Adi, AndiWahjono (2015) Peranan Aktivitas Lipoprotein Associated Phospholipase A2 Pada Sensitifitas Framingham Score Terhadap Resiko Infark Miokard Akut Pada Pria Indonesia. Magister thesis, Universitas Brawijaya.
Abstract
Lipoprotein associated phospholipase A2 (Lp-PLA2) merupakan biomarker inflamasi penyakit kardiovaskuler. Framingham score saat ini merupakan sarana untuk stratifikasi resiko terhadap kejadian Infark miokard akut(IMA) yang dipergunakan telah secara luas. Namun demikian masih perlu dibuktikan lebih lanjut apakah aktifitas Lp-PLA2 bersama dengan Framingham score dapat meningkatkan odd ratio (OR) kejadian IMA. Untuk itu kami akan meneliti peranan aktifitas Lp-PLA2 dalam meningkatkan sensitivitas Framingham score terhadap kejadian IMA. Sampel darah diambil dari 60 orang laki-laki dengan IMA yang dirawat di unit perawatan intensif dan 37 pasien dengan hasil treadmill normal sebagai kontrol. Pengukuran aktifitas Lp-PLA2 dengan menggunakan metode Enzyme-Linked Immuno Assay(ELISA) Aktifitas Lp-PLA2 diketemukan lebih tinggi pada kelompok IMA dibandingkan kontrol. (83.97±27.15 nmol/ml.menit vs 55.04±31.99 nmol/ml/menit; p 0.000). 18(30%) pasien IMA termasuk dalam kategori resiko tinggi menurut Framingham score yang meningkat menjadi 36 pasien setelah penambahan aktivitas Lp-PLA2 pada Framingham score. Analisa menggunakan Receiver operating characteristic(ROC) menghasilkan cut-off aktivitas Lp-PLA2 yang berkaitan dengan IMA kurang lebih 74.21 nmol/ml/menit dengan tingkat akurasi 67%. Odd ratio kejadian IMA meningkat setelah penambahan aktivitas Lp-PLA2 dari 1.01(CI95%,0.414-2.48) menjadi 4.67(CI95%,1.88-11.61). Penambahan aktivitas Lp-PLA2 pada Framingham score diduga dapat meningkatkan sensitivitas dan spesifisitas terhadap kejadian IMA.
English Abstract
Lipoprotein associated phospholipase A2 (Lp-PLA2) has been known as a useful inflammatory marker of cardiovascular risk. Framingham score has also been widely used in long term cardiovascular risk stratification. However, it remain to be clarified whe r increased Lp-PLA2 activity and Framingham score significantly increase odd ratio (OR) in acute myocardial infarction (AMI) setting. We refore investigated Lp-PLA2 activity and it`s additive value for Framingham cardiovascular risk among myocardial infarction men. Blood samples were drawn from 60 men admitted to intensive care unit early after myocardial infarction and 37 healthy men with negative treadmill test as a control. Framingham score were calculated among all subjects. We measured Lp-PLA2 activity by Enzyme-Linked Imunno Assay(ELISA). Lp-PLA2 activity was significantly higher in patients with myocardial infarction than those in control (83.97±27.15 nmol/ml/minute vs. 55.04±31.99 nmol/ml/minute; p=0.000). 18(30%) AMI patients were classified as high risk according to Framingham score. However after Lp-PLA2 activity addition, 36 AMI patients(60%) were classified as high risk. Receiver operating characteristic(ROC)analysis was performed to identify most useful Lp-PLA2 cut-off level. Lp-PLA2 activity equal to or more than 74.21 nmol/ml/minute associated with myocardial infarction with accuracy 67%. OR of AMI was increased by Lp-PLA2 activity added to Framingham score from 1.01(CI 95% 0.414- 2.48) to 4.67(CI 95% 1.88- 11.61) Addition of Lp-PLA2 activity to Framingham score may increase sensitivity and spesificity in AMI incidence .
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES;572.68/ADI/p/2015/041502661 |
| Subjects: | 500 Natural sciences and mathematics > 572 Biochemistry > 572.6 Proteins |
| Divisions: | Profesi Kedokteran > Spesialis Orthopedi dan Traumatologi, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 23 Jun 2015 09:47 |
| Last Modified: | 23 Jun 2015 09:47 |
| URI: | http://repository.ub.ac.id/id/eprint/160362 |
Actions (login required)
 |
View Item |