Kadar Fibrinogen pada Infark Miokard dengan St-Elevasi (STEMI) dan Sindroma Koroner Akut Non St-Elevasi (NSTEACS) di Rumah Sakit Umum Pusat Dr. Sardjito Yogyakarta  

Oleh:

Setianto, Budi Yuli ; Zulrifqi

Jenis: Article from Journal - ilmiah nasional
Dalam koleksi: Berkala Kesehatan Klinik vol. 12 no. 02 (Dec. 2006), page 80-84 .
Topik: Fibrinogen levels - STEMI -NSTEACS - Diabetes Mellitus - hypertension

Ketersediaan

Perpustakaan FK Nomor Panggil: B25.K.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: Acute coronary syndrome (ACS) can be divided into two major categories based on the 12-lead electrocardiogram (ECG) at presentation, those with ST-segment elevation on the ECG that is diagnostic of acute ST-elevation myocardial infarction (STEM I), and those who present with ST-segment depression, T-wave changes or no ECG abnormalities (non ST-segment elevation ACS, NSTEACS). The latter term (NSTEACS) encompasses both unstable angina and non-ST elevation myocardial infarction (NSTEACS). Inflammatory processes participate in the earliest stages of atherogenesis in response to insults to the vascular endothelium, as well as to the development of the intermediate and mature atheromatous plaque. Elevated levels of inflammatory biomarkers such as C-reactive protein, amyloid Aserum, fibrinogen are detectable in a substantial proportion of patients presenting with ACS. The precise basis for the relationship between inflammatory markers and risk in ACS has not been conclusively established. Fibrinogen certainly rises as a consequence of the inflammatory response to myocardial necrosis. Objective: Study aims to compare the level of fibrinogen at STEMI and NSTEACS. Method: A cross-sectional study conducted in intensive cardiac care unit of Dr. Sardjito Hospital Yogyakarta from January 2006 through February 2006. Patient which is diagnosed Acute Coronary Syndrome (ACS) and differentiated by STEMI and NSTEMI. Patient excluded if in a condition acute infection, malignancy and liver dysfunction. Each group was measured its quantitative fibrinogen levels and comparing the both results. Statistical analysis using the one sample Kolmogorov Smirnov to know the homogeneity of sample and Student's t test to know different of mean between both sample, and Chi square test to know different categorical data. Result: Patients consist of 76, 3% men and 23, 7% women. Out of the 33 patients, 42, 4% are STEMI and 57, 6% are NSTEMI. Fibrinogen levels was 503,5 ± 191,1 mg/ dL in STEMI group and 409,35 ± 213,36 mg/ dL in NSTEMI group. There is no significant difference of fibrinogen levels between two groups (P=0,193). Fibrinogen levels in STEMI with Diabetes Mellitus subgroups compared with NSTEACS with Diabetes Mellitus subgroups were 528, 65 ± 70, 64 mg/ dl vs. 477,07 ± 215,20 mg/dL, and statistically significant (P=0,005). Fibrinogen levels in STEMI with hypertension subgroups significantly higher than NSTEACS with hypertension subgroups: 572, 02 ± 139,18 mg/dL vs. 377, 75 ± 174, and 17 mg/dL. (P=0,036). Conclusion: Fibrinogen level in STEMI groups was higher compared than NSTEACS groups and the difference was not statistically significant. In Diabetes Mellitus and hypertension subgroups analysis the differences were statistically significant.

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