Intisari
Pendahuluan: Statin adalah suatu inhibitor 3-hidroxy-3-methyl glutaryl coenzyme-A (3 HMG-Co-A) reductase yang memiliki efek perbaikan fungsi endotel dan anti inflamasi. Endothelin-1 (ET-1) merupakan marker disfungsi endotel, sedangkan c-reactive protein (CRP) merupakan marker inflamasi. Pasien dengan ST-segment elevation myocardial infection (STEMI) terjadi gangguan fungsi endotel dan peningkatan inflamasi. Penelitian ini bertujuan membuktikan pengaruh pemberian terapi statin sebelum terapi fibrinolitik terhadap kadar ET-1 dan CRP serum pada pasien STEMI.
Metode: Desain penelitian eksperimental klinis randomized double blind controlled trial, pada bulan Agustus sampai Desember 2015 di RSDM Surakarta. Perbedaan rerata antara kelompok terapi statin dan tanpa terapi statin sebelum fibrinolitik menggunakan independent t test bila distribusi normal dan mann whitney test bila distribusi tidak normal. Beda rerata pre dan 24 jam post terapi statin dalam satu kelompok digunakan paired t test bila distribusi data normal dan Wilcoxon test bila distribusi tidak normal. Hasil bermakna bila p<0,05 dengan interval kepercayaan (IK) 95%.
Hasil: Terdapat perbedaan bermakna kadar ET-1 dan CRP pre dan 24 jam post terapi statin pada kelompok terapi statin sebelum fibrinolitik dengan nilai p=0,009 dan p=0,003 berturut-turut.
Simpulan: Terdapat pengaruh pemberian terapi statin sebelum fibrinolitik terhadap kadarET-1 dan CRP serum pada pasien STEMI.
Kata Kunci: Statin, endothelin-1, C-reactive protein, ST-segment elevation myocardial infarction
Abstract
Introduction: Statins is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-Co 3-A) reductase that has the effect of improving endothelial function and anti-inflammatory. Endothelin-1 (ET-1) is a marker of endothelial dysfunction, whereas c-reactive protein (CRP) is a marker of inflammation. Patients with ST-segment elevation myocardial infection (STEMI) disruption of endothelial function and increased inflammation. This study aims to prove the influence of statin therapy before fibrinolytic therapy on levels of ET-1 and CRP in serum in patients with STEMI.
Methods: The study design of clinical experimental double blind randomized controlled trial, from August to December 2015 in RSDM Surakarta. Mean difference between the groups without statin therapy and statins before fibrinolytic therapy using independent t test when the normal distribution and the Mann Whitney test when the distribution was not normal. The mean difference of pre and 24 hours post statin therapy in a group used paired t test when normal data distribution and the Wilcoxon test if the distribution was not normal. Results significant if p <0.05 with a confidence interval (CI) of 95%.
Results: There were significant differences in the levels of ET-1 and CRP 24 hours pre and post statin therapy on statin before fibrinolytic therapy group, with p= 0.009 and p= 0.003 respectively.
Conclusion: There is the influence of statin therapy before fibrinolytic on levels of ET-1 and CRP in serum in patients with STEMI.
Keywords: Statins, endothelin-1, c-reactive protein, ST-segment elevation myocardial infarction
