitian ini adalah 189 ng/ml dan kadar rerata kortisol pada pasien SKA pada penelitian ini adalah 2,19 ng/mL. Kesimpulan: Secara statistik, tidak ditemukan perbedaan signifikan antara kadar kortisol terhadap gejala depresi pada pasien paska sindrom koroner akut dengan nilai p-value 0,275. Namun, penelitian ini bermakna secara klinis dilihat dari kadar serotonin plasma yang lebih rendah pada pasien dengan depresi dan lebih tinggi pada pasien yang tidak depresi. Begitu pula dengan kadar kortisol saliva lebih tinggi pada pasien dengan depresi dan lebih rendah pada pasien yang tidak depresi.
Background: Cardio-cerebrovascular disease with the highest mortality is mostly due toAcute Coronary Syndrome (ACS). During the course of the disease, psychological disorders such as depression may happen. It has been reported that depression is commonand persistent, with a prevalence of approximately 20% in patients with heart disease. Psychological disorders have a close relationship with hormones such as cortisol and serotonin. In ACS patients, autonomic dysfunction and dysregulation ofthe HPA axis canoccur and cause an increase in cortisol which can worsen the prognosis of ACS patients. So it is important to know the how hormones, namely cortisol and serotonin in reducing depressive symptoms which will be examined in this study. Methods: This study is a cross-sectional study to determine the impact of cortisol and serotonin in the incidence ofdepression in post-treatment ACS patients. The research was conducted at the ICCU RSUPN dr. Cipto Mangunkusumo Central Jakarta, Division of Cardiology Department ofInternal Medicine FKUI/RSCM and Division of Psychosomatics and Palliative Department of Internal Medicine FKUI/RSCM in 73 respondents who met the inclusion criteria by using interviews, filling out HADS questionnaires, physical examinations andlaboratory tests. Results: A total of 15.1% of ACS patients experienced post-treatment depression. The statistical test results between plasma serotonin and depression were notstatistically significant with a p value of0.482, as well as salivary cortisol with a p valueof 0.275. However, it was found that the average serotonin level in ACS patients in this study was 189 ng/ml and the average cortisol level in ACS patients in this study was 2.19 ng/mL. Conclusion: Statistically, there was no significant relationship between cortisol levels and depressive symptoms in post-acute coronary syndrome patients with a p-valueof 0.275. However, this study is clinically significant in view of the lower plasma serotonin levels in patients with depression and higher in patients who are not depressed.Likewise, salivary cortisol levels were higher in patients with depression and lower in patients who were not depressed."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Ahmad Fariz Malvi Zamzam Zein
Pengaruh hiperglikemia admisi terhadap kejadian aritmia selama perawatan pasien sindrom koroner akut = The influence of hyperglycemia at admission on in hospital arrhythmia in patients with acute coronary syndrome
"ABSTRAK
Latar Belakang: Aritmia selama perawatan merupakan komplikasi yang sering
terjadi pada pasien sindrom koroner akut (SKA) sehingga dibutuhkan identifikasi
risiko secara dini.
Tujuan: Mengetahui insidens pasien SKA yang mengalami aritmia selama
perawatan dan mengetahui pengaruh hiperglikemia admisi terhadap kejadian
aritmia selama perawatan pasien SKA.
Metode: Studi kohort retrospektif ini menggunakan rekam medik pasien SKA yang
dirawat di ICCU RSPUN dr. Cipto Mangunkusumo dalam periode 1 Januari-31
Desember 2014. Hiperglikemia admisi didefinisikan sebagai kadar gula darah
admisi >140 mg/dL. Kejadian aritmia selama perawatan meliputi aritmia atrium,
takikardia supraventrikular, blok AV derajat tinggi, dan aritmia ventrikel, yang
diidentifikasi dalam tujuh hari pertama perawatan.
Hasil: Terdapat 232 subjek pada penelitian ini. Prevalensi hiperglikemia admisi
adalah 50,43%. Insidens pasien SKA yang mengalami aritmia selama perawatan
adalah 21,55% (IK 95% 16,26-26,84). Analisis bivariat menunjukkan
hiperglikemia admisi terkait dengan peningkatan risiko aritmia selama perawatan
(RR 1,747; IK 95% 1,042-2,930). Tidak terdapat hubungan yang bermakna antara
jenis SKA, diabetes melitus (DM), obesitas, dan hipertensi dengan kejadian aritmia
selama perawatan. Analisis multivariat menunjukkan OR hiperglikemia admisi
setelah penyesuaian adalah 2,852 (IK 95% 1,351-6,024), dengan variabel perancu
DM.
Simpulan: Insidens pasien SKA yang mengalami aritmia selama perawatan adalah
21,55%. Hiperglikemia admisi dapat meningkatkan risiko kejadian aritmia selama perawatan pasien SKA.ABSTRACT Background: The in-hospital arrhythmias complicating acute coronary syndrome
(ACS) is a common complication, and its ealy risk identification is urgently needed.
Aim: to determine the incidence of in-hospital arrhythmia complicating ACS and
to determine the influence of HA on in-hospital arrhythmia complicating ACS.
Methods: a retrospective cohort study was conducted using secondary data from
medical records of patients with ACS who were admitted to ICCU RSCM between
January 1st-Desember 31st, 2014. Hyperglycemia at admission was defined when
the blood glucose level at admission was >140 mg/dL. The in-hospital arrhythmias
were observed during the first seven days of hospitalization.
Result: there were 232 subjects. The prevalence of HA WAS 50.43%. The
incidence of in-hospital arrhythmias was 21.55% (95% CI 16.26-26.84). In
bivariate analysis, there was significant association between HA and in-hospital
arrhythmia (RR 1.747; 95% CI 1.042-2.930). There were no significant relationship
among the type of ACS, diabetes mellitus (DM), obesity, and hypertension, with
the influence of HA on in-hospital arrhythmia. In multivariate analysis, the adjusted
OR of HA was 2.852 (95% CI 1.351-6.024), and DM was the confounding variable.
Conclusion: In-hospital arrhythmias is a common complication in patients with
ACS. Hyperglycemia at admission may increase the risk of in-hospital arrhythmia complicating ACS. ;Background: The in-hospital arrhythmias complicating acute coronary syndrome
(ACS) is a common complication, and its ealy risk identification is urgently needed.
Aim: to determine the incidence of in-hospital arrhythmia complicating ACS and
to determine the influence of HA on in-hospital arrhythmia complicating ACS.
Methods: a retrospective cohort study was conducted using secondary data from
medical records of patients with ACS who were admitted to ICCU RSCM between
January 1st-Desember 31st, 2014. Hyperglycemia at admission was defined when
the blood glucose level at admission was >140 mg/dL. The in-hospital arrhythmias
were observed during the first seven days of hospitalization.
Result: there were 232 subjects. The prevalence of HA WAS 50.43%. The
incidence of in-hospital arrhythmias was 21.55% (95% CI 16.26-26.84). In
bivariate analysis, there was significant association between HA and in-hospital
arrhythmia (RR 1.747; 95% CI 1.042-2.930). There were no significant relationship
among the type of ACS, diabetes mellitus (DM), obesity, and hypertension, with
the influence of HA on in-hospital arrhythmia. In multivariate analysis, the adjusted
OR of HA was 2.852 (95% CI 1.351-6.024), and DM was the confounding variable.
Conclusion: In-hospital arrhythmias is a common complication in patients with
ACS. Hyperglycemia at admission may increase the risk of in-hospital arrhythmia complicating ACS. "
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Lumban Gaol, Donnie
Korelasi Kadar Asam Urat Serum dengan Kompleksitas Stenosis Arteri Koroner Berdasarkan Skor SYNTAX pada Pasien Sindrom Koroner Akut = Correlation Serum Level of Uric Acid with the Complexity of Stenosis Coronary Artery Based on SYNTAX score in Acute Coronary Syndrome Patients
"Latar Belakang dan Tujuan: Korelasi antara kadar asam urat dan penyakit kardiovaskular sudah lama diketahui dan terdapat sejumlah penelitian epidemiologi melaporkan korelasi antara kadar asam urat dan berbagai kondisi penyakit kardiovaskular. Kami meneliti korelasi antara kadar asam urat terhadap kompleksitas stenosis arteri koroner pada pasien sindrom koroner akut berdasarkan skor SYNTAX.
Metode Penelitian: Penelitian ini adalah studi analisis korelasi dengan desain potong lintang pada total 60 pasien sindrom koroner akut yang menjalani angiografi koroner dari data rekam medik. Penelitian dilakukan di RSCM pada bulan November 2012 dengan sampel data rekam medik ICCU RSCM Januari 2012-Oktober 2012, menggunakan teknik sampling konsekutif. Analisis korelasi pearson digunakan untuk melihat korelasi kadar asam urat dengan kompleksitas stenosis arteri koroner pada pasien sindrom koroner akut, dan analisis multivariat regresi linier.
Hasil: Analisis korelasi Pearson pada kadar asam urat terdapat korelasi positif lemah yang bermakna terhadap skor SYNTAX (r=0.3, p=0.02). Kadar asam urat memiliki pengaruh 8 % terhadap kompleksitas stenosis arteri koroner. Analisis multivariat regresi linier menunjukkan asam urat (?; 0.3, p<0.018) merupakan faktor independen terhadap skor SYNTAX.
Kesimpulan: Pada penelitian kami, kadar asam urat memiliki korelasi lemah dengan kompleksitas stenosis arteri koroner arteri koroner pada pasien sindrom koroner akut. Penelitian selanjutnya dianjurkan apakah pemberian inhibitor xanthine oxidase dapat mencegah progresifitas penyakit arteri koroner.
Background and Objectives: Serum uric acid has been associated with increased cardiovascular risk in general population recently in many studies. We hypothesized that serum uric acid would be correlated with severity of coronary artery disease. We therefore investigated the link between serum uric acid level and the extend of coronary artery disease (CAD) assessed by SYNTAX score (SS).
Materials and Methods: Subjects’ data were collected through medical record consecutively. A cross sectional study performed in 60 acute coronary syndrome patients who underwent coronary angiography in ICCU, Cipto Mangunkusumo Hospital, Jakarta, from January 2012 untill October 2012. We analyzed the correlation serum levels of uric acid and angiographic severity of CAD. SS was used for assessing the severity of coronary artery disease.
Result: Serum level of uric acid positively weak correlated with SS (r=0.3, p=0.02). Multivariate regression analysis showed that serum level uric acid (?;0.3, p<0.018) were the independent for SS.
Conclution: Serum level of uric acid is independenly correlated with the severity and complexity of CAD evaluated by SS in patient acute coronary syndrome. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T57622
UI - Tesis Membership  Universitas Indonesia Library
cover
Astuti Giantini
Peran faktor genetik dan epigenetik terkait resistensi klopidogrel terhadap kejadian kardiovaskular mayor pada pasien sindrom koroner akut pasca intervensi koroner perkutan = The role of genetic and epigenetic factors related to clopidogrel resistance in major adverse cardiovascular events on acute coronary syndrome patients after percutaneous coronary intervention
"Sindrom koroner akut (SKA) merupakan masalah kesehatan nasional karena tingginya angka morbiditas dan mortalitas serta beban biaya yang dibutuhkan. Intervensi koroner perkutan (IKP) dan terapi antiplatelet seperti klopidogrel merupakan tata laksana yang direkomendasikan oleh organisasi kardiologi internasional. Meskipun demikian, pasien SKA masih dapat mengalami kejadian kardiovaskular mayor (KKM). Kemungkinan, resistensi klopidogrel berperan pada KKM sedangkan resistensi klopidogrel mungkin dipengaruhi oleh faktor genetik dan epigenetik. Penelitian ini bertujuan untuk mengetahui hubungan faktor genetik yaitu polimorfisme gen CYP2C19 dan P2Y12, serta epigenetik yaitu metilasi DNA gen CYP2C19 dan P2Y12 serta ekspresi miRNA-26a dengan resistensi klopidogrel dan pengaruhnya terhadap KKM pada pasien SKA pasca IKP.
Untuk menganalisis hubungan faktor genetik dan epigenetik dengan resistensi klopidogrel, penelitian dilakukan dengan desain potong lintang, sedangkan untuk analisis hubungan faktor genetik dan epigenetik dengan KKM dilakukan dengan desain kohort prospektif. Subjek penelitian meliputi 201 pasien SKA pasca IKP dan mendapat terapi klopidogrel di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita dari bulan September 2018 sampai dengan Juni 2020. Resistensi klopidogrel ditentukan dengan pemeriksaan light transmission aggregometry (LTA) apabila hasilnya lebih besar dari 59% dengan agonis ADP 20 mM. Deteksi polimorfisme gen CYP2C19 dan P2Y12 serta ekspresi miRNA-26a dilakukan dengan metode qRT-PCR, sedangkan metilasi DNA gen CYP2C19 dan P2Y12 dikerjakan dengan metode konversi bisulfit. Pasien diobservasi selama satu tahun dan jika ada angina pektoris, infark miokard akut (IMA) rekuren, stroke, atau kematian, dicatat sebagai KKM.
Dari 201 subjek, terdapat 45,8% carrier mutant polimorfisme *2 dan *3 gen CYP2C19, 36,8% carrier mutant polimorfisme rs3679479 gen P2Y12, 10% hipometilasi DNA gen P2Y12, 80,1% hipometilasi DNA gen CYP2C19, dan 66,2% ekspresi miRNA-26a up regulated. Proporsi resisten klopidogrel adalah 49,8% dan proporsi KKM adalah 14,9% (kematian 7,5%). Terdapat hubungan antara merokok (p = 0,001; OR 0,37 [IK 95%; 0,20–0,68]), hipometilasi DNA gen CYP2C19 (p = 0,037; OR 2,13 [IK 95%; 1,04–4,37]), dan ekspresi miRNA-26a up regulated (p = 0,020; OR 2,03 [IK 95%; 1,12–3,68]) dengan resistensi klopidogrel. Terdapat hubungan antara jenis kelamin perempuan (p = 0,040; HR 2,73 [IK 95%; 1,05–7,14]), usia ≥ 60 tahun (p = 0,035; HR 2,17 [IK 95%; 1,06–4,48]), eGFR rendah (p = 0,001; HR 3,29 [IK 95%; 1,59–6,84]), dan polimorfisme *2 dan *3 gen CYP2C19 (p = 0,047; HR 2,12 [IK 95%; 1,01–4,46]) dengan KKM dalam satu tahun.
Hanya faktor epigenetik berupa metilasi DNA gen CYP2C19 dan ekspresi miRNA-26a yang berhubungan dengan resistensi klopidogrel. Walaupun resistensi klopidogrel tidak berhubungan dengan KKM, terdapat hubungan antara faktor genetik polimorfisme *2 dan *3 gen CYP2C19 dengan KKM.
Acute coronary syndrome (ACS) is a national health problem due to high morbidity and mortality, and cost burden as well. Percutaneous coronary intervention (PCI) and antiplatelet therapy such as clopidogrel are recommended. However, ACS patients could still experience major adverse cardiovascular events (MACE). Clopidogrel resistance possibly plays a role in MACE whereas it may be affected by genetic and epigenetic factors. Therefore, the objective of this study was to determine the relationship between genetic factors which are CYP2C19 and P2Y12 polymorphisms, as well as epigenetic factors which are DNA methylation of CYP2C19 and P2Y12, and miRNA-26a expression and their effects on MACE in post-PCI patients.
To analyze the association between genetic and epigenetic factors and clopidogrel resistance, the study design was cross-sectional, while the study design of relationship between genetic and epigenetic factors and MACE was prospective cohort. The subjects were 201 post-PCI ACS patients who received clopidogrel therapy at Harapan Kita Hospital from September 2018 to June 2020. Clopidogrel resistance was determined by light transmission aggregometry (LTA) if the result was greater than 59% with agonist ADP 20 µM. The detection of CYP2C19 and P2Y12 gene polymorphisms and miRNA-26a expression were carried out by qRT-PCR method, while the DNA methylation of the CYP2C19 and P2Y12 genes were carried out by bisulfite conversion method. Patients were observed for one year and angina pectoris, recurrent acute myocardial infarction (AMI), stroke, or death, were recorded as MACE.
From 201 subjects, 45.8% were CYP2C19*2 and CYP2C19*3 polymorphism mutant carrier, 36.8% were rs3679479 P2Y12 polymorphism mutant carrier, 10% were hypomethylated of P2Y12, 80.1% were hypomethylated of CYP2C19, and 66.2% were up regulated in miRNA-26a expression. 49.8% of subjects were clopidogrel resistant and 14.9% of subjects experienced MACE (death was 7.5%). Smoking (p = 0.001; OR 0.37 [CI 95%; 0.20–0.68]), hypomethylated of CYP2C19 (p = 0.037; OR 2.13 [CI 95%; 1.04–4.37]), and up regulated miRNA-26a expression (p = 0.020; OR 2.03 [CI 95%; 1.12–3.68]) were associated with clopidogrel resistance. Female gender (p = 0.040; HR 2.73 [CI 95%; 1.05–7.14]), age over 60 years old (p = 0.035; HR 2.17 [CI 95%; 1.06–4.48]), low eGFR (p = 0.001; HR 3.29 [CI 95%; 1.59–6.84]), and CYP2C19*2 and CYP2C19*3 polymorphisms (p = 0.047; HR 2.12 [CI 95%; 1.01–4.46]) were associated with MACE in one year.
Only DNA methylation of CYP2C19 and miRNA-26a expression were associated with clopidogrel resistance. Although clopidogrel resistance was not associated with MACE, there was association between CYP2C19*2 and CYP2C19*3 polymorphisms and MACE."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
D-Pdf
UI - Disertasi Membership  Universitas Indonesia Library
cover
Anditha Ratnadhiyani
Pengalaman wanita pasca sindrom koroner akut dalam adaptasi terhadap perubahan kemampuan fungsional = The experiences of women after acute coronary syndrome in adaptation to functional ability changes / Anditha Ratnadhiyani
"ABSTRAK
Nama : Anditha RatnadhiyaniProgram Studi : Magister Ilmu KeperawatanJudul : Pengalaman Wanita Pasca Sindrom Koroner Akut dalam Adaptasi terhadap Perubahan Kemampuan Fungsional Pemulihan pasca sindrom koroner akut mencakup proses adaptasi individu terhadap perubahan kemampuan fungsional. Perkembangan dalam penelitian di bidang kardiovaskular menunjukkan dampak dan prognosis sindrom koroner akut yang lebih buruk pada wanita jika dibanding pria, yang dikaitkan dengan perbedaan dalam persepsi, prediktor klinis, dan status sosioekonomi. Penelitian ini bertujuan untuk mengeksplorasi pengalaman wanita pasca sindrom koroner akut dalam adaptasi terhadap perubahan kemampuan fungsional. Metode kualitatif dengan desain fenomenologi deskriptif digunakan untuk memperoleh gambaran pengalaman sepuluh partisipan dalam penelitian ini. Pengambilan data dilakukan dengan wawancara mendalam, kemudian dilakukan content analysis dengan metode Colaizzi. Teridentifikasi enam tema utama dari penelitian ini yaitu respon ketidaknyamanan setelah mengalami sindrom koroner akut, penurunan kemandirian dan kemampuan melakukan aktivitas sebagai dampak perubahan kondisi fisik, self-adjustment sebagai koping terhadap perubahan kemampuan fisik, revaskularisasi memberikan harapan kesembuhan, pengaruh dukungan terhadap psikologis, dan self-effort untuk memulihkan kemampuan fungsional. Hasil penelitian menunjukkan peran penting faktor psikologis dalam proses adaptasi wanita selama pemulihan, sehingga direkomendasikan peningkatan intervensi yang mendukung psikologis dalam tatalaksana pasien wanita dengan sindrom koroner akut. Kata kunci: adaptasi, kemampuan fungsional, sindrom koroner akut, wanita
ABSTRACT
Name Anditha RatnadhiyaniStudy Program Master of NursingTitle The Experiences of Women after Acute Coronary Syndrome in Adaptation to Functional Ability Changes Adaptation to functional ability changes is part of recovery after Acute Coronary Syndrome ACS . Earlier studies have indicated that women with ACS have worse impact and prognosis. It is associated with perception differences, clinical predictors and socio economy status. The aim of this study is to explore experiences of women after ACS in adaptation to functional ability changes. A qualitative study using phenomenological description design was conducted. Ten women after ACS participated in individual in depth interview. Data were analysed using Colaizzi rsquo s procedural approach. Women rsquo s experiences in adaptation were formulated into six main themes 1 inconvenience response to ACS 2 decrease in autonomy and ability to perform activities as a result of physical changes 3 self adjustment as a mechanism to cope with physical ability changes 4 being recovered by revascularization 5 social support promotes psychological improvement and 6 self efforts to improve functional abilities. This research denotes a major role of psychological factors in women rsquo s adaptation during recovery process. Therefore, developing a psychological based intervention for women after ACS is an important strategy to improve outcomes. Keywords acute coronary syndrome, adaptation, functional ability, women"
2016
T47065
UI - Tesis Membership  Universitas Indonesia Library
cover
Diding Heri Prasetyo
Korelasi kadar asam urat serum dengan keparahan stenosis arteri koroner pasien sindrom koroner akut (Studi Meta Analisis) = Correlation of serum uric acid levels with the severity of coronary artery stenosis in patients with acute coronary syndrome (Meta Analysis Study)
"Latar Belakang: Sindrom koroner akut (SKA) adalah gangguan yang mengancam jiwa yang tetap menjadi sumber morbiditas dan mortalitas yang tinggi meskipun ada kemajuan dalam pengobatan. Hubungan antara asam urat serum dengan penyakit jantung iskemik masih kontroversial dan belum ditetapkan sebagai faktor risiko kardiovaskular. Interaksi kooperatif antara keduanya tidak sepenuhnya dipahami. Beberapa bukti epidemiologis hubungan kausal tersebut masih kontroversial. Sering sekali penelitian dengan kasus yang sama dan menggunakan metode yang sama tetapi hasilnya berbeda.
Tujuan: Penelitian ini bertujuan untuk melakukan meta analisis untuk mensintesis hasil-hasil penelitian yang berbeda tersebut agar diperoleh data baru yang bersifat kuantitatif dan lebih akurat.
Metode: Protokol penelitian didaftarkan di PROSPERO (CRD42020210948) dan telaah sistematis mengikuti pedoman preferred reporting items for systematic reviews and meta-analyses (PRISMA), dengan menelusuri studi yang dipublikasikan dalam rentan waktu dari Januari 2010 hingga Mei 2020. Cochrane Library, Ebsco, Medline/PubMed, ProQuest dan Sience Direct adalah sumber dari studi yang dipublikasikan. Meta analisis dilakukan untuk mensintesis korelasi antara kadar asam urat serum dan keparahan stenosis arteri koroner. Heterogenitas dinilai menggunakan I2, dan meta analisis menggunakan perangkat lunak Comprehensive Meta Analysis Version 3 (CMA3).
Hasil: Lima studi (n = 601 pasien) diidentifikasi didapatkan korelasi antara kadar asam urat serum dan skor Gensini (r = 0,548; p <0,001) pada pasien SKA. Bias heterogenitas ditemukan dalam analisis.
Simpulan: Keparahan stenosis arteri koroner pada pasien dengan SKA berkorelasi positif dengan kadar asam urat serum.
Background: Acute coronary syndrome (ACS) is a life-threatening disease which remains a source of high morbidity and mortality despite advances in treatment. The relationship between serum uric acid (SUA) level and ischemic heart disease abides controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between those two factors is not fully understood. Prior epidemiological evidences of the causal relationship is still argumentative. There were various studies using the same methods yet the outcome were different.
Objective: This study aims to conduct a meta-analysis to synthesize the results of recent studies in order to obtain data quantitatively and also accurately.
Methods: The study protocol was registered in PROSPERO (CRD42020210948) and systematic study follows the guidelines for preferred reporting items for systematic reviews and meta-analysis (PRISMA), tracing studies published in January 2010 to May 2020. Sources of database using Cochrane Library, Ebsco, Medline/PubMed, ProQuest and Science Direct. Meta-analysis was conducted to synthesize the associations between SUA level and severity of coronary artery stenosis. Heterogeneity was assessed using I2, and the meta-analysis was performed using Comprehensive Meta Analysis Version 3 (CMA3) software.
Results: Five studies (n = 601 patients) identified a correlation between serum uric acid levels and Gensini scores (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis.
Conclusions: The severity of coronary artery stenosis in patients with ACS is positively correlated with serum uric acid levels"
Depok: Fakultas Kedokteran Universitas Indonesia, 2020
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Dedi Supriadi
Pengaruh intervensi terapi murotal Al-Quran terhadap penurunan kecemasan pasien dengan Sindrom Koroner Akut (SKA) = The influence of intervention of murotal Al-Quran therapy over the anxiety decrease of patient with acute coronary syndrome (ACS)
"Kecemasan merupakan masalah psikologis yang sering muncul pada penyakit jantung terutama pada pasien dengan sindrom koroner akut. Fokus intervensi pada pasien dengan SKA seharusnya tidak hanya pada pengobatan atau mengatasi gangguan fisik saja akan tetapi harus mempertimbangkan juga aspek psikologisnya. Salah satu penanganannya dengan menggunakan terapi murotal Al-Quran.
Tujuan penelitian ini untuk mengidentifikasi pengaruh intervensi terapi murotal Al-Quran terhadap kecemasan pada pasien dengan SKA. Desain penelitian menggunakan quasy experiment pre-post test dengan grup kontrol. eknik pengambilan sampel dengan cara consecutive sampling yang terdiri dari 15 responden sebagai kelompok intervensi dan 15 responden sebagai kelompok kontrol. Terapi murotal Al-Quran diberikan dengan durasi selama 30 menit.
Hasil penelitian menunjukkan adanya perbedaan rata-rata skor kecemasan yang signifikan setelah mendapat terapi murotal Al-Quran antara kelompok intervensi dan kelompok kontrol. Perbedaan rata-rata kecemasan pada kelompok intervensi lebih besar dibandingkan dengan kelompok kontrol. Kesimpulannya, terapi murotal Al-Quran secara signifikan dapat menurunkan kecemasan pada pasien dengan SKA. Disarankan agar terapi murotal Al-Quran diterapkan sebagai bagian dari intervensi keperawatan dalam menangani pasien SKA yang mengalami kecemasan.
Anxiety is a psychological problem that often appears in cardiac disease, specially in patient with acute coronary syndrome. Intervention focus on patients with ACS should not only on treatment of or overcoming physical disorder, but should also consider the psychological aspect. One of the treatment is using Murotal Al-Quran therapy.
The aim of this research is to identify the influence of intervention of murotal Al-Quran therapy on the anxiety of patient with ACS. The research used a quasy experiment pre-post test with control group. The sample was collected using a consecutive sampling, fifteen respondents was assigned for the intervention group and fifteen respondents was assigned for the control group. A therapy of murotal Al-Quran was implemented for 30 minutes.
The result showed that there is a significant difference in average score of anxiety after having the murotal Al-Quran therapy between the intervention group and the control group. The difference in average score of anxiety on the intervention group is higher than the control group. The conclusion, murotal Al-Quran therapy is significantly decrease the anxiety of patients with ACS. It is suggested that murotal Al-Quran therapy is implemented as part of nursing intervention in taking care of patient with ACS who experience anxiety."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2013
T35240
UI - Tesis Membership  Universitas Indonesia Library
<<   1 2 3 4 5 6 7 8 9 10   >>