Skip to main content Skip to main navigation menu Skip to site footer

Indeks trigliserida-glukosa, beban trombus intrakoroner, dan kompleksitas lesi koroner sebagai prediktor kejadian kardiovaskular mayor selama perawatan pada pasien ST elevasi miokard infark yang menjalani intervensi koroner perkutan

  • Gede Wikananda ,
  • I Kadek Susila Surya Darma ,
  • I Made Junior Rina Artha ,


Abstract

Background: Coronary heart disease (CHD) is a major global health problem, with increased morbidity and mortality in patients due to Major Adverse Cardiovascular Events (MACE). Triglyceride-Glucose Index (TyG) values, intracoronary thrombus burden, and SYNTAX I and II scores can help assess CHD characteristics and predict the risk of death. This study aims to assess TyG, intracoronary thrombus burden, and SYNTAX II score as predictors of MACE at Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar.

Methods: This study used an analytical observational study with data sourced from medical records of patients with STEMI who were hospitalized at Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar from April to July 2024. The sampling method used consecutive sampling with a total sample of 83 subjects consisting of 32 subjects with MACE and 51 patients without MACE. Data were analysed using SPSS version 24 in the form of descriptive analysis, normality test, ROC test, chi-square test, correlation test, survival test, dan cox regression analysis.

Results: The results of the analysis in this study showed that high ITG values ​​(>8.63), large intracoronary thrombus burden, and high SYNTAX II Score (>28) were significant predictors of KKM with AUC values ​​of 0.797 (p<0.000); 0.717 (p=0.001), respectively. In addition, there were significant differences in ITG values, intracoronary thrombus burden, and SYNTAX II Score. The worst survival was found in the group with high ITG values ​​(36.8%), and the best survival rate was found in the group with small thrombus burden (86.4%).

Conclusion: High TyG values, large intracoronary thrombus burden, and high SYNTAX II score on admission are predictors of MACE events in patients with STEMI who are hospitalized.

 

Latar Belakang: Penyakit jantung koroner (PJK) merupakan masalah kesehatan global yang utama, dengan peningkatan morbiditas dan mortalitas pada pasien karena Kejadian Kardiovaskuler Mayor (KKM). Nilai Indeks Trigliserida-Glukosa (ITG), beban trombus intrakoroner, dan Skor SYNTAX I dan II dapat membantu menilai karakteristik PJK dan memprediksi risiko kematian. Penelitian ini bertujuan untuk menilai ITG, beban trombus intrakoroner, dan Skor SYNTAX II sebagai prediktor KKM di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar.

Metode: Penelitian ini menggunakan studi observasional analitik  dengan data yang bersumber dari rekam medis pasien dengan STEMI yang menjalani rawat inap di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar mulai pada tanggal April-Juli 2024. Metode sampling dilakukan menggunakan consecutive sampling dengan total sampel sebanyak 83 subyek yang terdiri dari 32 subyek dengan KKM dan 51 pasien tanpa KKM. Data dianalisis menggunakan SPSS versi 24 berupa analisis deskriptif, uji normalitas, uji ROC, uji chi-square, uji korelasi, uji kesintasan dan analisis regresi cox.

Hasil: Hasil analisis pada penelitian ini menunjukan bahwa nilai ITG tinggi (>8,63), beban trombus intrakoroner besar, dan Skor SYNTAX II tinggi (>28) merupakan prediktor dari KKM yang signifikan dengan nilai AUC masing-masing 0,797 (p<0,000); 0,717 (p=0,001). Selain itu didapat perbedaan kadar yang signifikan pada nilai ITG, beban trombus intrakoroner, dan Skor SYNTAX II. Survival paling buruk ditemukan pada kelompok dengan nilai ITG tinggi (36,8%), dan survival rate paling baik ditemukan pada kelompok dengan beban trombus kecil (86,4%).

Simpulan: Nilai ITG yang tinggi, beban trombus intrakoroner besar, dan Skor SYNTAX II yang tinggi pada saat admisi merupakan prediktor bagi kejadian KKM pada pasien dengan STEMI yang menjalani rawat inap.

Keywords: Indeks Trigliserida-Glukosa Kejadian Kardiovaskuler Mayor Syntax STEMI

References

  1. Farooq V, Girasis C, Magro M, Onuma Y, Morel M-A, Heo JH, et al. The coronary artery bypass graft SYNTAX Score: final five-year outcomes from the SYNTAX-LE MANS left main angiographic substudy. EuroIntervention. 2013;9(8):1009–10. Available from: http://dx.doi.org/10.4244/eijv9i8a170
  2. Kemenkes. (2018, July). Hasil Riset Kesehatan Dasar Tahun 2018. 1680–1699.
  3. Braunwald E, Bonow RO, Libby P, Mann D, Zipes DP. Foreword [Internet]. Hypertension: A Companion to Braunwald’s Heart Disease. Elsevier; 2013. p. xiii. Available from: http://dx.doi.org/10.1016/b978-1-4377-2766-1.06001-4
  4. Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, et al. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2023;23(1):206. Available from: https://pubmed.ncbi.nlm.nih.gov/37087452
  5. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Kardiol Pol. 2018;76(2):229–313. Available from: http://dx.doi.org/10.5603/kp.2018.0041
  6. Hendrickson MJ, Arora S, Vaduganathan M, Fonarow GC, Mp G, Bansal A, et al. Prevalence and prognostic implications of reduced left ventricular ejection fraction among patients with STEMI in India. ESC Hear Fail. 2022/08/10. 2022;9(6):3836–45. Available from: https://pubmed.ncbi.nlm.nih.gov/35950269
  7. Nasution SA, Perkasa H, Ginanjar E, Rinaldi I. In-Hospital Major Adverse Cardiac Events Factor Predictors on ST-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention at dr. Cipto Mangunkusumo General Hospital. eJournal Kedokt Indones. 2022;10(2):107–13. Available from: http://dx.doi.org/10.23886/ejki.10.193.107-13
  8. Wilar GI, Panda AL, Rampengan SH. Pengamatan 6 Bulan Terhadap Kejadian Kardiovaskular Mayor Pada Pasien Dengan Infark Miokard Akut Dengan Elevasi Segmen St (Stemi) Di Rsup Prof. Dr. RD Kandou Manado Periode Januari-Desember 2017. Jurnal Medik Dan Rehabilitasi. 2019;1(3):1-8.
  9. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The syntax score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 2005;1:219–227.
  10. Yan L, Li P, Wang Y, Han D, Li S, Zhang J, et al. Impact of the residual SYNTAX score on clinical outcomes after percutaneous coronary intervention for patients with chronic renal insufficiency. Catheter Cardiovasc Interv. 2019/12/23. 2020;95 Suppl 1(Suppl 1):606–15. Available from: https://pubmed.ncbi.nlm.nih.gov/31868307
  11. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison with the Euglycemic-Hyperinsulinemic Clamp. J Clin Endocrinol & Metab. 2010;95(7):3347–51. Available from: http://dx.doi.org/10.1210/jc.2010-0288
  12. Angoorani P, Heshmat R, Ejtahed H-S, Motlagh ME, Ziaodini H, Taheri M, et al. Validity of triglyceride–glucose index as an indicator for metabolic syndrome in children and adolescents: the CASPIAN-V study. Eat Weight Disord - Stud Anorexia, Bulim Obes. 2018;23(6):877–83. Available from: http://dx.doi.org/10.1007/s40519-018-0488-z
  13. Yusuf S, Hawken S, Ôunpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640–9. Available from: http://dx.doi.org/10.1016/s0140-6736(05)67663-5
  14. Zhang M, Wang B, Liu Y, Sun X, Luo X, Wang C, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study. Cardiovasc Diabetol. 2017;16(1):30. Available from: https://pubmed.ncbi.nlm.nih.gov/28249577
  15. Sánchez-Iñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. Risk of incident ischemic stroke according to the metabolic health and obesity states in the Vascular-Metabolic CUN cohort. Int J Stroke. 2016;12(2):187–91. Available from: http://dx.doi.org/10.1177/1747493016672083
  16. Hao Q, Yuanyuan Z, Lijuan C. The Prognostic Value of the Triglyceride Glucose Index in Patients With Acute Myocardial Infarction. J Cardiovasc Pharmacol Ther. 2023;28. Available from: http://dx.doi.org/10.1177/10742484231181846
  17. Tanboga IH, Topcu S, Aksakal E, Kalkan K, Sevimli S, Acikel M. Determinants of Angiographic Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb. 2013;20(7):716–22. Available from: http://dx.doi.org/10.1177/1076029613483169
  18. Tran AV, Truong DD, Ngo TH, Nguyen OTK, Tran SK, Huynh PK. Prognostic value of in-hospital and 6-month mortality after acute coronary syndrome using GRACE, TIMI, and HEART scores. Med Clínica Práctica. 2024;7(2):100419. Available from: http://dx.doi.org/10.1016/j.mcpsp.2023.100419
  19. Correia LCL, Garcia G, Kalil F, Ferreira F, Carvalhal M, Oliveira R, et al. Prognostic value of TIMI score versus GRACE score in ST-segment elevation myocardial infarction. Arq Bras Cardiol. 2014/07/15. 2014;103(2):98–106. Available from: https://pubmed.ncbi.nlm.nih.gov/25029471
  20. Abimanyu R, Sitepu A, Nasution AN. Comparison of Syntax II Score And Grace Score As Predictors of Major Cardiovascular Events 30 Days after Treatment in STEMI Undergoing PPCI ARTICLE INFO. Journal of Society Medicine. 2024;3(6):2023–2025. doi: https://doi.org/10.47353/jsocmed.v3i6.150.
  21. Kocas BB, Cetinkal G, Kocas C, Arslan S, Abaci O, Dalgic Y, et al. Usefulness of the SYNTAX Score II to Predict In-Hospital and Long-Term Mortality in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention. Sisli Etfal Hastan tip Bul. 2022;56(2):182–8. Available from: https://pubmed.ncbi.nlm.nih.gov/35990300
  22. Artha IMJR, Bakta IM, Manuaba IBP, Wita IW, Rohman MS, Astawa INM, Bhargah A. The Effects of Percutaneous Coronary Intervention on Biomarkers and Quality of Life in Patients With Chronic Total Coronary Artery Obstruction. Cardiol Res. 2023;14(1):69-78. doi: 10.14740/cr1455.

How to Cite

Wikananda, G., Darma, I. K. S. S. ., & Artha, I. M. J. R. . (2024). Indeks trigliserida-glukosa, beban trombus intrakoroner, dan kompleksitas lesi koroner sebagai prediktor kejadian kardiovaskular mayor selama perawatan pada pasien ST elevasi miokard infark yang menjalani intervensi koroner perkutan. Intisari Sains Medis, 15(3), 943–951. https://doi.org/10.15562/ism.v15i3.2124
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
0

Share

Search Panel

Gede Wikananda
Google Scholar
Pubmed
ISM Journal

I Kadek Susila Surya Darma
Google Scholar
Pubmed
ISM Journal

I Made Junior Rina Artha
Google Scholar
Pubmed
ISM Journal