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Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah

  • I Made Gunarsa ,
  • Wayan Aryadana ,
  • I Made Junior Rina Artha ,

Abstract

Introduction: Non-HDL cholesterol is a lipid parameter that describes the overall component of atherogenic lipids and is strongly correlated with apoB and sdLDL (small-dense LDL). There has been no study linking non HDL cholesterol (high density lipoprotein) with the degree of coronary stenosis based on the assessment of the previous syntax score. This study aims to prove the relationship between high non-HDL cholesterol and the degree of severe coronary artery lesions in patients with chronic coronary syndrome who underwent coronary angiography at Sanglah Hospital Denpasar.

Methods: This analytical observational study was conducted at Sanglah General Hospital from June to November 2020. Sampling was carried out by consecutive sampling. Non HDL cholesterol was calculated by subtracting total cholesterol with HDL and divided into 2 categories based on ROC analysis. The syntax score was calculated based on the results of coronary angiography and was divided into 2 categories (cut off 22). The relationship between non-HDL cholesterol and the degree of coronary stenosis was assessed by chi-square test analysis.

Results: Seventy-two subjects were included in this study with a mean age of 59.43±8.9 years. At the cut-off point of 104.5 mg/dL based on the ROC curve, non-HDL cholesterol had an AUC of 0.846, a sensitivity level of 80% and a specificity of 78.1% (p < 0.001). The results of bivariate analysis showed that high non-HDL cholesterol was associated with the degree of severe coronary stenosis with a prevalence ratio of 3.385 (p<0.001). Multivariate logistic regression analysis showed that high non-HDL cholesterol proved to be an independent predictor of severe coronary artery stenosis in patients with chronic coronary syndrome at Sanglah Hospital.

Conclusion: High non-HDL cholesterol was shown to be independently associated with severe coronary artery stenosis in SKK subjects at Sanglah Hospital.

 

 

Pendahuluan: Kolesterol non HDL merupakan parameter lipid yang menggambarkan keseluruhan komponen lipid atherogenik dan berkorelasi kuat dengan apoB dan sdLDL (small-dense LDL). Belum ada penelitian yang menghubungkan kolesterol non HDL (high density lipoprotein) dengan derajat stenosis koroner berdasarkan penilaian skor syntax sebelumnya. Penelitian ini bertujuan untuk membuktikan hubungan kolesterol non HDL  yang tinggi dengan derajat lesi arteri koroner yang berat pada penderita sindroma koroner kronis yang dilakukan tindakan angiografi koroner di RSUP Sanglah Denpasar.

Metode: : Penelitian observasional analitik ini dilakukan di Rumah Sakit Umum Sanglah dari Juni hingga November  2020. Pengambilan sampel dilakukan secara concecutive sampling. Kolesterol non HDL dihitung dengan cara mengurangi total kolesterol dengan HDL dan dibagi menjadi 2 kategori berdasarkan analisis ROC. Skor syntax dihitung berdasarkan hasil angiografi koroner dan dibagi menjadi 2 kategori (cut off 22). Hubungan antara kolesterol non HDL dan derajat stenosis koroner dinilai dengan analisis chi-square test.

Hasil: Tujuh puluh dua subyek dilibatkan dalam penelitian ini dengan dengan rerata usia 59,43±8,9 tahun. Pada nilai titik potong 104.5 mg/dL berdasarkan kurva ROC, kolesterol non HDL memiliki AUC 0.846, tingkat sensitifitas 80% dan spesifisitas 78,1% (p <0.001). Hasil analisis bivariat menunjukkan kolesterol non HDL yang tinggi berhubungan derajat stenosis koroner berat dengan rasio prevalens 3,385 (p<0.001). Analisis multivariat regresi logistik menunjukkan kolesterol non HDL yang tinggi terbukti sebagai prediktor independen stenosis arteri koroner berat pada penderita sindroma koroner kronis di RSUP Sanglah.

Simpulan: Kolesterol non HDL yang tinggi terbukti berhubungan secara independen dengan stenosis arteri koroner berat pada subyek SKK di RSUP Sanglah.

Section

References

  1. Gaziano T, Prabhakaran D, Gaziano J. Global Burden of Cardiovascular Disease. In: Barunwald E, Zipes DP, Libby, P., Bonow RO, Mann DL, Tomaselli G., editors. Braunwald’s Heart Disease : A textbook of cardiovascular medicine. 11th ed. Philadelphia: Elsevier; 2019. p. 1–17.
  2. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4(13):1–12.
  3. Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–77.
  4. Moore KJ, Sheedy FJ, Fisher EA. Macrophages in atherosclerosis: A dynamic balance. Nat Rev Immunol. 2013;13(10):709–21. Available from: http://dx.doi.org/10.1038/nri3520
  5. Wilder J, Sabatine M., Lilly L. Ischemic Heart Disease. In: Lilly, Leonard S, editors. Pathophysiology of Heart Disease. 6th ed. Philadelphia: Wolters Kluwer; 2016. p. 134–61.
  6. Su X, Kong Y, Peng D. Evidence for changing lipid management strategy to focus on non-high density lipoprotein cholesterol. Lipids Health Dis. 2019;18(1):1–7.
  7. Boekholdt SM, Arsenault BJ, Mora S, Nestel PJ, Simes RJ, Durrington P, et al. CLINICIAN ’ S CORNER Association of LDL Cholesterol , Non – HDL Cholesterol , and Apolipoprotein B Levels With Risk of Cardiovascular Events. Jama. 2012;307:1302.
  8. Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, De Graaf J, et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein b as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes. 2011;4(3):337–45.
  9. Hermans MP, Sacks FM, Ahn SA, Rousseau MF. Non-HDL-cholesterol as valid surrogate to apolipoprotein B100measurement in diabetes: Discriminant Ratio and unbiased equivalence. Cardiovasc Diabetol. 2011;10:1–7.
  10. Hayashi T, Koba S, Ito Y, Hirano T. Method for estimating high sdLDL-C by measuring triglyceride and apolipoprotein B levels. Lipids Health Dis. 2017;16(1):1–10. Available from: http://dx.doi.org/10.1186/s12944-017-0417-6
  11. Lu W, Resnick HE, Jablonski KA, Jones KL, Jain AK, Howard WMJ, et al. Non-HDL cholesterol as a predictor of cardiovascular disease in type 2 diabetes: The strong heart study. Diabetes Care. 2003;26(1):16–23.
  12. Moriyama K, Takahashi E. Non-HDL cholesterol is a more superior predictor of small-dense LDL cholesterol than LDL cholesterol in Japanese subjects with TG levels <400 mg/dL. J Atheroscler Thromb. 2016;23(9):1126–37.
  13. Manocha A, Bhargava S, Jain R, Kankra M, Singla P, Chugh P. Non-HDL as a Valid Surrogate Marker of Small Dense LDL in a Young Indian Population. Indian J Clin Biochem. 2019;34(3):263–71. Available from: https://doi.org/10.1007/s12291-018-0758-6
  14. Dahlan M. Statistik untuk Kedokteran dan Kesehatan : Deskriptif, Bivariat dan Multivariat. 6th ed. Jakarta: Epidemiologi Indonesia; 2014.
  15. Al-Shudifat AE, Johannessen A, Azab M, Al-Shdaifat A, AbuMweis SS, Agraib LM, et al. Risk factors for coronary artery disease in patients undergoing elective coronary angiography in Jordan. BMC Cardiovasc Disord. 2017;17(1):1–5.
  16. Mehta PA, Cowie MR. Gender and heart failure: A population perspective. Heart. 2006;92(SUPPL. 3):14–8.
  17. Jackson G. Gender differences in cardiovascular disease prevention. Menopause Int. 2008;14(1):13–7.
  18. Gao Z, Chen Z, Sun A, Deng X. Gender differences in cardiovascular disease. Med Nov Technol Devices. 2019;4(December):100025. Available from: https://doi.org/10.1016/j.medntd.2019.100025
  19. Zhang Y, Wu NQ, Li S, Zhu CG, Guo YL, Qing P, et al. Non-HDL-C is a Better Predictor for the Severity of Coronary Atherosclerosis Compared with LDL-C. Hear Lung Circ. 2016;25(10):975–81. Available from: http://dx.doi.org/10.1016/j.hlc.2016.04.025
  20. Al-Daghri NM, Al-Attas OS, Al-Rubeaan K. The atherogenic and metabolic impact of non-HDL cholesterol versus other lipid sub-components among non-diabetic and diabetic Saudis. Lipids Health Dis. 2007;6(Dm):1–6.
  21. Puri R, Nissen S., Shao M, Elshazly M., Kataoka Y, Kapadia S. Non-HDL Cholesterol and Triglycerides Implications for Coronary Atheroma Progression and Clinical Events. Arter Thromb Vasc Biol. 2016;36:2220–8.

How to Cite

Gunarsa, I. M., Aryadana, W., & Artha, I. M. J. R. (2022). Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah. Intisari Sains Medis, 13(1), 162–170. https://doi.org/10.15562/ism.v13i1.1004

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I Made Gunarsa
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Wayan Aryadana
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I Made Junior Rina Artha
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