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"Menurut badan kesehatan dunia World Health Organization (WHO) pada tahun 2015, sebanyak 70% penyebab kematian pada penyakit jantung disebabkan oleh penyakit jantung koroner (PJK). Tercatat 17,5 juta kematian atau setara dengan 30,0 % dari total kematian di dunia disebabkan oleh penyakit jantung koroner (WHO, 2017). Penyakit jantung koroner merupakan gangguan fungsi jantung yang disebabkan adanya plaque yang menumpuk di dalam pembuluh darah arteri sehingga mengganggu supply oksigen ke jantung. Hal ini menyebabkan aliran darah ke otot jantung menjadi berkurang dan terjadi defisiensi oksigen. Pada keadaan yang lebih serius dapat mengakibatkan serangan jantung. Faktor risiko penyakit jantung koroner diantaranya adalah Usia, Jenis Kelamin, Hipertensi, Kolesterol, Riwayat Keluarga dan sebagainya. Jika kemungkinan seseorang untuk menderita penyakit jantung koroner dapat diprediksi sejak awal berdasarkan faktor risiko yang ada, maka tingkat kematian akibat penyakit jantung koroner dapat ditekan menjadi lebih rendah.Tesis ini mengusulkan Model Regresi Logistik Fuzzy untuk memprediksi kemungkinan seseorang untuk menderita penyakit jantung koroner. Tahap pertama dari penelitian ini adalah membangun model prediksi, kemudian mengestimasi nilai parameter dengan menggunakan metode least square. Selanjutnya pada tahap ketiga mengaplikasikan model yang didapatkan untuk memprediksi penyakit jantung koroner. Setelah itu melakukan uji kelayakan atau kesesuaian model dengan metode Mean Degree of Membership dan yang terakhir menghitung akurasi prediksi dengan menggunakan Confusion Matrix.

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According to the World Health Organization (WHO) in 2015, as many as 70% of the causes of death in heart disease were caused by coronary heart disease (CHD). It was recorded that 17.5 million deaths or the equivalent of 30.0% of the world's total deaths were caused by coronary heart disease (WHO, 2017). Coronary heart disease is a disorder of heart function caused by plaque that builds up in the arteries so it interferes with oxygen supply to the heart. This causes blood flow to be reduced and oxygen deficiency occurs. In more serious situations it can prevent heart attacks. Risk factors for coronary heart disease are Age, Gender, Hypertension, Cholesterol, Family History and so on. If there is someone who is a victim of coronary heart disease can be predicted from the beginning, then there is likely to arise more.

This thesis proposes a Fuzzy Logistic Regression Model to predict the possibility of a person suffering from coronary heart disease. The first stage of this research is to build a predictive model, then estimate the parameter values using the least square method. Furthermore, in the third stage, apply a model to predict coronary heart disease. After that, test the feasibility or suitability of the model with the Mean Degree of Membership method and finally calculate the prediction accuracy using the Confusion Matrix."

"Stres sebagai salah satu faktor risiko PJK belum mendapat perhatian sebagaimana faktor risiko PJK lain. Stres dapat mencetuskan sindrom koroner akut seperti Infark Mioakard Akut (IMA) dan mempengaruhi terjadinya komplikasi lebih lanjut selama perawatan, namun masih kurang menjadikan perhatian.Tujuan penelitian untuk mengetahui pengaruh stres terhadap terjadinya komplikasi IMA selama perawatan.Bahan dan Cara : penderita yang dirawat di ICCU RSUPNCM 1990-1997 dengan kohort historiakal.Hasil : Stres merupakan prediktor yang independen terhadap terjadinya komplikasi pada penderita IMA selama perawatan intensif. (RR 2,17, p 0,02 ,CI 1,33 - 3,53). Komplikasi aritmia merupakan komplikasi yang terbanyak pada IMA dengan pajanan stres dan berbeda bermakna secara statistik. (p 0,03 ).Komplikasi lain seperti prolong chest pain, pericarditis (sindrom Dressler), gagal jantung, syok kardiogenik sampai dengan kematian juga lebih tinggi pada penderita IMA, dengan stres selama perawatan intensif.Kesimpulan stres sebagai prediktor independen terhadap terjadinya komplikasi IMA selama perawatan intensif perlu mendapat perhatian sebagai mana faktor klinis lain seperti hipertensi dan diabetes melitus, sehingga morbiditas dan mortalias IMA dapat lebih diturunkan.

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The Influence of Stress on Acute Myocardial Infarction during Intensive CareIt has been known that stress is one of many risk factors for coronary heart disease. Stress may also become a trigger factor to acute coronary syndrome such as event of Acute Myocardial Infarction (AMI) and further complications during intensive care. However most clinicians have still less concern to stress in the relation to these cardiac events.The objective of this study is to determine the influence of stress on acute myocardial infarction during intensive care. The study was perform in January, 1998-December 1998 using historical cohort design.Populations of the study consist of patients hospitalized in Intensive Coronary Care Unit (ICCU), Ciptomangunkusumo Hospital, Jakarta, Indonesia.We observed 160 cases of AMI exposed to stress and of 160 cases of AMI unexposed to stress. Totally 320 cases of AMI hospitalized in ICCU were included the study.The result of this study indicated that the complications of AMI exposed to stress about 2 times higher compared to AMI which were unexposed to stress during intensive care, (p 0.002; CI 1.33 -3.53 ). The proportion of arrhythmia on AMI with stress 32 (20 %) was higher than AMI without stress 18 (11 %) and statistically significant, (p <0,005 ). Other complications on AMI with stress such as heart failure, Dressler syndrome and mortality were also higher compared to AMI without stress.The conclusion of this study suggested that stress is one of independent predictor to AMI complications during intensive care. Stress needs more attentions to reduce morbidity and mortality during intensive care of AMI."

"ABSTRAKTujuan:Untuk mengetahui hubungan antara kadar kromium serum dengan kadar insulin, gula darah, HbAlc, profit lipid dan tingkat oklusi koroner pada penderita baru penyakit jantung koroner.Tempat : Bagian Cath-Lab RS Jantung Harapan Kita.Bahan dan Cara: Penelitian dilakukan pada laki-laki di atas usia 35 tahun yang memenuhi kriteria dikumpulkan data mengenai sosio-ekonomi, keadaan kesehatan, gaya-hidup, aktivitas, IMT, asupan makanan, proporsi zat dan pemeriksaan tekanan darah, kadar kromium serum, insulin, gula darah, HbAlc, profil lipid dan tingkat oklusi koroner.Karakteristik subyek disajikan secara deskriptif, sedangkan analisis dilakukan dengan uji statistik chi kuadrat, t, Mann Whitney, dan uji korelasi Spearman.Hasil: Dari 65 subyek penelitian yang diteliti, umur rata-rata 51.17 + 7.44 tahun, terbanyak (60 %) antara 40 - 55 tahun, 73.9% golongan ekonomi menengah atas, prevalensi DM 13.8%, Hipertensi 16.9%, Merokok 69.2%, olahraga 28%, Obese dan gemuk 52.3%, aktivitas ringan 100%. Asupan nutrisi secara kualitatif sesuai dengan anjuran diit Konsensus Nasional Pengelolaan Dislipidemia di Indonesia, secara kuantitatif subyek dengan tingkat oklusi > 50%, mempunyai asupan protein hewani dan kolesterol yang lebih besar secara bermakna (p<0,05) dibandingkan dengan subyek dengan tingkat oklusi < 50%, dan telah jauh di atas AKG. Nilai rata-rata kromium serum 8.08 ug/L. Nilai ini 431 lebih rendah dari nilai normal. Nilai insulin, gula darah puasa dan trigliserida masih berada dalam batas normal. Nilai HbAlc, LDL, HDL dan Total kolesterol berada dalam batas yang diwaspadai. Berdasarkan Triad Lipid 98.5% menderita Dislipidemia.Berdasarkan tingkat oklusi koroner, didapatkan 44 orang subyek dengan tingkat oklusi >50%, dan 21 orang dengan tingkat oklusi <50% . Subyek dengan tingkat oklusi >50% mempunyai kadar LDL dan total kolesterol yang lebih besar secara bermakna. Kadar kroaium, insulin, gula puasa, HbAlc, trigliserida dan HDL kolesterol tidak berbeda secara bermakna. Pada tingkat oklusi koroner <50%, tidak ada korelasi yang bermakna antara kromium serum dengan faktor-faktor resiko. Pada tingkat oklusi koroner >50% ada korelasi yang bermakna kromium serum dengan gula puasa, trigliserida dan HDL kolesterol.Kesimpulan: Tidak ada hubungan antara kromium serum dengan kadar gula puasa, profil lipid dan tingkat oklusi koroner. Pada tingkat oklusi > 50% ada korelasi yang bermakna antara kroaium serum dengan gula puasa, trigliserida dan HDL kolesterol."

"Proporsi PJK menurut SKRT 1995 adalah 26 %, tidak saja menempati urutan pertama pada penyakit Cardin vasculer disease tapi juga meningkat dari tahun ke tahun, hal ini sangat dipengaruhi oleh gaya hidup. Tujuan penelitian ini adalah untuk melihat pengaruh rasio total kolesterol/HDL, HDL, trigliserida terhadap timbulnya PJK. Manfaat aplikatif dari penelitian ini untuk dapat melakukan pencegahan terhadap timbulnya PJK terutama bagi orang orang yang mempunyai risiko tinggi. Metode : Desain penelitian adalah kasus kontrol dengan populasi kasus penderita PJK di RSPP Januari ski Desember 1997 Jakarta Selatan sebanyak 60 kasus yang di diagnosis DSPD atau DSJP, untuk kontrol diambil dari bagian Bedah umum sebanyak 60 orang yang di nyatakan tidak menderita PJK oleh DSPD dan atau DSJP Dengan kekuatan 80 %, dan derajat kepercayaan 95 %. Penentuan cut off point memakai Cara ROC, serta data di analisis dengan analisis logistik regresi. Hasil penelitian : Pada analisis bivariat rasio total kollesterol ? 4,19 mempakan faktor risiko untuk terkena PJK 1,23 kali 95 % CI ( 0,5023-3,0218 ) di bandingkan mereka dengan kadar rasio total kolesterolJHDL kurang dari 4,19 walaupun secara statistik tidak bermakna 1-IDL pada kadar >36 mg/dl meznpunyai risiko rendah untuk terkena PJK yaitu 0,40 kali 95% CI (0,1683-0,9505) secara statistik bermakna, demikian juga trigliserid pada kadar ≥ 106 mg/dl merupakan faktor risiko terkena PJK sebesar 2,63 kali 95% CI ( 1,0748-6,4159 ) secara statistik bermakna. Dari hasil analisis multivariat permodelan akhir rasio total kolesterol/HDL merupakan faktor risiko 1,53 kali untuk terjadinya PJK, 95% Cl ( 0,5407 - 4,3490 ), HDL tinggi merupakan faktor proteksi sehingga risiko untuk terkena PJK rendah yaitu 0,23 kali, 95% CI ( 0,0761- 0,8719 ), hipertrigliserid mempunyai risiko 2,85 kali untuk terkena PJK, 95% C1 ( 1,0352 -7,8240 ), umur mempunyai risiko 1,09 kali untuk terkena PJK, 95% Cl (1,7128-64,3385) body mass index tinggi mempunyai risiko 3,54 kali untuk terkena PJK. Kesimpulan : Rasio total kolesterol/HDL yang tinggi merupakan faktor risiko untuk terkena PJK dengan di kontrol oleh variabel lain walaupun secara statistik tidak bermakna, pada kadar HDL rendah merupakan faktor risiko untuk terkena PJK baik( berdiri sendiri maupun di kontrol oleh variabel lain, demikian juga trigliserid tinggi merupakan faktor risiko untuk terkena PJK baik berdiri sendiri maupun setelah di kontrol oleh variabel lain.

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Proportion of cardio vascular diseases according to SKRT 1995 is 26 %, this not only occupies the top of the list of cardio vascular diseases, but also has been increasing over the years, which is highly influenced by life style. Purpose of this research is to study the ratio effect of total cholesterol/NDL, HDL, triglyceride against emergence of cardio vascular disease. The applicative benefit of this research is in order to be able to carry out preventive measures against emergence of cardio vascular disease, particularly for persons with high risk.

Method : Design of research is case control with a population case of cardio vascular disease in Pertarnina hospital centre from January to December 1997 in South Jakarta, totalling 60 cases which were diagnozed by internist or cardiologist. Based on a strength of 80 % and 95 % confidence interval, determination of the cut point was done by using the ROC method, and data being furher analyzed by logistic regression analysis.

Research Result : In bivariate analysis, the cholesterol total ratio Z 4.19 constitutes a risk factor to be subjected to cardio vascular disease L23 times 95% Cl ( 0.5023 - 3.0218) compared with those with a total ratio content of chloresterolfHDL of less than 4.19, even though statistically it has no significance_ NDL at the content of z 36 mg/dl has a lower risk to be affected by radio vascular disease, notably 0.40 times 95% Cl ( 0.1683 -- 0.9505 ) by way of reliable statistics, the same goes for triglyceride at the content of z 106 mg/dl constitutes an risk factor 163 times to be affected by cardio vascular disease 95% CI ( 1.0748 - 6,4159 ) by reliable statistics. From results of multivariate analysis of latest total ratio models cholesterolll4DL constitutes a risk factors of 1.53 times to be affected by cardio vascular disease, 95% CI ( 0.5408 - 4.3490 ), high HDL constitutes a protective factor thus resulting the risk to be affected by cardio vascular disease is low, notably 0.23 times, 95% Cl ( 0.0761- 0,8719 ), hypertriglyceride has the risk of 2.85 times to be affected by cardio vascular disease 95% CI ( L0352 -- 7.8240 ), age has the risk factor of 1.09 times to be affected by cardio vascular disease 95% Cl ( 1.0356 --L1643 ), hyperglycemia has the risk of 10.49 times to be affected by cardio vascular disease 95% Cl ( L7128 - 64.3385 ), high body mass index the risk of 154 times to be affected by cardio vascular disease.

Conclusion : Total ratio of high CholesterolLHDL constitutes a risk factor to be affected by cardio vascular disease with the control of other variables, even though statistically this is not significant, while a low HDL content constitutes a risk factor to be affevted by cardio vascular disease, both individually as well as under control by other variables, the same is valid for high tiglyceride also constitues a risk factor to be affected by cardio vascular disease, both individually as well after being controlled by other variables."

"ABSTRACTAs the center of national defense and security system, The Indonesian Armed Forces requires a certain complement of strong troops within a relatively slender organization, but effective and efficient, consisting of professionally well trained soldiers. With such a kind of requisite, it was necessary to focused on the system to examine the health condition and physical fitness of the men power resources in accordance to standardized soldier?s health test system, which should be easy and inexpensive, effective and efficient enough and could be applied in extensive mass health selection. Meanwhile there was a problem observed in Gatot Soebroto Hospital as the top referral hospital of The Armed Forces Health Service, indicated the increased CHD prevalence among the soldier's society within 10 years from January 1976 to December 1985 as the following reports :1.The number of cardiac patients, both the ambulatory as well as the admitted patients, showed the tendency to increase from year to year.2.In regards to the type of Cardiovascular Disease, CHD was found being the majority.3.CHD was mostly found among active soldiers in the top of soldier's career in their productive ages beyond high positions in the armed services.4.CHD showed high enough morbidity and mortality rates.5.The clinical manifestations of CHD often appeared as unexpected episodes of AMI and often ended as unexpected cardiac deaths in their first attacks.The underlying causes of high morbidity and mortality of CHD was hypothesized to be due to inadequate health examinations of candidates and soldiers during extensive mass health screening. In clinical observation it was seen that the health test system recently applied was still not effective enough, chiefly because it could not anticipate the tendency of CHD to appear during their active duty in the armed services."

"ABSTRACTCoronary Heart Disease (CHD) morbidity and mortality rate is increasing dramatically in the last 15 years in Indonesia. Available data show that among the contribution factor changes in life style and demographic transition are prominent.A hypothetical risk factor for CHD is lipid peroxidation, a reaction between oxygen free radical and lipid parts of cell membranes and low density lipoprotein (LDL). Food habit is following a pattern of nutrient and non-nutrient intakes, including fatty acids and antioxidants. Fatty acid intakes determine the susceptibility of the lipid parts of eell membranes and LDL to peroxidation by free radicals. Theoretically, antioxidants will protect against oxidative damage caused by oxygen free radicals. Commercially available and advertised antioxidants such as vitamin E are widely used inspite of limited information on the interrelation between lipid peroxide levels in the Indonesian elderly with CHD risk factors such as food habits, dyslipidemia and obesity.A two-phase study on the elderly (55-85 years.) guided by the health centers was undertaken in Jakarta. Data for both phases were collected through interviews, anthropometric measurements, blood analysis and blood pressure measurements. Univariate, bivariate and multivariate analysis were done using SPSS and WorldFood 2 programs.The first phase was a cross-sectional study to see the association between lipid peroxides and fatty acids, vegetables, fruits, tempe intakes, obesity, smoking, dyslipidemia and hypertension. The samples were 394 elderly. The variables found correlated with lipid peroxides were LDL, intake of mono and poly-unsaturated fatty acids, tempe, and vitamin E. The study showed an increase level of lipid peroxides with age and ethnic differences with the highest level of lipid peroxides among the Minangkabau.The second phase is a randomized double-blind trial giving 600 mg/day vitamin E supplementation or placebo for 12 weeks to 152 elderly with the high level of lipid peroxides found in the cross-sectional study. The objective was to see if there was a change of lipid peroxide levels after the intervention. The results showed a significant decrease of lipid peroxides level in the vitamin E group compared to placebo after being adjusted with age, waist-hip ratio (WHR), plasma cholesterol, and saturated fatty acids (SAFA) intake. The high density lipoprotein (HDL) was also increased significantly in the vitamin E group compared to placebo group.Randomized controlled trial taking into account the confounding variables such as age, sex, ethnic, waist-hip ratio, saturated fat intake, carbohydrate intake and plasma cholesterol might be able to elucidate the specific beneficial effect of vitamin E supplementation. Health education and information concerning foods that have effect on lipid peroxidation, such as tempe should be endorsed. More studies should be undertaken to find other food or beverage that have protecting effects against lipid peroxides."

"Profit lipid yang abnormal merupakan faktor risiko mayor untuk penyakit jantung koroner (PJK) dan beberapa penelitian sebelumnya menunjukkan adanya hubungan dengan gangguan pertumbuhan prenatal (BBLR) atau postnatal. Penelitian ini bertujuan untuk mengetahui besarnya risiko mempunyai profil lipid yang abnormal pada individu dengan gangguan pertumbuhan prenatal. Penelilian dilakukan pada populasi kohort di Kecamatan Tanjungsari Kabupaten Sumedang Sawa Barat yang lahir tahun 1988-1990. Kriteria BBLR berdasarkan pada bayi lahir > 37 minggu dengan berat badan lahir 2700 gram. Kriteria inklusi, BBLR dan non-BBLR dengan pertumbuhan postnatal sampai usia 36 bulan adekuat, mempunyai catatan lengkap BB lahir, TB lahir sampai usia 36 bulan dan catatan BB, TB pada usia 12-14 tahun, bersedia ikut dalam penelitian.Setelah dilakukan pemeriksaan profil lipid, validitas data dan stratifikasi, dari 871 orang subyek yang diteliti, hanya 229 yang memenuhi kriteria yang telah ditentukan. Ditentukan sebanyak 105 subyek penelitian melalui simple random yang mengalami dislipidemia dimasukkan kedalam kelompok kasus, untuk kelompok kontrol, diambil jumlah yang sama dengan matching. Untuk membandingkan data-data antara kedua kelompok dipakai uji student t-test, sedangkan menjawab masalah utama yaitu besarnya risiko mengalami dislipidemia digunakan perhitungan odds ratio dengan menggunakan table 2x2.Hasi penelitian karakteristek umum kedua kelompok (umur, jenis kelamin, berat badan dan tinggi bada) tidak ada perbedaan bermakna p<0,05. Tidak ada perbedaan yang bermakna kadar kolesterol total dan kolesterol LDL remaja dengan BBLR dibandingkan remaja yang non BBLR, p>0,05. Radar trigliserida lebih tingi bermakna pada remaja dengan BBLR dibandingkan dengan remaja non BBLR, p=0,00004, sedangkan kadar kolesterol HDL lebih rendah bermakna pads remaja dengan BBLR dibandingkan remaja non-BBLR, p=0,00004.. Pada remaja dengan BBLR mempunyai risiko lebih besar untuk teijadi dislipidemia dibandingkan remaja non BBLR dengan odds ratio 3,26 95%CI 1,77-6,02; p=0,00003.Kesimpulan : Remaja dengan gangguan pertumbuhan prenatal mempunyai risiko lebih besar untuk terjadi dislipidemia.

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Abnormal lipid profile is an independent risk factor for coronary artery disease. Some studies have shown that small for gestational age (SGA) was associated with abnormal plasma lipid profile in adolescent and adulthood. This study was conducted to asses whether SGA children are more prone to have abnormal plasma lipid profile.

This study was performed to cohort population in Kecamatan Tanjungsari Kabupaten Sumedang-West Java who was born between 1988-1990. The criteria of SGA are term infants, gestational age of > 37 weeks, birth weight : 2700 grams and birth length 45-50 centimeters. Appropriate gestational age (AGA) are term infants, gestational age > 37 weeks; birth weight > 2700 grams and birth length > 47 centimeters. Inclusion criteria were SGA and AGA with postnatal growth up to 36 months adequately, complete birth weight and birth length records up to 36 months as well and birth weight and birth length during 12-14 years of age, willing to accompany in this study.

After lipid profile examination was performed, validity and stratification data of 871 subjects, 229 subjects were complied with including criteria. With the simple random, I05 subjects of dislipidemia were decided as the case group and the same number of control group were included as matching. The significance of differences between two groups was examined using student t -test and Mann Whitney. A p level of 0.05 was considered statistically significant.

There were no differences in general characteristic of both group (age, gender, birth length) p>0.05. No significant differences between total cholesterol and LDL cholesterol levels in subject with SGA compared with AGA, p>0 05. Triglyceride level was higher found significant in subject SGA compared with AGA, p=0.00004, however the HDL cholesterol level have a significant more less in subject SGA compared with AGA, p=0.00004. Subject with SGA have an increase risk to develop of dislipidaemia compare with subject AGA, odds ratio of 3.26, 95%CI 1.77-6.O2;p=0.00003.

Conclusion :

Subject with prenatal growth retardation have an increase risk for dislipidaemia in adult life."

"Latar Belakang: Studi epidemiologi menunjukkan bahwa DM merupakan salah satu faktor dalam proses terjadinya aterosklerosis dan mempengaruhi secara nyata kesaldtan dan kematian akibat PIK. Dibandingkan dengan penderita bukan DM, penderita DM 2-4 kali lebih banyak menderita P3K dan 2-4 kali lebih banyak mengalami kematian jangka pendek setelah menderita serangan infark miokard akut Dewabrata mendapati 23,2% penderita infark miokard akut yang di rawat di RSCM selama periode 1994-1999. Data di Indonesia tersebut belum banyak menggambarkan bagaimana karakteristik penderita DM tersebut saat terbukti menderita infark miokard akut. Dengan demildan, gambaran penderita DM yang mengalami sindrom koroner akut merupakan ha! yang renting untuk diketahui, baik karakteristik klinis maupun komplikasi yang muncul akibat S1CA tersebut.Tujuan. Penelitian ini ingin mengetahui prevalensi SKA pada penderita DM tipe-2. Penelitian ini juga ingin mengetahui karakteristik klinis dan komplikasi SKA pada penderita DM tipe-2 serta perbandingannya dengan penderita bukan DM. Metodologi. Studi potong lintang retrospektif untuk mengetahui prevalensi dan karakteristik klinis serta studi kohort retrospektif untuk mengetahui perbandingan komplikasi SKA pads penderita DM tipe-2 dan penderita bukan DM, terhadap penderita yang dirawat di ICCU RSCM periode 1 Januari 2001 s.d. 31 Desember 2005.Hasil. Didapatkan data: Prevalensi SKA penderita DM tipe-2: 34,2%. Awitan nyeri penderita DM lebih lama, 70,7% vs 53,4%, p=0,001; 1K 95%; DR=2,259 (1,372-3,719). Nyeri dada tidak khas, didapati penderita DM lebih banyak, 17,3% vs 9,8% p~ 0,041; 1K 95%; OR=1,713 (1,019-2,881)_ Komplikasi: Gagal jantung: penderita DM tipe-2 Iebih banyak: 39,35% vs 16,8%, p=0,001; 11(95%; RR-3,213 (1,992-5,182). Untuk komplikasi syok kardiogenik, didapati penderita DM tipe-2 Iebih banyak, 16,2% vs 8,9%, p= 0,031; IK 95%; RR==1,983 (1,057-3,721). Sedangkan komplikasi kematian didapati penderita DM tipe-2 lebih banyak, 17,3% vs 6,3%, dengan p= 0,001; 1K 95%; RR= 3,116 (1,556-6,239).Simpulan. Didapatkan perbedaan karakteristik klinis SKA antara penderita DM tipe-2 dengan penderita SKA bukan DM. Awitan nyeri lebih lama dan keluhan nyeri dada yang tidak khan, Iebih banyak didapati Dada penderita DM tipe-2. Didapatkan juga perbedaan dalam hat komplikasi SKA. Kejadian gagal jantung, syok kardiogenik dan kematian didapatkan lebih tinggi pada penderita DM tipe-2.

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Background. Epidemiologic studies revealed diabetes mellitus (DM) as one of the factors involved in atherosclerosis process. DM also influence morbidity and mortality-related to coronary artery disease (CAD). Compared to non diabetic patients, type -2 DM patients suffer CAD 2-4 times more often and had increased short term mortality rate due to acute myocardial infarction 2-4 times more likely. During 1994-1999, Dewabrata found 23.2% of all acute myocardial infarction patients was diabetic patients treated in ICCU Cipto Mangunkusumo hospital. Unfortunately these data did not describe the clinical characteristic and complication ACS in type -2 DM patients. Therefore it is important to know the clinical characteristics and ACS related complications in type-2 DM patients.

Objectives. To know the prevalence of type-2 DM among ACS patients, to learn clinical characteristics and ACS related complications in type-2 DM compared to non diabetic patients.

Methods. A cross sectional retrospective study was performed to know the prevalence of ACS in type -2 DM patients and their clinical characteristics_ A retrospective cohort study was performed to compare the differences in ACS related complications in type -2 DM and non diabetic patients who were hospitalized in ICCU Cipto Mangunkusumo hospital during 5 years period (January 1st, 200I December 31st, 2005).

Results. Prevalence of Type-2 DM among ACS patients : 34.2%. The onset of chest pain in type-2 DM patients was longer, 70.7% vs 53.4%, p=0.40l; CI 95%; OR=2.259 (1.372-3.719). Aypical chest pain were often in type-2 DM patients, 17.3% vs 9.8%; p= 0.041; CI 95%; OR 1.713 (L019 2.881). Heart failure as complications were more often found in type-2 DM patients, 39.35% vs 16.8%, p=0.001; CI 95%; RR=3.213 (1.992-5.182), cardiogenic shock were more often found in type-2 DM patients, 16.2% vs 8.9%, p= 0.031; CI 95%; RR 1.983 (1.057-3.721), and death were more often found in type-2 DM patients, 17.3% vs 6.3%, p= 0.001; CI 95%; RR= 3.116 (L556-6.239).

Conclusions. There are differences in clinical characteristics of ACS between type-2 DM patients and non diabetic patients; which are longer onset of chestpain and atypical chestpain more often in type-2 DM patients. There are also differences in complications related ACS between Type-2 DM patients and non diabetic patients; heart failure, cardiogenic shock, and death more often in Type-2 DM patients."

"Buku yang berjudul "Handbook of coronary care" ini ditulis oleh Joseph S. Alpert dan Gary S. Francis. Buku ini merupakan sebuah buku panduan mengenai penanganan penyakit jantung."