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Opie, Lionel H.
Abstrak :
Presents information on every drug class used to treat cardiovascular disease. This title features dosages, interactions, indications and contraindications, side effects, and more at your fingertips, equipping you to make effective clinical decisions on behalf of your patients
Philadelphia, PA: Elsevier, Saunders, 2013
615.71 DRU
Buku Teks  Universitas Indonesia Library
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Sutriwati Yuni Lestari
Abstrak :
ABSTRAK
Program Ners Spesialis Keperawatan Medikal Bedah kekhususan Kardiovaskular merupakan serangkaian kegiatan pendidikan yang berfungsi untuk menerapkan teori keperawatan dalam upaya untuk memberikan asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular. Peran sebagai pemberi asuhan keperawatan dilakukan oleh residen dengan mengelola sebanyak 31 pasien dengan menggunakan teori adaptasi Roy. Peran sebagai peneliti dilakukan dengan menerapkan Evidence Based Nursing EBN yaitu menerapkan pengkajian resiko perdarahan dengan metode HAS-BLED untuk mengetahui resiko perdarahan lebih dini. Peran sebagai innovator diwujudkan dengan membuat karya innovasi berupa format pengkajian discharge planning. Hasilnya adalah: 1. Model konsep adaptasi Roy efektif diterapkan sebagai upaya untuk memberikan asuhan keperawatan pada pasien gangguan sistem kardiovaskular, 2. Pengkajian HAS-BLED efektif untuk menilai risiko perdarahan, dan 3. Format discharge planning dengan pendekatan 5 model discharge planning terbukti cukup efektif digunakan sebagai sarana pendokumentasian discharge planning di RSJPDHK Jakarta
ABSTRACT
Medical surgical nursing clinical practise especially in cardiovascular is a educational programme to applied nursing theory model in nursing care with cardiovascular disease. Nurses performed their roles as a care provider by managed 31 patients with the nursing theory model approach used is Roy rsquo s adaptation theory. The role as a researcher was excuted by applying evidence based nursing practice with the topic HAS BLED Form to assess bleeding risk earlier. The role as a innovator, the practician trying to created Discharge Planning Form. The results of the practice analysis are 1. Roy rsquo s Adaptation model is effective to apply in nursing care with cardiovascular diseases. 2. HAS BLED is effective to scoring bleeding risk assessment, and 3. Discharge planning Form with five models approach is acceptable in Nasional Cardiovascular Centre Harapan Kita.
2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Sibarani, Marcel H. Reinhard
Abstrak :
Latar belakang : Setiap tahapan gangguan metabolisme glukosa pada disglikemia berhubungan dengan peningkatan risiko kejadian kardiovaskular. Pada disglikemia perlu diketahui prediktor serta stratifikasi risiko individu mengalami kejadian kardiovaskular sehingga dapat dilakukan pencegahan primer. Penelitian ini bertujuan mengembangkan model prediktor kejadian kardiovaskular pada disglikemia. Metode : Penelitian ini merupakan penelitian kohort retrospektif pada “Studi Kohort Faktor Risiko Penyakit Tidak Menular Bogor” tahun 2011-2018. Pada awal penelitian dilakukan pencatatan usia, jenis kelamin, tekanan darah, indeks massa tubuh, lingkar perut, glukosa darah, kolesterol, kebiasaan merokok, riwayat penyakit kardiovaskular dalam keluarga dan aktivitas fisik. Selanjutnya dilakukan pengamatan kejadian kardiovaskular yaitu penyakit jantung koroner, stroke atau all cause cardiovascular mortality dalam enam tahun. Hubungan variabel yang secara independen yang mempengaruhi kejadian kardiovaskular dianalisis dengan cox proportional hazards regression, lalu dilakukan pembuatan model prediksi, penilaian diskriminasi dengan menggunakan kurva ROC dan kalibrasi dengan Hosmer -Lemeshow. Hasil : Sebanyak 1.085 subjek masuk dalam penelitian ini dengan 73,5% subjek adalah perempuan. Insidens kejadian kardiovaskular dalam enam tahun adalah 9,7%. Faktor prediktor kejadian kardiovaskular pada disglikemia dalam enam tahun pada penelitian yaitu usia 45-65 tahun (HR=2,737; IK 95% 1,565-4,787) dan hipertensi (HR=2,580;IK 95% 1,619-4,112). Total skor pada model prediktor adalah dua dengan probabilitas kejadian kardiovaskular dalam enam tahun 17,2%. Hasil analisis kurva ROC didapatkan nilai Area Under the Curve (AUC) model prediktor sebesar 0,689 dengan p < 0,001 (IK 95% 0,641-0,737). ......Background: Each stage of impaired glucose metabolism in dysglycemia is associated with an increased risk of cardiovascular events. In dysglycemia, it is necessary to acknowledge the predictors and the risk stratification in individuals at high risk for cardiovascular disease so that primary prevention can be done. This study aims to develop a predictive model of cardiovascular events in dysglycemia. Method: This is a retrospective cohort study conducted in the “The Bogor Cohort Study of Noncommunicable Diseases Risk Factors" from 2011 to 2018. Data associated with age, gender, blood pressure, body mass index, waist circumference, blood glucose, cholesterol, smoking habits, family history of cardiovascular disease, and physical activity were obtained. Cardiovascular events in six years were observed include coronary heart disease, stroke, or all-cause cardiovascular mortality. Cox proportional hazards regression models were used to determine independent predictors of cardiovascular events. Model discrimination was evaluated by the ROC curve, while the Hosmer-Lemeshow test evaluated the calibration. Results: A total of 1085 subjects included in this study, with 73.5% are female. The incidence of cardiovascular events in six years is 9.7%. Predictors of cardiovascular events in dysglycemia are age 45-65 (HR=2.737;95% CI 1.565-4.787) and hypertension (HR=2.580;95% CI 1.619-4.112). The predictor model's total score is two, with a six-year probability of cardiovascular events being 17.2%. The ROC curve analysis showed that the AUC value for the predictor model was 0.689 with p < 0.001 (95% CI 0.641-0.737). Conclusion: Age 45-65 and hypertension were predictors of cardiovascular events in six years in dysglycemia patients. The scoring system has adequate performance, with a total score of two and the probability of cardiovascular events in six years 17.2%.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Chris Tanto
Abstrak :
Latar Belakang. Prediksi mortalitas pada kelompok lanjut usia yang semakin meningkat jumlahnya akan memberikan banyak manfaat bagi kesehatan. Cystatin C ditunjukkan memiliki kemampuan sebagai prediktor mortalitas pada beberapa studi. Studi-studi mengenai kemampuan prediksi cystatin c masih sangatlah beragam dan belum ada telaah sistematis untuk menilai kemampuannya dalam memprediksi mortalitas jangka panjang pada kelompok lansia. Tujuan. Penelitian ini bertujuan untuk menilai kemampuan cystatin c sebagai prediktor mortalitas semua sebab dan mortalitas kardiovaskular jangka panjang pada kelompok lanjut usia. Metode. Studi ini merupakan telaah sistematis dan meta-analisis dari studi kohort prospektif observasional. Pencarian studi dilakukan di PubMed, Cochrane, Scopus, EBSCOHost, dan Proquest serta pencarian menual. Kriteria inklusi berupa lansia minimal berusia 65 tahun dengan data cystatin c serum tercantum, kematian semua sebab sebagai luaran. Waktu follow up minimal 5 tahun. Seleksi studi dilakukan berdasarkan alur dari PRISMA. Penilaian kualitas studi dan risiko bias dinilai menggunakan Newcastle Ottawa Scale untuk studi kohort. Hasil studi ditampilkan dalam bentuk deskriptif serta Forest plot. Hasil. Dari 609 studi hasil pencarian, didapatkan 12 studi yang memenuhi kriteria: 5 studi menilai kematian semua sebab, 3 studi menilai kematian kardiovaskular saja, dan 4 studi menilai keduanya. Sebanyak 6 studi dengan kualitas baik dan 6 studi kualitas sedang setelah dilakukan penilaian. Hasil meta-analisis menunjukkan kadar Cystatin C yang tinggi meningkatkan risiko mortalitas jangka panjang akibat semua sebab [HR: 1,74 (95% CI: 1,48 – 2,04); p < 0,00001)] dan mortalitas jangka panjang kardiovaskular [(HR: 2,01 (95% CI: 1,63 – 2,47); p < 0,00001)] pada lansia. Kemampuan prognostik cystatin c tergolong moderat [AUC 0,70 (95% CI: 0,68-0,72); p = 0,02)]. ...... Background. Prediction of mortality in growing aged-population will offer several benefits for health sector. Cystatin C, which has long been known as biomarker to more accurately evaluate glomerular filtration rate in elderly, has also been shown to predict mortality from several studies. Studies regarding its predictive ability were vastly varied and there has not been systematic review to examine its ability in predicting long-term mortality in elderly population. Objectives. This study aimed to evaluate Cystatin C performance as predictor for all-cause and cardiovascular mortality among elderly population. Methods. A systematic review of prospective cohort studies was performed. Literature searching was done in major databases such as PubMed, Cochrane, Scopus, EBSCOhost, and Proquest. Manual searching was also performed. Inclusion criteria were studies involving elderly age 65 or older, cystatin c serum levels available, all-cause mortality as outcome, and 5-years minimum of follow-up. Study selection was performed according to PRISMA algorithm. Newcastle Ottawa Scale for cohort study was used to assess primary studies’ quality and risk of bias. Study results were presented in descriptive tables and Forest plot. Results. Initial searching revealed 609 hits with 12 studies eligible for the review: five studies evaluated all-cause mortality, three studies evaluated cardiovascular mortality, and four studies evaluated both. Meta-analysis showed that high cystatin c levels increasing risk of long-term all-cause mortality [(HR: 1.74 (95% CI: 1.48 – 2.04); p < 0.0001)] and cardiovascular mortality [HR: 2.01 (95% CI: 1,63 – 2,47); p < 0,0001)]. The prognostic ability of cystatin c was considerably moderate [AUC 0.70 (95% CI: 0.68-0,72); p = 0.02]. Conclusion. Cystatin C was able to predict long-term mortality in elderly population.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Abstrak :
Statin adalah kelompok obat antihiperlipidemik yang dapat menurunkan kadar kolesterol dalam darah. Statin dapat menghambat kerja enzim HMG CoA reductase yang berperan dalam reaksi konverasi HMG CoA dalam sintsesis kolesterol dalam hati. Dehidrolovastatin adalah senyawa analog dari lovastatin yang nantinya digunakan untuk terapi pasien yang mempunyai kadar kolesterol darah yang tinggi. Tujuan dari penelitian ini adalah mendapatkan metode yang valid untuk penetapan kadar dehidrolovastatin dalam plasma in vitro. Validasi metode analisis ini meliputi studi tentang kurva kalibrasi dan linieritas, LLOQ dan selektivitas, akurasi, presisi, perolehan kembali dan stabilitas. Metode analisis ini menggunakan KCKT Knauer dengan perangkat detektor UV 2500, kolom Kromasil ®100-5, C18, 250 x 4,6 mm. Sistim fase terbalik ini mempunyai kondisi optimum yaitu menggunakan fase gerak asetonitril dan asam fosfat 0,1 % (75:25), laju alir 1,2 mL/menit, standar internal simvastatin dan panjang gelombang 238 nm. Sampel dengan rentang konsentrasi 0,013 - 0,200 ppm memberikan kurva kalibrasi dengan koefisien korelasi 0,998 dan LLOQ 0,013 ppm. Hasil penelitian validasi metode penetapan kadar ini memenuhi persyaratan standar.
Abstract
Statins are antihyperlipidemic drugs for lowering LDL-cholesterol level in human blood. They were designed to inhibit HMG CoA reductase in the liver so that the enzyme will not catalyze the transformation of HMG CoA into early precursor of LDL-cholesterol. Dehydrolovastatin is a kind of statins whose structure is analogous to lovastatin (its starting material). The aim of this study was to validate method for in vitro analysis of dehidrolovastatin in plasm. The validation included studies of calibration curve and linearity, LLOQ and selectivity, accuracy, precision, recovery, and stability. Dehidrolovastatin was deteminated by Knauer ® HPLC using UV 2500 detector, Kromasil ® 100-5, C18, 250 mm, 4.6 mm i.d., column. Reversed phase was applied with the optimal condition such as mobile phase acetonitrile and phosphoric acid 0.1 % (75:25), the flow rate of 1.2 mL. minutes -1, simvastatin as internal standard and wavelength 238 nm. Concentrations of sample ranged from 0.013 to 0.200 ppm with correlation coefficient of the calibration curves 0,998 and lower limit of quantitation was 0.013 ppm. The results of validation studies fulfilled standard criteria.
[Fakultas Farmasi Universitas Indonesia, Lembaga Biomedis Direktorat Kesehatan TNI-AD, Jakarta], 2008
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Artikel Jurnal  Universitas Indonesia Library
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Vika
Abstrak :
ABSTRAK
Penelitian ini merupakan uji validitas dan reliabilitas kuesioner Morisky Medication Adherence Scale 8 (MMAS-8) versi bahasa Indonesia untuk mengukur kepatuhan konsumsi statin pada 40 penerbang militer di Skadron Udara Halim Perdanakusuma pada tanggal 6 April-15 Mei 2016. Hiperkolesterolemia merupakan penyebab penyakit kardiovaskular yang dapat menyebabkan inkapasitasi dalam penerbangan. Salah satu cara untuk mengontrol hiperkolesterolemia adalah dengan minum obat antikolesterol golongan statin, namun belum ada instrumen yang dapat digunakan untuk mengukur kepatuhan minum obat statin di kalangan penerbang militer di Indonesia. Validitas diuji dengan validitas kriteria. Reliabilitas diuji dengan konsistensi internal dan uji ulang (test-retest). Didapatkan korelasi negatif lemah dan tidak ditemukan hubungan bermakna antara antara kadar kolesterol dan tingkat kepatuhan minum statin (koefisien Spearman -0,199; p=0,218). Konsistensi internal moderat (Cronbach?s α=0,759) dengan reliabilitas tes ulang yang baik (koefisien Spearman=0,860). Hasil uji validitas dan reliabilitas MMAS 8 versi bahasa Indonesia pada penerbang militer belum dapat digunakan untuk mengukur kepatuhan minum statin pada penerbang militer di Indonesia.
ABSTRACT
This study analyzed the validity and reliability of Morisky Medication Adherence Scale 8 (MMAS-8) Bahasa version to measure statin adherence among 40 military pilots in Halim Perdanakusuma Air Force Base on April 06th-May 15th 2016. Hypercholesterolemia is the cause of cardiovascular disease which lead to inflight incapacitation. One of the way to control hypercholesterolemia is using statin medication, however there has not been an instrument to measure statin adherence in military pilots in Indonesia. Validity was confirmed using crirerion-related validity. Reliability was tested for internal consistency and test-retest reliability. Negative weak correlation and no significant association between cholesterol and statin adherence level (Spearman coefficient -.199, p=0.218) was found. Moderate internal consistency and excellent test-retest reliability were found (Cronbach?s α=0.759; Spearman correlation=0.860). Validity and reliability of MMAS 8 Bahasa version has not been able to be used to measure statin adherence among military pilots in Indonesia.
2016
T46639
UI - Tesis Membership  Universitas Indonesia Library
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Sabbath Marchend
Abstrak :
Statin telah diketahui dapat menurunkan kandungan kolesterol dalam darah. Statin menurunkan kandungan kolesterol dengan cara menghambat kefja enzim HMG Co-A reduktase yang dibutuhkan pada biosintesis kolesterol, Enzim tersebut mengkatalis reaksi perubahan p^iidrokshpmetilglutaril Co-A menjadi asam mevalonat. Statin biasanya dihasilkan melalui fermentasi dengan menggunakan kapang jenis Aspergillus dan Monascus. Akan tetapl, statin yang dihasilkan dari kapang Monascm tipe liar, kadamya masih relatif kecil. Untuk Itu dilakukan upaya peningkatan galur untuk mendapatkan galur yang leblh potensial dafem menghasilkan statin. Jenis Monascus yang dipakal adalah Monascus purpumus. Upaya peningkatan galur dilakukan dengan mutasi sinar gamma (y) pada beberapa dosis irradiasi yaitu 0,1-0,5 kGy. Seleksl mutan dilakukan secara aoak trerdasarican pola penampakan koloni pada cawan petii dan setelah itu dipilih dosis optimum irradiasi (dosis yang memberikan persentasi survival terkecil) berdasarkan jumlah koloni tunggal yang terbentuk. Dosisdosis optimum yang didapatkan adalah 0,2 ; 0,3 dan 0,4 kGy. Fermentasi yang dilakukan terhadap Monascus purpureus tipe liar dan isolat-isolatnya tidak menunjukkan adanya statin. Beberapa senyawa yang diperkirakan dihasilkan pada fermentasi dari isolat Monascus purpureus dan tipe liarnya adalah pigmen warna monascin, monascorubrin, ankaflavin, serta rubropunctatin ......Statin has been known capable of reducing cholesterol content in blood by inhibiting HMG Co-A reductase enzyme (an enzyme which is needed in cholesterol biosynthesis). This enzyme catalysts the formation of mevalonic acid from p-hydroxyl- p-methylglutaryl Co-A. Statin is usually produced from the fermentation of AspergUlus and Monascus, but the statin yield from the fermentation of Monascus wild type is still low. Therefore, it needs strain improvement to increase the statin production which is done by modifying the genetics. The strain used in this experiment Is Monascus purpureus. The strain improvement is done by mutating Monascus purpureus wild type using gamma (y) ray in several doses. The doses used in the irradiation are 0,1; 0,2; 0,3; 0,4 and 0,5 kGy. Mutant selection is done randomly based on the single colony pattern on petri dish. Before random selection, the optimum doses of irradiation are needed to be determined. The optimum doses are those which give the smallest survival fractions. Those optimum doses are 0,2 kGy, 0,3 kGy and 0,4 kGy. Monascus purpureus wild type and its isolates did not produce any statin under fermentation in Miyake's medium. Several compounds which were predicted produced from Monascus purpureus wild type and its isolates are monascin, monascorubrin, ankaflavin and rubropunctatin
Depok: Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Indonesia, 2004
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UI - Skripsi Membership  Universitas Indonesia Library
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Fakrul Ardiansyah
Abstrak :

Praktik ilmu keperawatan didasarkan hasil riset dan inovasi terbaru. Kualitas asuhan keperawatan ditentukan dari level pendidikan perawat. Perawat spesialis keperawatan medikal peminatan sistem kardiovaskuler berperan pemberi asuhan, edukator, peneliti, dan inovator. Praktik residensi Ners spesialis dilaksanakan selama 2 semester yang bertujuan melakukan peran ners spesialis dengan pendekatan konservasi. Asuhan keperawatan pada gangguan sistem kardiovaskuler menggunakan pendekatan model konsep konservasi Myra Estrin Levine. Asuhan keperawatan pada 30 kasus resume dan 1 kasus utama pada ADHF. Active Cycle of Breathing Technique (ACBT) diterapkan pada pasien paska bedah jantung untuk pemulihkan fungsi paru paska bedah jantung. Proyek inovasi rehabilitasi jantung fase I pada pasien sindrom koroner akut untuk pemulihan toleransi aktivitas. Hasil analisis praktik bahwa model konsep konservasi efektif diterapkan pada gangguan sistem kardiovaskuler untuk mempertahankan konservasi holistik, ACBT mampu memulihkan fungsi paru pasien paska bedah jantung, dan penerapan rehabilitasi jantung fase I mampu toleran terhadap aktivitas, dan standard prosedur operasional dapat dipahami, mudah dilaksanakan oleh pasien dan perawat. The nursing science practice is based on research results and the most current innovations. The quality of nursing care is determined by the nurses education level. Nurses of medical surgical nursing specialist, whose specialty are for cardiovascular system disorder, have some roles which are as a care provider, educator, researcher, and innovator. The clinical residency practice is conducted for 2 semesters and aims to implement the roles of specialist nurse by applying a conservation model approach. The nursing care on cardiovascular system disorders is using Myra Levine Conservation model approach to 30 patients with various cardiovasculer disorders, which the primary case is ADHF. The active cycle of breathing technique is applied to postoperative cardiac surgery patients for pulmonary function recovery after a cardiac surgery. The phase I of cardiac rehabilitation is applied to acute coronary syndrome patients for activity tolerance recovery. The analysis practice result shows  that the conservation model might be applied effectively to the nursing care for cardiovasculer disorders in order to maintain a holism conservation. The active cycle of breathing technique is able to aid pulmonary function recovery post cardiac surgery and the phase I of cardiac rehabilitation is able to aid for activities tolerance, and the standard operating procedures is able to be easily understood and implemented by the patients and nurses.

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2019
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UI - Tugas Akhir  Universitas Indonesia Library
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Ika Ainur Rofi`ah
Abstrak :
Keperawatan medikal bedah merupakan bidang praktik khusus dalam keperawatan profesional yang fokus dalam perawatan respon pasien terhadap masalah kesehatan aktual maupun potensial. Clinical nurse specialist (CNS) didefinisikan sebagai clinical leader dalam praktik keperawatan yang memiliki pengetahuan dan keterampilan tingkat lanjut seperti keahlian klinis dalam bidang tertentu, praktik berbasis bukti, kolaborasi, konsultasi, edukator, mentoring, dan manajemen. Peran CNS meliputi direct patient care, nursing practice, dan organization atau system. Peran perawat direct patient care diterapkan pada 31 pasien kasus kardiovaskuler baik medikal maupun bedah dengan pendekatan Model Adaptasi Roy. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy dapat diterapkan dalam memberikan asuhan keperawatan pasien dengan gangguan sistem kardiovaskuler. Penerapan peran perawat nursing practice, yaitu perawat menerapkan praktik yang berbasis bukti (evidence) adalah efektivitas cold therapy sebelum latihan napas dalam (deep breathing) dan batuk efektif (coughing) terhadap nyeri akut pada pasien post cardiac surgery. Penerapan peran perawat organisation atau system, yaitu perawat membuat pengembangan profesional melalui inovasi terbaru untuk perkembangan asuhan keperawatan dengan menyusun SPO rehabilitasi jantung fase 1 pada pasien sindrom koroner akut (SKA). ......Medical surgical nursing is a special area of nursing profesional practice that focuses on the care of patient s response to actual and potential health problems. Clinical nurse specialist (CNS) is defined as a clinical leader in nursing practice that has advance knowledge and skill such as clinical expertise in a particular area, evidence-based practice, collaboration, consulting, eduvator, menoting, and management. The role of CNS included direct patient care, nursing practice, and organization or system. The role as a direct patient care was applied to 31 cardiovascular patients both medical and surgical with the Roy s Adaptation Model approach. The result of practice analysis showed that Roy s Adaptation Model could be applied in providing nursing care in cardiovascular disease. The application of nursing practice nursing role, that nurse applied evidence-based practice that was effectiveness of cold therapy before deep breathing and coughing for acute pain post cardiac surgery patient. Aplication of the role of nurse organization or system, that nurses made professional development through the innovation for the development of nursing care. It was 1st phase cardiac rehabilitation in patient with acute coronary syndrome by formed standard operational procedure (SOP).
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2019
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UI - Tugas Akhir  Universitas Indonesia Library
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Rita Zahara
Abstrak :
Edema miokardium dapat menyebabkan disfungsi miokardium. Pada operasi bedah pintas arteri koroner (BPAK), proses inflamasi dan reperfusion injury menyebabkan edema miokardium. Berbagai cara telah dilakukan untuk menghambat edema miokardium namun belum ada yang terbukti efektif. Statin merupakan obat yang memiliki efek pleiotropik sebagai anti inflamasi. Penelitian pada subjek hewan menunjukkan bahwa statin dapat mengurangi edema miokardium. Sebagai respons terhadap kondisi stress, jantung mengeluarkan berbagai sitokin seperti follistatin-like 1 (FSTL1). FSTL1 berperan dalam proses edema miokardium. Untuk mengurangi edema miokardium pasien BPAK dilakukan pemberian Atorvastatin 80 mg selama 2 minggu sebelum operasi. Penelitian dilakukan secara uji klinis tersamar ganda pada pasien berusia 40–65 tahun yang menjalani operasi BPAK. Dilakukan dari Februari 2017 hingga Maret 2018 di rumah sakit jantung dan pembukuh darah Harapan Kita. Subjek penelitian diacak ke dalam dua kelompok, kelompok Atorvastatin dosis 80 mg dan Atorvastatin dosis 10 mg. Pemeriksaan edema miokardium dilakukan dengan MRI pada hari ke-6 pascaoperasi. Pemeriksaan FSTL1, PKA, PKB dan hs-CRP diambil dari plasma darah 1 hari sebelum operasi, hari ke-1 dan hari ke-6 pasca operasi. Parameter MRI yang dinilai adalah nilai T2 relaxation time. Sebanyak 20 pasien termasuk dalam kelompok Atorvastatin 80 mg dan 20 pasien dalam kelompok Atorvastatin 10 mg. Terdapat 7 subjek yang drop out. Pemeriksaan MRI mendapatkan nilai T2 relaxation time yang lebih rendah pada kelompok Atorvastatin 80 mg (50,11 ms vs. 59,03 ms, p = 0,01). Tidak didapatkan korelasi yang bermakna antara FSTL1 dengan T2 relaxation time. Pemeriksaan FSTL1, PKA dan PKB tidak berbeda secara bermakna antara kedua kelompok sedangkan kadar hs-CRP lebih rendah serta bermakna secara statitistik pada kelompok Atorvastatin 80 mg. Simpulan: Pemberian Atorvastatin dosis 80 mg dapat menurunkan kejadian edema miokardium pasca BPAK dan menunjukkan efek antiinflamasi yang lebih baik dari pada Atorvastatin 10 mg. ......Myocardial edema can cause myocardial dysfunction in many pathological states. During coronary artery bypass surgery (CABG), there is inflammatory system activation as well as reperfusion injury which can produce myocardial edema. Many efforts has been applied in order to prevent those process but none has proven effective. Statin is a drug with many pleiotropic effects as anti inflammatory. Animal study revealed that statin can decrease myocardial edema, In response to stress conditions, heart produced many cytokines, such as follistatin-like 1 (FSTL1). FSTL1 has a principal role in reducing myocardial edema. This study tried to find the effectiveness of Atorvastatin 80 mg, also known as high dose statin, in decreasing myocardial edema after CABG surgery. Double blinded clinical trial was performed, in patients 40–65 years of age who underwent CABG surgery. This study was conducted from February 2017 until March 2018 at National Cardiovascular Centre Harapan Kita. Subjects were randomized and divided in two groups, high dose Atorvastatin (80 mg) and low dose atorvasatin (10 mg). Myocardial edema evaluation using magnetic resonance imaging (MRI) was done in day-6 after surgery. FSTL1, PKA, PKB, and hs-CRP were evaluated before surgery, day-1 after surgery, and day-6 after surgery. T2 relaxation time was used as the MRI parameter of myocardial edema. There were 20 patients treated with Atorvastatin 80 mg and 20 patients at Atorvastatin 10 mg. There were 7 subject who dropped out. MRI evaluation found lower T2 relaxation time in high dose group (50,11ms vs. 59,03 ms, p = 0,01). There was no significant correlation between FSTL1 and T2 relaxation time. FTSL1, PKA and PKB in both groups were not statistically different but hs-CRP value was statistically lower in high dose group. Conclusion: Atorvastatin 80 mg can decrease the incidence of myocardial edema after CABG surgery and shows a better anti-inflammatory effect than Atorvastatin 10 mg. The correlation between statin and FSTL1 in term of myocardial edema has not been defined yet.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Disertasi Membership  Universitas Indonesia Library
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