GAMBARAN PROFIL LIPID DAN RASIO LIPID PADA PASIEN STROKE ISKEMIK BERULANG DI RSUD ABDUL WAHAB SJAHRANIE SAMARINDA

Muhammad Fadlan Adam, Yetty Octavia Hutahaean, Loly Rotua Dharmanita Siagian

Abstract


Stroke iskemik merupakan tipe stroke yang paling sering terjadi pada serangan berulang. Subtipe yang paling sering terjadi adalah aterosklerosis arteri besar yang menyebabkan oklusi arteri pada otak. Abnormalitas lipid plasma merupakan penyebab utama terjadinya aterosklerosis. Rasio lipid dapat menginformasikan risiko aterosklerosis yang sulit diukur dengan pemeriksaan rutin dan peningkatan rasio lipid menggambarkan ketidakseimbangan antara fraksi lipid aterogenik dan antiaterogenik. Penelitian ini bertujuan untuk mengetahui gambaran profil lipid dan rasio lipid pada pasien stroke iskemik berulang di RSUD Abdul Wahab Sjahranie Samarinda. Penelitian ini bersifat deskriptif dengan desain studi cross sectional. Pengambilan sampel secara purposive sampling pada pasien stroke iskemik yang mempunyai riwayat stroke iskemik sebelumnya sebanyak 71 sampel. Pengambilan data profil lipid menggunakan data sekunder dari rekam medik dan rasio lipid didasarkan pada perbandingan kolesterol total (K-Total)/kolesterol high density lipoprotein (K-HDL), kolesterol low density lipoprotein (K-LDL)/K-HDL, dan trigliserida (TG)/K-HDL. Pada penelitian ini didapatkan hasil pasien stroke iskemik berulang paling banyak dengan K-Total yang optimal sebesar 49,3%, K-LDL mendekati optimal 42,2%, K-HDL rendah 71,8%, TG optimal 62,0%, rasio K-Total/K-HDL di atas nilai risiko 76,1%, rasio K-LDL/K-HDL di atas nilai risiko 63,4%, dan rasio TG/K-HDL di atas nilai risiko 52,1%. Berdasarkan hasil ini dapat disimpulkan bahwa profil lipid pasien stroke iskemik berulang di RSUD Abdul Wahab Sjahranie Samarinda paling banyak ditemukan dengan kadar K-Total dan TG yang optimal, K-LDL yang mendekati optimal, dan kadar K-HDL yang rendah. Rasio lipid yang terdiri dari rasio K-Total/K-HDL, rasio K-LDL/K-HDL dan rasio TG/K-HDL masing-masing ditemukan paling banyak dengan rasio di atas nilai risiko.


Keywords


stroke iskemik berulang, profil lipid, rasio lipid, kolesterol, trigliserida

Full Text:

PDF

References


Johnson W, Pnuma O, Owolabi M, and Sachdev S. Stroke: a global response is needed. Bull World Health Organ. 2016; 94 :634-634A.

Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistic-2018 update. Circulation. 2018; 137 : e67-e492.

Kemenkes (Kementerian Kesehatan). Hasil utama riskesdas 2018. 2018.

Agoes A, Agoes A, and Agoes A. Penyakit di usia tua. Dany F dan Nirmala WK, editor. Jakarta: EGC. 2013.

Oza R, Rundell K, and Garcellano M. Recurrent ischemic stroke: strategies for prevention. Am Fam Physician. 2017; 96 (7) :436-40.

Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA and Hennerici MG. Classification of stroke subtypes. Cerebrovasc Dis. 2009; 27 (5) :493-501.

PERKENI (Perkumpulan Endokronologi Indonesia). Pedoman pengelolaan dislipidemia di Indonesia 2019. 2019.

Zheng J, Sun Z, Zhang X, Li Z, Guo X, and Xie Y. Non-traditional lipid profiles associated with ischemic stroke not hemorrhagic stroke in hypertensive patients: results from an 8.4 years follow-up study. Lipids Health Dis. 2019; 18 :9.

Amarenco P and Labreuche J. Lipid management in the prevention of stroke: review and update meta-analysis of statins for stroke prevention. Lancet Neurol. 2009; 8 (5) :453-63.

Prasetyo E and Garini AS. Prevalensi dislipidemia pada pasien stroke iskemik berulang rawat jalan dana tau rawat inap di rumah sakit pusat otak nasional periode 2015-juni 2017. Pharmamedika. 2018; 10 (1) :31-39.

Millan J, Pinto X, Munoz A, et al. Lipoprotein ratio: physiological significance and clinical usefulness in cardiovascular prevention. Dove Press. 2009; 5 :757-65.

Park JH, Lee J, and Ovbiagele B. Nontraditional serum lipid variables and recurrent stroke risk. Stroke. 2014; 45 (11) :3269-74.

Riva DL, Zubikarai M, Saeasqueta C, et al. Nontraditional lipid variables predict recurrent brain ischemia in embolic stroke of undetermined source. Journal of Stroke and Cerebrovaskular Disease. 2017; 26 (8) :1670-77.

Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics and prevention. Stroke Circ Res. 2017; 120 (3) :472-495.

Buenaflor FG, Navarro JC, Lara KJ, and Venketasubramanian N. Recurrence rate of ischemic stroke: a single center experience. Austin Journal od Cerebrovascular Disease & Stroke. 2017; 4 (2) :1057.

Gofir A. Manajemen stroke. Herdanto DY, Utomo AB, dan Indera, editor. Jakarta: EGC. 2011.

Saposnik G, Fonarow GC, Pan W, Liang L, Hernandez AF and Schwamm LH. Guideline-directed low-density lipoprotein management in high risk patients with ischemic stroke. Stroke. 2014; 45 (11) :3343-51.

Loscalzo J. Harrison kardiologi dan pembuluh darah. Jakarta: EGC. 2014.

Kumral E, Evyapan D, Gokcay F, Karaman B and Orman M. Association of baseline dyslipidemia with stroke recurrence within five years after ischemic stroke. Int J Stroke. 2014; SA100 :119-26.

PERKI (Perhimpunan Dokter Spesialis Kardiovaskular Indonesia). Panduan tata laksana dislipidemia. 2017.

Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke. 2014; 45 (7) :2160-236.

Rampengan SH. Meningkatkan kolesterol HDL. Jurnal Biomedi. 2015; 7 (2) :89-98.

Sarwar N, Sandhu MS, Ricketts SL, et al. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet. 2010; 375 (9726) : 1634-39.

Eren E, Yilmaz N and Aydin O. High density lipoprotein and its dysfunction. Open Biochem J. 2012; 6 :78-93.

Tamada M, Makita S, Abiko A, Naganuma Y, Nagai M and Nakamura M. Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio as a useful marker for early-stage carotid atherosclerosis. Metabolisml. 2010; 59 (5) :653-7.

Marotta T, Russo BF, and Ferrara A. Tryglicerida-to-HDL-cholesterol ratio and metabolic syndrome as contributors, to cardiovascular risk in overweight patients. Obesity Silver Spring. 2010; 18 (8) :1608-13.

Liana P. Peran small dense low density lipoprotein terhadap penyakit kardiovaskular. Jurnal Kedokteran dan Kesehatan. 2014; 1 (1) :67-72.

Packard CJ. Triacil-glycerol-rich lipoprotein and the generation of small, dense low density lipoprotein. Biochemical Soc Trans. 2003; 31 (5) :1066-9.




DOI: http://dx.doi.org/10.30872/jkm.v7i2.4293

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Jurnal Kedokteran Mulawarman

Creative Commons License
Jurnal Kedokteran Mulawarman by Faculty of Medicine Mulawarman University is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.