Research Article

Asam urat serum tinggi dan risiko mortalitas kardiovaskular: sebuah tinjauan sistematik penelitian kohort

Anak Agung Gede Bilwa Bhavendra , Yuliana Yuliana, Muliani Muliani, I Nyoman Gede Wardana

Anak Agung Gede Bilwa Bhavendra
Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Udayana. Email: bilwabhavendra@gmail.com

Yuliana Yuliana
Departemen Anatomi, Fakultas Kedokteran Universitas Udayana

Muliani Muliani
Departemen Anatomi, Fakultas Kedokteran Universitas Udayana

I Nyoman Gede Wardana
Departemen Anatomi, Fakultas Kedokteran Universitas Udayana
Online First: April 01, 2021 | Cite this Article
Bhavendra, A., Yuliana, Y., Muliani, M., Wardana, I. 2021. Asam urat serum tinggi dan risiko mortalitas kardiovaskular: sebuah tinjauan sistematik penelitian kohort. Intisari Sains Medis 12(1): 41-46. DOI:10.15562/ism.v12i1.945


Introduction: Serum uric acid has been reported as a predictor of cardiovascular mortality, but there are many debates regarding this finding. This systematic review will analyze and discuss about serum uric acid as an indicator of cardiovascular mortality risk.

Methods: A literature search was carried out on the PubMed and ProQuest databases for publication that focused on the association of serum uric acid and cardiovascular mortality risk within 2015-2020. The preparation of this systematic review is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).

Results: In this review, four studies were relevant and met the selection criteria. All studies were prospective cohort studies. There were a total of 668,768 participants involved, with a slight female majority (55%). Participants involved in this study were aged 35 years or older. Three of the studies examined showed an association between high serum uric acid levels and cardiovascular disease mortality. Only one study did not show a statistically significant relationship. Each study used a different cut-off point for serum uric acid categories, making the uric acid indicator difficult to apply in clinical practice. The three studies conducted in Asia provide a more practical result that is relevant to the Indonesian population. In all three studies, results were consistent, showing elevated serum uric acid increases cardiovascular mortality risk.

Conclusion: Serum uric acid level can predict the risk of death from cardiovascular disease. The study conducted in Asia is quite relevant to the Indonesian population, where the results of the study significantly and consistently found that high serum uric acid levels can increase the risk of cardiovascular mortality.  



Pendahuluan: Asam urat serum dilaporkan dapat memperkirakan risiko dari mortalitas kardiovaskular, akan tetapi masih terdapat banyak perdebatan terkait temuan tersebut. Dalam tinjauan ini akan dibahas lebih jauh mengenai hubungan asam urat serum terhadap risiko mortalitas kardiovaskular yang disajikan dalam systematic review.

Metode: Pencarian literatur dilakukan pada database PubMed dan ProQuest dengan mengidentifikasi jurnal yang diterbitkan dari tahun 2015-2020 yang berfokus pada topik asam urat serum dan hubungannya terhadap risiko mortalitas kardiovaskular. Penyusunan systematic review ini disusun berdasarkan pedoman Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).

Hasil: Dalam tinjauan ini terdapat 4 studi yang relevan dan memenuhi kriteria seleksi. Seluruh studi merupakan studi kohort prospektif. Terdapat total 668.768 partisipan yang terlibat dengan persentase perempuan sebesar 55%. Partisipan yang terlibat dalam studi ini berusia 35 tahun atau lebih. Tiga dari empat penelitian yang ditinjau menunjukan adanya hubungan antara kadar asam urat serum yang tinggi dengan kematian akibat penyakit kardiovaskular. Hanya satu penelitian yang tidak menunjukan hubungan yang bermakna secara statistik. Masing-masing penelitian menggunakan titik potong kategori asam urat serum yang berbeda-beda yang menyebabkan efektivitas indikator asam urat serum sulit untuk diaplikasikan. Tiga studi yang dilakukan di Asia memberikan gambaran yang lebih sesuai untuk aplikasi di Indonesia karena populasi partisipannya lebih mendekati keadaan populasi Indonesia.  Pada ketiga studi tersebut diperoleh hasil yang konsisten menunjukan peningkatan asam urat serum meningkatkan risiko mortalitas kardiovaskular.

Kesimpulan: Kadar asam urat serum dapat dapat memperkirakan risiko mortalitas akibat penyakit kardiovaskular. Studi yang dilakukan di Asia, cukup relevan dengan populasi Indonesia, dimana hasil studi ini secara signifikan dan konsisten mendapatkan kadar asam urat serum yang tinggi dapat meningkatkan risiko mortalitas akibat penyakit kardiovaskular.

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