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Abstrak :
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.

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Latar Belakang : Atherosklerosis adalah suatu proses penyakit yang difus, dengan adanya satu pembuluh darah yang rusak akan memprediksikan adanya kelainan pada pembuluh darah lain. Ankle Brachial Indeks (ABI) dan Toe Brakhial Indeks (TBI) adalah test non invasif terbukti sensitive dan spesifik untuk mendeteksi beratnya penyakit arteri perifer. Tujuan : Mengetahui hubungan derajat Penyakit Arteri Perifer (PAP) Asimtomatis dengan beratnya Penyakit Jantung Koroner (PJK) stabil Metode : Dilakukan studi potong lintang pada tujuh puluh tiga pasien PJK stabil yang menjalani angiografi koroner. Derajat stenosis arteri coroner dinilai dengan skor Gensini > 40 (berat) dan < 40 (ringan-sedang). PAP dinilai dengan pemeriksaan ABI dan TBI dengan metode Oscillomtreic. Analisis menggunakan uji Spearman correlation test dan uji Pearson correlation test. Hasil : Proporsi PAP asimtomatis pada PJK stabil 47 pasien (64,4%). Nilai median ABI adalah 1,07 (kisaran 0,57-1,27), nilai rerata TBI adalah 0,57 (SB 0,155) dan nilai rerata skor Gensini adalah 46,60 (SB 33,64). Analisis bivariat ABI dengan skor Gensini menunjukkan tidak terdapat korelasi (r=-0,099, p 0,407) dan analis bivariate TBI dengan skor Gensini juga menunjukkan tidak terdapat korelasi (r= -0,153, p= 0,196) Simpulan : ABI dan TBI dengan metode Oscillometric tidak berkorelasi dengan derajat stenosis arteri koroner berdasarkan skor Gensini. ABI dan TBI tidak memiliki kemampuan yang baik untuk membedakan pasien PJK ringan-sedang dan berat berdasarkan skor Gensini.

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ABSTRACT
Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores., Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease. Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD) Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables. Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.]

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ABSTRAK
Latar Belakang: Muatan besi berlebih akibat transfusi darah dan peningkatan serapan besi di saluran cerna, masih merupakan isu penting pada Thalasemia Intermedia TI , dan dikaitkan dengan berbagai komplikasi yang meningkatkan morbiditas dan mortalitas. Pemeriksaan MRI T2 hati sebagai pemeriksaaan yang tervalidasi dalam menilai Liver Iron Concentration LIC , merupakan pemeriksaan yang mahal dan tidak tersedia secara merata di Indonesia.Tujuan: Mengetahui gambaran muatan besi berlebih darah dan hati pada pasien thalasemia intermedia dewasa dan korelasi antara saturasi transferin, feritin serum, MRI T2 hati, dan LIC yang dinilai dengan pemeriksaan MRI T2 hati dengan nilai elastografi hati.Metode: Penelitian potong lintang pada pasien thalasemia intermedia dewasa dengan transfusi darah dan dengan atau tanpa kelasi besi di RSUPNCM dr. Cipto Mangunkusumo mulai dari bulan Agustus sampai dengan Oktober 2016, dengan total subyek penelitian sebanyak 45 orang. Dilakukan pemeriksaan saturasi transferin, feritin serum, elastografi hati, dan MRI T2 hati. Analisis statistik menggunakan uji korelasi Pearson dan Spearman.Hasil: Sebanyak 64,4 subyek penelitian adalah Thalasemia ?-Hb E, dengan median RIK umur 33 22 tahun. Sebanyak 84,4 subyek penelitian mendapatkan transfusi darah secara reguler. Seluruh subyek penelitian mengalami komplikasi hemosiderosis hati melalui pemeriksaan MRI T2 hati. Sebanyak 48,9 mengalami hemosiderosis hati berat, dengan nilai median MRI T2 hati 1,6 ms. rerata feritin serum adalah 2831 1828 ng/mL, dengan nilai median saturasi transferin 66 . Nilai rerata LIC melalui pemeriksaan MRI T2 adalah 15,36 7,37 mg besi/gr berat kering hati dan nilai rerata elastografi hati adalah 7,7 3,8 Kpa. Uji korelasi didaptakan terdapat korelasi nilai elastografi hati dan rerata feritin serum r = 0,651; p = 0,000 , nilai elastografi hati dan LIC r = 0,433; p = 0,003 dan korelasi negatif nilai elastografi hati dan MRI T2 hati r = -0,357; p = 0,016 .Simpulan: Terdapat korelasi antara muatan besi berlebih feritin serum dan LIC dengan nilai elastografi hati. Terdapat korelasi negatif nilai elastografi hati dengan MRI T2 hati pada pasien thalasemia intermedia dewasa.

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ABSTRACT
Background Iron overload is a common feature of thalassemia intermedia due to regular blood transfusion and increase gastrointestinal iron absorption. Early detection and adequate iron chelator can significantly decrease related morbidities and mortality due to complication from iron overload. Liver Iron Concentration LIC is the best way to measure body iron stores. MRI T2 as a validated test to identify LIC, is expensive and currently not available in all medical services in Indonesia.Objective To identify liver iron overload and correlation of transferrin saturation, serum ferritin, liver MRI T2 , and LIC with transient liver elastography in adult thalassemia intermedia patient.Methods We conducted a cross sectional study enrolling 45 patients with thalassemia intermedia with blood transfusion and with and without iron chelator therapy. The study was conducted at Cipto Mangunkusumo Hospital from August 2016 through October 2016. We performed measurements of transferrin saturation, serum ferritin level, transient liver elastography and liver MRI T2 . The Pearson and Spearman correlation test were used to evaluate the correlation transient liver elastography with transferrin saturation, serum ferritin, Liver MRI T2 , and LIC.Results As much as 64,4 of study subject are Hb E Thalasemia Intermedia with median IQR age is 33 22 years old. As much as 84,4 of study subject have regular blood transfusion. On the basis of liver MRI T2 , all studi subject suffered from liver iron overload, with 48,9 had severe liver iron overload. The median value of Liver MRI T2 was 1,6 ms. The mean serum ferritin was 2831 1828 ng mL, with median value of transferrin saturation was 66 . The mean of LIC corresponding to Liver MRI T2 and mean liver stiffness measurement was 15,36 7,37 mg Fe gr dry weight and 7,7 3,8 Kpa respectively. Liver Stiffness correlated with serum ferritin r 0,651 p 0,000 , Liver MRI T2 r 0,357 p 0,016 , and LIC r 0,433 p 0,003 . No correlation was found between liver elastography and transferrin saturation r 0,204 p 0,178 .Conclusions Serum ferritin, Liver MRI T2 , and LIC correlated with liver elastography. No correlation was found between transferin saturation and liver elastography.