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Pengaruh penambahan terapi statin terhadap hipertensi portal pada pasien dengan sirosis: sebuah tinjauan sistematis

Sebuah Tinjauan Sistematis

Abstract

Background: Cirrhosis can cause portal hypertension, which is characterized by an increase in the hepatic venous pressure gradient (HVPG) >5 mmHg. Portal hypertension is associated with the formation of gastroesophageal varices as well as variceal bleeding and death. The addition of therapy with statins is considered to have pleiotropic effects by increasing nitric oxide (NO) production and reducing stellate cell activity so that it can be an effective therapy for portal hypertension. This systematic review aims to examine the effect of statin administration on portal hypertension in cirrhosis patients.

Methods: This study used a descriptive study design by searching published scientific articles using the Preferred Reporting, Items for Systematic Review and Meta Analyses (PRISMA) method. The search was carried out using the databases PubMed, ScienceDirect, Google Scholar and The Cochrane Library.

Results: Twelve articles were reviewed in this systematic observation including 7 randomized clinical trial (RCT) studies and 5 cohort studies included in this systematic observation. The addition of statins can reduce portal hypertension and a statistically significant reduction in mortality in the treatment group, while the secondary outcomes of variceal bleeding and variceal re-bleeding still require further evaluation because they tend not to be statistically significant.

Conclusion: Statins have the potential to reduce portal hypertension and reduce mortality in patients with liver cirrhosis, but more evidence is needed before they can be widely recommended.

 

Latar Belakang: Sirosis dapat menyebabkan hipertensi portal, yang ditandai dengan adanya peningkatan hepatic venous pressure gradient (HVPG) >5 mmHg. Hipertensi portal berhubungan dengan pembentukan varises gastroesofageal serta perdarahan varises dan kematian. Penambahan terapi dengan statin dinilai memiliki efek pleiotropik dengan meningkatkan produksi nitric oxide (NO) dan menurunkan aktivitas sel stelata sehingga bisa menjadi terapi yang efektif untuk hipertensi portal. Tinjauan sistematis ini bertujuan untuk menelaah pengaruh pemberian statin terhadap hipertensi portal pada pasien sirosis.

Metode: Studi ini menggunakan desain studi deskriptif dengan penelusuran artikel ilmiah terpublikasi menggunakan metode Preferred Reporting, Items for Systematic Reviews and Meta Analysis (PRISMA). Pencarian dilakukan dengan basis data PubMed, ScienceDirect, Google Scholar dan The Cochrane Library.

Hasil: Dua belas artikel ditelaah dalam tinjauan sistematis ini termasuk 7 penelitian randomized clinical trial (RCT) dan 5 penelitian kohort termasuk dalam tinjauan sistematis ini. Penambahan statin dapat menurunkan hipertensi portal dan penurunan mortalitas yang signifikan secara statistik pada kelompok perlakuan, sedangkan luaran sekunder terhadap perdarahan varises dan perdarahan ulang varises masih membutuhkan evaluasi lebih lanjut karena cenderung tidak bermakna secara statistik.

Simpulan: Statin berpotensi menurunkan hipertensi portal dan mengurangi angka kematian pada pasien sirosis hati, namun diperlukan lebih banyak bukti sebelum dapat direkomendasikan secara luas.

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How to Cite

Pradyani, M. A. A., Dewi, K. I. M. ., & Budiono, C. . (2024). Pengaruh penambahan terapi statin terhadap hipertensi portal pada pasien dengan sirosis: sebuah tinjauan sistematis: Sebuah Tinjauan Sistematis. Intisari Sains Medis, 15(1), 5–13. https://doi.org/10.15562/ism.v15i1.1925

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Made Ayu Agustia Pradyani
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Kadek Intan Murti Dewi
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Catarina Budiono
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