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"Background: Adiponectin, an adipocyte-secreted hormone involved in energy homeostasis, has broad anti-inflammatory, antioxidant, and endothelium- and myocardial-protective effects, together with a potentially positive regulatory function in coronary microcirculation. Although the physiological role of adiponectin has not yet been fully elucidated, it may well be involved in the regulation of many of the inflammatory processes or lipid metabolisms that contribute to atherosclerosis. In this study we investigate the plasma concentration of adiponectin in patients with coronary artery disease (CAD), those with coronary slow flow (CSF) and in healthy subjects. Methods: this study was conducted according to a cross-sectional design involving 30 CAD, 30 CSF, and 30 healthy subjects. These subjects were sourced from the Dr. Zainoel Abidin Center Hospital, Banda Aceh, Indonesia, between December 2017 and February 2018. The plasma concentration of adiponectin was measured using enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s specifications. Results: there were statistically significant differences at p<0.001 between the CAD, CSF, and healthy-subject groups in terms of age, sex, systolic blood pressure, total cholesterol, triglycerides, and creatinine. Mean plasma concentrations of adiponectin in patients with CAD were significantly lower than in patients with CSF and in healthy subjects (CAD: 3.40 (0.87) μg/ml; CSF: 4.58 (2.32) μg/ml; healthy subjects: 5.65 (4.87) μg/ml; P<0.001). Conclusion: the findings suggest that low plasma adiponectin concentration is associated with atherosclerosis. Plasma concentrations of adiponectin may be related to the pathophysiology role of cardiovascular disease in both CAD and CSF patients.

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Latar belakang: Adiponektin, hormon yang disekresikan oleh adiposit yang berperan pada homeostasis energi dan memiliki efek antiinflamasi, antioksidan, endothelium serta efek protektif terhadap endotelium dan miokard dengan fungsi regulasi yang positif terhadap mikrosirkulasi koroner. Meskipun secara fisiologis peran adiponektin masih belum diketahui secara pasti,namun adiponektin berperan pada proses inflamasi atau metabolisme lipid, yang berkontribusi terhadapa proses aterosklerosis. Pada studi ini, kami melakukan evaluasi kadar konsentrasi adiponektin pada pasien CAD, aliran darah lambat dan subjek sehat.

Metode: penelitian ini dilakukan dengan design cross-sectional yang melibatkan 30 pasien CAD, 30 pasien SCF dan 30 pasien subjek sehat dari Desember 2017-Februari 2018 di RSUD dr. Zainoel Abidin, Banda Aceh, Indonesia. Kadar plasma adiponektin di ukur dengan menggunakan alat immunosorbent enzyme-linked (ELISA) sesuai dengan spesifikasi alat.

Hasil: terdapat hasil yang signifikan bermakna secara statistik di antara subjek CAD, SCF dan subjek sehat dalam hal usia, jenis kelamin, tekanan darah sistolik, kolesterol total, trigliserida dan kreatinin dengan p<0,001. Rerata kadar konsentrasi adiponektin pada pasien CAD secara signifikan menunjukkan nilainy yang lebih rendah dibandingkan pasien dengan SCF dan subjek sehat (CAD 3,40 (0,87) μg/ml; SCF 4,58 (2,32) μg/ml; subyek sehat 5,65 (4,87) μg/ml; P<0,001).

Kesimpulan: penelitian ini menunjukkan kadar plasma adiponektin yang rendah merupakan molekul penting yang berhubungan dengan aterosklerosis. Kadar plasma adiponektin mungkin berhubungan dengan peran terjadinya patofisiologi dari penyakit kardiovaskular baik pasien CAD dan CSF"

"This volume highlights the mechanisms leading to immune privilege in tissues and organs, the deviation of immune responses and the modification of the behavior of the immune cells that manage to cross the blood barriers of tissues, in the context of infection."

"Aterosklerosis sebagai penyebab terjadinya PJK merupakan proses multifaktorial karena banyak sekali faktor-faktor yang menyebabkannya dengan mekanisme yang saling terkait. Saat ini proses aterosklerosis dianggap sebagai proses inflamasi. Inflamasi terbukti berperan penting pada inisiasi, progresi maupun destabilisasi plak aterosklerosis. High sensitivity C-reactive protein (hs-CRP) merupakan salah satu petanda inflamasi yang penting pada penyakit jantung koroner (PJK) yang berhubungan dengan tingkat keparahan aterosklerosis, iskemi miokardium dan nekrosis miokardium. Tujuan penelitian ini adalah untuk mengetahui dan membandingkan kadar hs-CRP pada pasien sindroma koroner akut (SKA), PJK kronik dan bukan PJK, serta untuk mengetahui apakah terdapat hubungan antara kadar hs-CRP dengan kadar enzim CKMB pada pasien infark miokard akut (IMA). Penelitian bersifat observasional deskriptif dan analitik dengan pendekatan potong lintang. Dilakukan pemeriksaan kadar hs-CRP dengan metode chemiluminescent pada 21 pasien SKA, 20 pasien PJK kronik dan 20 bukan PJK. Didapatkan kadar hs-CRP rerata pada pasien SKA, PJK kronik dan bukan PJK sebesar 8,40 (SD 5,53) mg/l, 2,81 (SD 2,09) mg/l dan 1,07 (SD 0,81) mg/l. Analisis statistik didapatkan perbedaan kadar hs-CRP yang bermakna antara pasien SKA, PJK kronik dan bukan PJK (p 0,000). Kadar hs-CRP mempunyai korelasi positif yang bermakna dengan kadar enzim CKMB pada pasien IMA (p 0,004). Sebagai kesimpulan, kadar hs-CRP pada pasien SKA secara bermakna lebih tinggi dibanding PJK kronik dan bukan PJK. Terdapat hubungan yang bermakna antara peningkatan kadar hs-CRP dengan peningkatan kadar enzim CKMB. (Med J Indones 2004; 13: 102-6)

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Coronary heart disease (CHD) due to atherosclerosis is a multifactorial process with multiple interdependent factors. At present time, atherosclerosis is considered to be an inflammatory process. It has been proven that inflammation plays a mayor role in the initiation, progression as well as the destabilitation of the atherosclerosis plaque. High sensitivity C-reactive protein (hs-CRP) is one of the most important inflammatory marker in CHD and directly related to the extent and severity of atherosclerosis, extent of myocardial ischemia and myocardial necrosis. The purpose of this study is to determine hs-CRP levels in patients with acute coronary syndrome (ACS), chronic CHD and non CHD. And, to determine the correlation between hs-CRP levels and CKMB enzyme level in patients with acute myocardial infarction (AMI). This is a descriptive observational analytic study with cross sectional design. hs-CRP levels were measured by using chemiluminescent method on 21 ACS patients, 20 chronic CHD patients and 20 non CHD patients. The mean hs-CRP level in ACS, chronic CHD and non CHD patients were respectively 8.40 (SD 5.53) mg/l, 2.81 (SD 2.09) mg/l and 1.07 (SD 0.81) mg/l. A statistically significant difference in hs-CRP level was found between ACS, chronic CHD and non CHD (p = 0.000 ). A positive correlation was found between hs-CRP level and CKMB enzyme level in AMI patients (p = 0.004). In conclusion hs-CRP level is consistently higher in patients with ACS compared to patients with chronic CHD and non CHD. A positive correlation was found between the increased level of hs-CRP and CKMB enzyme level. (Med J Indones 2004; 13: 102-6)"

"Coronary artery disease (CAD) is an important cause of death in end-stage renal disease (ESRD) patients on regular hemodialysis. The high risk of CAD occurrence in ESRD patients is partially due to a high prevalence of established atherosclerotic risk factors, which are hypertension, diabetes and dyslipidemia. However, unique renal-related risk factors are also likely to contribute to this high risk of CAD. The high prevalence of hyperhomocysteinemia in ESRD patients is of interest because of the probable cardiovascular risk associated with the increase of total plasma homocysteine concentration. The aim of this study was to evaluate the role of homocysteine as a risk factor for CAD in non-diabetic ESRD patients on regular hemodialysis.Total fasting plasma homocysteine, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, hypertension and smoking habit were documented from 80 non-diabetic ESRD patients on regular hemodialysis (48 men, 32 women; mean age 54.5±6.5 years). Twenty-two (27.5%) among these patients suffered from CAD according to ECG and echocardiographic criteria. The risk of CAD was analyzed using a stepwise multiple logistic regression. Total fasting plasma homocysteine concentration and other risk factors for CAD were also determined in 80 age- and sex-matched normal controls.Total fasting plasma homocysteine concentration was significantly higher in non-diabetic ESRD patients than in normal controls (26.0±1.5 versus 14.6±1.3 fimol/L; p<0.01). Hyperhomocysteinemia was observed in 92.5% ESRD patients. Homocysteine concentration was significantly higher in ESRD patients with CAD than without CAD (33.8±1.4 versus 23.5+1.5 umol/L; p<0.01). High total plasma homocysteine concentration and hypertension were independently associated with CAD in non-diabetic ESRD patients on regular hemodialeine concentration in the upper tertile (>30.6 jxmol/L) had an adjusted odds ratio of 2.95 (CI, 1.02 to 8.53; p<0.05). In ESRD patients, the intake of folic acid is the only factor associated with total plasma homocysteine concentration. The increase of total plasma homocysteine concentration in normal controls was associated with increased age and smoking habit.This study concludes that a high total plasma homocysteine concentration is an independent risk factor for coronary artery disease in non-diabetic ESRD patients on regular hemodialysis."

"Tujuan: Mengetahui hubungan antara asupan asam lemak tak jenuh tunggal (ALTJT) serta faktor-faktor lainnya dengan kadar kolesterol high density lipoprotein (HDL) plasma penderita penyakit jantung koroner (PJK). Tempat: Rumah Sakit Jantung Harapan Kita. Metodologi: Penelitian ini merupakan penelitian kasus-kontrol tanpa berpasangan, yang telah disetujui oleh panitia tetap penilai etik penelitian Fakultas Kedokteran Universitas Indonesia. Sebanyak 134 orang penderita PJK diikut sertakan dalarn penelitian ini, terdiri dari 67 orang kelompok kasus (kadar kolesterol HDL plasma <35 mg/dL) dan 67 orang kelompok kontrol (kadar, kolesterol HDL plasma (35 mg/dL). Pengambilan subyek penelitian dilakukan dengan metode consecutive sampling. Data yang dikumpulkan meliputi: karakteristik demografi, asupan zat gizi makro dengan metode tanya ulang 1x24 jam dan food frequency questionnaire (FFQ) semikuantitatif 3 bulan terakhir, kebiasaan olahraga, merokok, minum alkohol, indeks massa tubuh (IMT) dan rasio lingkar pinggang/lingkar panggul (rasio Lpi/Lpa). Hasil: Berdasarkan karakteristik demografi, kelompok kasus dan kontrol setara. Asupan ALTJT kelompok kontrol lebih tinggi dibandingkan kelompok kasus namun tidak berbeda bermakna. IMT kedua kelompok berada pada kategori obes I dan tidak berbeda bermakna. Terdapat hubungan yang bermakna antara rasio Lpi/Lpa dengan kadar kolesterol HDL plasma (p=0,034;OR=2,55; 95%CI=1,06-6,15). Didapatkan korelasi positif yang bermakna antara asupan ALTJT dengan kadar kolesterol HDL pada kelompok kontrol Terdapat korelasi negatif yang bermakna antara rasio Lpi/Lpa dengan kadar kolesterol HDL plasma pada kelompok kontrol (p=0,03;r=0.23). Tidak didapatkan hubungan yang bermakna antara variabel-variabel lain yang diteliti dengan kadar kolesterol HDL plasma. Kesimpulan: 1. Terdapat korelasi positif yang bermakna antara asupan ALTJT dengan kadar kolesterol HDL plasma pada kelompok control.2. Terdapat korelasi negatif yang bermakna dari rasio Lpi/Lpa dengan kadar kolesterol HDL plasma pada kelompok kontrol. 3. Terdapat hubungan yang bermakna antara rasio Lpi/Lpa dengan kadar kolesterol HDL plasma. 4. Hubungan antara asupan ALTJT (15% dari kalori total dengan kadar kolesterol HDL plasma, pada penelitian ini belum dapat dibuktikan.)

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Objective: The aim of this study was to determine the relationship between of mono unsaturated fatty acid (MUFA) intake and other factors with plasma high density lipoprotein (HDL) cholesterol level on coronary heart diseases (CHD) patients.

Place: Rumah Sakit Jantung Harapan Kita.

Method: The design was unmatched case- control study, which has been approved by ethical committee Faculty of Medicine University of Indonesia. One hundred and thirty four patients with CHD as subjects of the study, consist two groups. 67 subjects as case (plasma HDL cholesterol < 35 mg/dL) and 67 subjects as control group (plasma HDL cholesterol (35 mg/dL) respectively. Consecutive sampling method was used to obtain the subjects. Data collected were demographic characteristics, macronutrient intake using 24 hours recall and semiquantitative food frequency questionnaire (FR)) method in the last three month, smoking habit, alcohol consumption, exercise, body mass index (BMI), and waist hip ratio (WHR) measurements.

Results: Demographic characteristic of both groups were similar. MUFA intake in the control group was higher than case, but no significant difference was found between groups. No significant difference was found in term of the BMI between case and control group. There was significant relationship between WHR and plasma HDL cholesterol (p0.034; OR=2,55; 95%CI= 1,06-6,15). Significant positive correlation between MUFA intake and plasma HDL cholesterol in the control group was found (p=O,Ol;r~,29). There was significant negative correlation between WHR and plasma HDL cholesterol in the control group (p=),03;r=-0,23). Other variables did not show any relationship with plasma HDL cholesterol.

Conclusion:

1. There was significant positive correlation between MUFA intake and plasma HDL cholesterol and negative correlation between WHR and plasma HDL cholesterol in the control group.

2. There was significant relationship between WHR and plasma HDL cholesterol. Relationship between of MUFA intake (l5% total calorie and plasma HDL cholesterol has not been proved yet."

"Latar belakang. Perubahan fungsi endotel mendahului proses perubahan morfologi dan berkontribusi terhadap perkembangan lesi aterosklerosis dan progresinya. Evaluasi dengan menggunakan metode non invasif FMD (flow mediated dilation) brakial memberikan informasi inkonsisten mengenai ekstensi dan beratnya aterosklerosis koroner terkait disfungsi endotel. Penelitian ini akan melihat korelasi nilai FMD brakial dengan derajat beratnya stenosis arteri koroner. Metode. Penelitian ini merupakan suatu penelitian potong lintang. Evaluasi dilakukan pada 85 pasien yang menjalani angiografi koroner elektif di Pusat Jantung Nasional Harapan Kita dan memenuhi kriteria inklusi sejak Januari hingga Oktober 2012. Korelasi nilai FMD brakial dengan beratnya stenosis penyakit arteri koroner (PAK) menggunakan Skor Gensini dinilai dengan analisis regresi linier. Hasil. FMD brakial memiliki korelasi negatif dengan Skor Gensini (R= -0,227; P= 0,037). Hipertensi memiliki korelasi negatif dengan nilai FMD brakial (R= -0,235; P= 0,032). Jenis kelamin laki-laki memiliki korelasi positif dengan nilai FMD brakial (R= 0,220; P= 0,040). Kesimpulan. Nilai FMD brakial memiliki korelasi negatif yang lemah dengan Skor Gensini.

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Background. Endothelial dysfunction precedes the development of morphological changes and contributes to atherosclerotic lesion development and progression. Evaluation using non invasive method such as brachial FMD (flow mediated dilation) has given inconsistent information for extension and coronary atherosclerotic severity regarding endothelial dysfunction. This research will evaluate the correlation between brachial FMD and severity of coronary artery disease (CAD) stenosis.

Methods. It was a cross sectional study. Evaluations were performed in 85 patients who had followed elective coronary angiography and fulfilled inclusion criteria in National Cardiovascular Center Harapan Kita since January until October of 2012. Correlation between brachial FMD and severity of CAD stenosis (Gensini score) was evaluated using linear regression analysis.

Results. Brachial FMD had negative correlation with Gensini score (R= -0,227; P= 0,037). Hypertension had negative correlation with brachial FMD (R= -0,235; P= 0,032). Male gender had positive correlation with brachial FMD (R= 0,220; P=0,040).

Conclusion. There was weak negative correlation between brachial FMD and Gensini score."