INTISARI

Acute Myocardial Infarction (AMI) merupakan penyebab kematian utama

di dunia dan merupakan penyebab kematian pertama di Indonesia pada tahun
2002 dengan angka mortalitas 220.000 (14%) (WHO, 2008).Major adverse
cardiac events (MACE) atau major cardiac events (MCE) sebagai kejadian
kardiovaskuler utama selanjutnya yang merugikan, merupakantitik akhiryang
umum digunakandalam penelitiankardiovaskular. Komplikasi AMI sebagian besar
muncul 72 jam pertama dari onset infark, dan dapat berlangsung 4 sampai 6
minggu. Insidensi MCE selama fase akut AMI terdiri berbagai macam, beberapa
dikategorikan sebagai kematian kardiak, reinfark dan gangguan hemodinamik
(gagal jantung akut dan syok kardiogenik).
Liporotein (a) [Lp(a)] salah satu penyebab penyakit kardioserebrovaskuler
yang berkaitan dengan aterotrombosis, berhubungan dengan perkembangan lesi
koroner baru sesudah serangan AMI. Kadar Lp(a) 30 mg/dL dihubungkan
dengan peningkatan kejadian MCE.Penelitian ini bertujuan untuk menilai kadar
Lp(a) 30 mg/dLdalam memberikan risiko luaran buruk (MCE)selama perawatan
intensif pasien AMI. Analisis penelitian menggunakan analisis regresi logistik dan
multipel regresi.
Hasil penelitian menunjukkan rerata Lp(a) pada MCE (+) 37,72 22,75
dan MCE (-) 19,78 13,5 (p=0,002). Analisis univariat terhadap faktor-faktor
prognostik luaran AMI (MCE) yang bermakna secara statitik (p<0,05) adalah
Lp(a) (RR=5,11), GDS (RR=5,00), Hipertensi (RR=4,2), dan jenis kelamin
(RR=0,21). Analisis multivariat terhadap faktor-faktor prognostik luaran AMI
(MCE) yang bermakna secara statistik (p<0,05) adalah Lp(a) (RR=9,53,
95%CI=2,18-41,58) dan hipertensi (RR=7,58, 95%CI=1,34-42,85).
Kadar Lp(a) 30 mg/dL memberikan risiko 9,53 kali luaran buruk (MCE)
selama perawatan intensif pasien AMI. Perlu dilakukan pemeriksaan Lp(a) pada
penderita AMI sebagai prediktor independen luaran buruk (MCE). Perlu
penelitian lebih lanjut tentang Lp(a) sebagai prediktor luaran buruk AMI (MCE)
dengan meningkatkan pengendalian terhadap faktor prognostik lain

Kata kunci: AMI, Lp(a), prediktor, MCE

xi

 ABSTRACT

Acute Myocardial Infarction (AMI) is the leading cause of death in the

world and the first cause of death in Indonesia in 2002 with the mortality rate
220,000 (14%) (WHO, 2008).Major adverse cardiac events (MACE) or major
cardiac events (MCE), the next major cardiovascular events that harm, are the
endpoint common used in cardiovascular research. Complications of AMI mostly
appear at the first 72 hours of the onset of infarction, and can last for 4 to 6 weeks.
There are various kinds of incidence of MCE during the acute phase of AMI,
some of them are categorized as cardiac death, reinfarction and hemodynamic
disorders (acute heart failure and cardiogenic shock).
Liporotein (a) [Lp(a)],one of the causes of cardiocerebrovaskuler disease
that related to atherothrombotic, associated with the development of new coronary
lesions after AMI attack.The levels of Lp(a) 30 mg/dL is associated with the
increasing of MCEincidence. This study is aimed to assess the levels of Lp(a)
30 mg/dLin giving the bad risk output (MCE) during intensive care of AMI
patients. Research analysisuses linear regression analysis and multiple regression.
The results showed mean of Lp (a) in the MCE (+) were 37.72 22.75
and MCE (-) were 19.78 13.5 (p = 0.002). Univariate analysis of the
MCEprognostic factors that statistically significant (p <0.05) were Lp (a) (RR =
5.11), GDS (RR = 5.00), hypertension (RR = 4, 2), and gender (RR = 0.21).
Multivariate analysis of MCEprognostic factorsthat statisticallysignificant(p
<0.05)were Lp (a) (RR = 9.53, 95% CI = 2.18 to 41.58) and hypertension (RR =
7.58, 95% CI = 1.34 to 42.85).
Levels of Lp (a) 30 mg/dLshowed risk 9.53 times of bad outcomes
(MCE) of AMI patients during intensive care. Lp (a) in patients with AMI need to
check as an independent predictor of poor outcome (MCE). Further research on
Lp (a) as a predictor of poor outcome AMI (MCE) was needed with
improvementin controlling other prognostic factors.

Key words: AMI, Lp(a), predictor, MCE

xii