ABSTRAK
Latar Belakang
Penyakit kardiovaskuler bertanggung jawab sekitar 70% kasus kematian, terutama penyakit jantung koroner akibat aterosklerosis dini, yang merupakan penyebab utama morbiditas dan mortalitas penderita DM tipe 2. Trombosis merupakan tahap krusial perkembangan dan progresivitas aterosklerosis serta kejadian kardiovaskuler sehubungan dengan aterosklerosis. Tissue factor (TF) merupakan pemicu koagulasi yang paling kuat sedangkan plasminogen activator inhibitor-1 (PAI-1) merupakan inhibitor fibrinolisis. Pada DM tipe 2 terjadi peningkatan kadar TF dan kadar PAI-1. Simvastatin menunjukkan sifat antitrombosis dengan menekan TF, serta meningkatkan profibrinolisis dengan menekan PAI-1.
Tujuan Penelitian
Penelitian ini bertujuan untuk mengetahui pengaruh simvastatin terhadap kadar TF dan PAI-1 pada pasien DM tipe 2.
Metode Penelitian
Metode yang digunakan adalah randomized double blind controlled trial, melibatkan 24 pasien, 12 pasien kelompok kontrol diberikan plasebo dan 12 pasien kelompok perlakuan diberikan simvastatin 20 mg/hari. Penelitian berlangsung selama 6 minggu. Analisis statistik dengan SPSS 17 for windows, signifikan bila p<0,05.
Hasil Penelitian
Hasil penelitian menunjukkan, pada kelompok perlakuan didapatkan penurunan kadar TF (pre vs post: 54,69 ± 37,99 pM vs 31,62 ± 1,58 pM; p=0,02) tetapi tidak didapatkan perubahan kadar PAI-1 (pre vs post: 1,05 ± 1,27 U/ml vs 1,29 ± 1,08 U/ml; p=0,07). Pada kelompok kontrol tidak didapatkan perbedaan kadar TF dan PAI-1 sebelum maupun sesudah perlakuan (TF pre vs post: 32,23 ± 3,28 pM vs 34,34 ± 7,86 pM, p=0,29; PAI-1 pre vs post: 1,08 ± 1,19 U/ml vs 2,1 ± 2,67 U/ml, p=0,13).
Kesimpulan
Simvastatin menurunkan kadar TF tetapi tidak berpengaruh terhadap kadar PAI-1 pada pasien DM tipe 2.
Kata kunci: simvastatin, tissue factor, plasminogen activator inhibitor-1, DM tipe 2
ABSTRACT
Background
Cardiovascular disease is responsible for about 70% case of death, especially coronary heart disease due to premature atherosclerosis, which is a major cause of morbidity and mortality of patients with type 2 DM. Thrombosis is a crucial stage of development and progression of atherosclerosis and cardiovascular events in relation to atherosclerosis. Tissue factor (TF) is the most powerful trigger of coagulation, while plasminogen activator inhibitor-1 (PAI-1) is an inhibitor of fibrinolysis. The level of TF and PAI-1 increased in type 2 DM. Simvastatin showed antithrombotic properties by pressing TF, as well as improving profibrinolysis by pressing PAI-1.
Objectives
This study aims to determine the effect of simvastatin on the level of TF and PAI-1 in patients with type 2 DM.
Methods
The method used was a double blind randomized controlled trial, involving 24 pateints, 12 patients were given placebo in the control group and 12 pateints were given simvastatin 20 mg/day. The study lasted for 6 weeks. Statitical analysis with SPSS 1 for windows, significant if p<0.05.
Results
The results showes that the treatment group obtained a decrease in the level of TF (pre vs post: 54,69 ± 37,99 pM vs 31,62 ± 1,58 pM; p=0,02) but did not change the level of PAI-1 (pre vs post: 1,05 ± 1,27 U/ml vs 1,29 ± 1,08 U/ml; p=0,07). In the control group was not found differences in the level of TF and PAI-1 before and after treatment (TF pre vs post: 32,23 ± 3,28 pM vs 34,34 ± 7,86 pM, p=0,29; PAI-1 pre vs post: 1,08 ± 1,19 U/ml vs 2,1 ± 2,67 U/ml, p=0,13).
Conclusions
Simvastatin decreased TF level but had no effect on PAI-1 level in patients with type 2 DM.
Key words: simvastatin, tissue factor, plasminogen activator inhibitor-1, type 2 DM