scholarly journals Gambaran dislipidemia pada pasien stroke akut di Rumah Sakit Umum Daerah Arifin Achmad Provinsi Riau periode Januari-Desember 2019

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dimas Pramita Nugraha ◽  
Eka Bebasari ◽  
Sahwal Sahputra

Abstrak. Stroke adalah penyakit gangguan fungsional otak yang timbul mendadak dan berlangsung lebih dari 24 jam atau berakhir dengan kematian tanpa diketahui penyebab yang jelas selain gangguan vaskuler. Stroke secara umum diklasifikasikan menjadi stroke iskemik atau stroke non hemoragik dan stroke hemoragik. Salah satu faktor risiko terjadinya stroke adalah dislipidemia. Tujuan penelitian ini adalah untuk mengetahui gambaran dislipidemia pada pasien stroke akut di RSUD Arifin Achmad Provinsi Riau Periode Januari–Desember 2019. Desain penelitian yang digunakan adalah penelitian deskriptif  dengan rancangan cross sectional menggunakan data sekunder rekam medis pasien stroke akut di  RSUD Arifin Achmad Provinsi Riau  Periode Januari-Desember 2019 dengan jumlah sampel sebanyak 103 kasus. Hasil penelitian menunjukkan stroke banyak terjadi pada jenis kelamin laki-laki yaitu 63 orang (61,2%). Usia terbanyak terjadi pada rentang usia 51-65 tahun sebanyak 54 (52,4%). Jenis stroke terbanyak adalah stroke hemoragik yaitu 59 orang (57,3%). Kadar kolesterol total terbanyak pada  rentang normal yaitu sebanyak 46 orang (44,7%). Kadar High Density Lipoprotein (HDL)  terbanyak pada rentang normal yaitu sebanyak 49 orang (47,6%). Kadar Low Density  Lipoprotein (LDL) terbanyak pada kategori tinggi sebanyak 26 orang (25,2%) dan normal tapi berisiko sebanyak 26 orang (25,2%). Kadar trigliserida terbanyak pada kategori normal sebanyak 65 orang (63,1%). Terdapat 17 orang (16,5%) pasien dislipidemia, sebanyak 9 orang (52,9%) adalah stroke iskemik. Kesimpulan dari penelitian ini adalah dislipidemia lebih banyak terjadi pada stroke iskemik disbanding stroke hemoragik.Kata kunci:  dislipidemia, stroke, stroke non hemoragikAbstract. Stroke is a disease of the brain functional disorders that arises suddenly and lasts more than 24 hours or ends in death situation without a known cause other than vascular disorders. Strokes are generally classified into ischemic stroke (non-hemorrhagic) and hemorrhagic stroke, One of the risk factors of stroke is dyslipidemia. The aim of this study was to describe dyslipidemia in acute stroke patients at Arifin Achmad Regioal General Hospital of Riau Province in January to December 2019. This was a descriptive study design with cross sectional study method by using secondary data of the acute stroke patient's medical record at Arifin Achmad Regional General Hospital of Riau Province in January to December 2019 with a total sample of 103 cases. The results show that stroke is more common in male that is 63 (61.2%) cases, and the majority happened within the 51-65 years age groups with 54 (52.4%) cases. Most of the stroke’s type in patients were hemorrhagic stroke in 59 (57.3%) cases. Highest total of cholesterol level remains normal in 46 (44.7%) cases. The majority of patients still presented with normal level of High Density Lipoprotein (HDL) in 49 (47.6%) cases. In contrary, most patients presented with high level of Low Density Lipoprotein (LDL) in 26 (25.2%) cases and also with normal level but considered as high-risk group in  26 (25.2%) cases. Most patients still presented with normal level of triglyceride in 65 (63.1%) cases. There were 17 (16.5%) cases of patient with dyslipidemia, 9 of them were considered as ischemic stroke (52.9%). The conclusion of this study is that dyslipidemia commonly occurs in ischemic stroke types compared to a hemorrhagic stroke.Keywords: dyslipidemia, stroke, non hemorrhagic stroke

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhijun Wu ◽  
Zhe Huang ◽  
Alice H. Lichtenstein ◽  
Yesong Liu ◽  
Shuohua Chen ◽  
...  

Abstract Background The risk of stroke in individuals with very low low-density lipoprotein cholesterol (LDL-C) concentrations remains high. We sought to prioritize predictive risk factors for stroke in Chinese participants with LDL-C concentrations < 70 mg/dL using a survival conditional inference tree, a machine learning method. Methods The training dataset included 9327 individuals with LDL-C concentrations < 70 mg/dL who were free of cardiovascular diseases and did not use lipid-modifying drugs from the Kailuan I study (N = 101,510). We examined the validity of this algorithm in a second Chinese cohort of 1753 participants with LDL-C concentrations < 70 mg/dL from the Kailuan II study (N = 35,856). Results During a mean 8.5–9.0-year follow-up period, we identified 388 ischemic stroke cases and 145 hemorrhagic stroke cases in the training dataset and 20 ischemic stroke cases and 8 hemorrhagic stroke cases in the validation dataset. Of 15 examined predictors, poorly controlled blood pressure and very low LDL-C concentrations (≤ 40 mg/dL) were the top hierarchical predictors of both ischemic stroke risk and hemorrhagic stroke risk. The groups, characterized by the presence of 2–3 of aforementioned risk factors, were associated with a higher risk of ischemic stroke (hazard ratio (HR) 7.03; 95% confidence interval (CI) 5.01–9.85 in the training dataset; HR 4.68, 95%CI 1.58–13.9 in the validation dataset) and hemorrhagic stroke (HR 3.94, 95%CI 2.54–6.11 in the training dataset; HR 4.73, 95%CI 0.81–27.6 in the validation dataset), relative to the lowest risk groups (presence of 0–1 of these factors). There was a linear association between cumulative average LDL-C concentrations and stroke risk. LDL-C concentrations ≤ 40 mg/dL was significantly associated with increased risk of ischemic stroke (HR 2.07, 95%CI 1.53, 2.80) and hemorrhagic stroke (HR 2.70, 95%CI 1.70, 4.30) compared to LDL-C concentrations of 55–70 mg/dL, after adjustment for age, hypertension status, and other covariates. Conclusion Individuals with extremely low LDL-C concentrations without previous lipid-modifying treatment could still be at high stroke risk. Trial registration Chinese Clinical Trial Register, ChiCTR-TNRC-11001489. Registered on 24-08-2011.


e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Mentari Simbar ◽  
Karel Pandelaki ◽  
M. C.P Wongkar

Abstract: Waist circumference is often used to evaluate abdominal fat mass. Waist circumference is correlated with abdominal mass and is a predictor of type 2 diabetes mellitus compared to BMI. Diabetes Mellitus Type 2 (T2DM) is more common in individuals with overweight and obesity. T2DM is not only occured due to carbohydrate metabolism disorder of lipid metabolism but also due to dyslipidemia. Dyslipidemia caused by substances called lipoprotein VLDL (Very Low Density Lipoprotein) or triglycerides, decreased HDL cholesterol (High Density Lipoprotein) and the formation of small dense LDL (Low Density Lipoprotein) which are atherogenic. This study aimed to determine the relationship of waist circumference with the lipid profile in T2DM patients Prof. R.D. Kandou Hospital Manado. This was a descriptive cross sectional analytic study. There were 53 respondents that met the inclusion criteria. This study was conducted for three months starting from September – November 2013 in the Endocrine Clinic. Conclusions: There was no significant correlation between waist circumference and total cholesterol, LDL, and triglycerides levels. However, there is a significant correlation between waist circumference and HDL levels.Keywords: Waist circumference, total cholesterol, HDL, LDL, Triglycerides, T2DMAbstrak: Lingkar pinggang sering digunakan sebagai penilai massa lemak abdominal, karena lingkar pinggang berkorelasi dengan massa lemak abdominal dan merupakan prediktor Diabetes Melitus Tipe 2 (DMT2) yang paling kuat dibandingkan dengan IMT. DMT2 lebih sering terjadi pada individu dengan berat badan lebih dan obesitas. Pada DMT2 bukan saja terjadi gangguan metabolisme karbohidrat melainkan juga terdapat metabolisme lipid, keadaan ini disebut dislipidemia. Dislipidemia terjadi akibat gangguan metabolisme lipoprotein yaitu Very Low Density Lipoprotein (VLDL), trigliserida, penurunan kolesterol High Density Lipoprotein (HDL), dan terbentuknya small dense Low Density Lipoprotein (LDL) yang bersifat aterogenik. Penelitian ini bertujuan untuk mengetahui hubungan lingkar pinggang dengan profil lipid pada pasien DMT2 di RSUP Prof. R.D. Kandou Manado. Jenis penelitian ini ialah deskriptif analitik dengan pendekatan cross sectional. Responden penelitian sebanyak 53 pasien yang memenuhi kriteria inklusi. Penelitian ini dilakukan selama tiga bulan yaitu dari bulan September – November 2013 di Poliklinik Endokrin Bagian/SMF Ilmu Penyakit Dalam RSUP. Prof. R.D. Kandou Manado. Simpulan: Tidak terdapat hubungan yang bermakna antara lingkar pinggang dengan kadar kolesterol total, kadar LDL, dan trigliserida. Terdapat hubungan bermakna antara lingkar pinggang dan kadar HDL.Kata kunci: Lingkar Pinggang, Kolesterol Total, HDL, LDL, Trigliserida, DMT2


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Dian Novita

! exhaustion (VE) merupakan prediktor utama terjadinya infark miokard (IM), diduga kepribadian D mempunyai hubungan independen dengan VE. Hubungan kepribadian tipe-D, faktor fisiologi: sterol total, indeks masa tubuh (IMT), high density lipoprotein (HDL), low density lipoprotein (LDL), tekanan darah diastolik (TDD), serta faktor gaya hidup dengan VE, telah diungkapkan oleh beberapa namun belum jelas. Penelitian ini bertujuan untuk mengindentifikasi hubungan antara kepribadian D dan faktor fisiologi berbungan dengan terjadinya VE pada pasien IM penelitian ini menggunakan da cross sectional designs. Dengan jumlah sampel sebanyak 68 yang dipilih menggunakan teknik ecutive sampling pada subjek yang datang dirawat di ICCU RSUPN Cipto Mangunkusumo dan ung Perawatan lantai 3,4, dan 5 RSJPD Harapan Kita Jakarta, mulai tanggal 1 Mei sampai dengan 15 2009. VE diukur dengan 21 pertanyan dari Maastric Questionnaire, kepribadian tipe-D terdiri dari ciri afekif negatif (AN) 7 dan hambatan sosial (HS) 7 pertanyaan, faktor fisiologi: IMT, kolesterol , HDL, LDL, dan TDD data sekunder yang didapat pada catatan medis pasien. Karakteristik subjek Ipakan perancu. Hasil penelitian membuktikan kepribadian tipe D, kolesterol total dan TDD ubungan signifikan dengan VE dan faktor yang paling berhubungan dengan VE adalah kepribadian D. p=0,01a:0,05, OR 6,83 (CI:1,58-29,48). Simpulan penelitian ini yaitu pasien IM yang epribadian tipe-D mempunyai peluang 6,8 kali mengalami VE dibanding pasien IM bukan tipe-D ah dikontrol oleh kolesterol total, TDD dan peminum minuman keras, dan pasien dengan kolesterol berisiko berpeluang 5,9 kali mengalami VE dibanding dengan kolesterol total tidak berisiko setelah ntrol oleh tipe-D, TDD, dan peminum minuman keras, serta pasien dengan TDD berisiko berpeluang kali mengalami VE setelah dikontrol TDD tidak berisiko, kolesterol total dan tipe-D. Rekomendasi elitian adalah memasukkan kepribadian tipe-D dan VE, dalam format pengkajian asuhan keperawatan Etiap seting pelayanan pasien jantung.


2020 ◽  
Vol 7 (2) ◽  
pp. 1
Author(s):  
Muhammad Fadlan Adam ◽  
Yetty Octavia Hutahaean ◽  
Loly Rotua Dharmanita Siagian

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.


Author(s):  
Al Rasyid ◽  
Salim Harris ◽  
Muhammad Kurniawan ◽  
Taufik Mesiano ◽  
Rakhmad Hidayat

     THE EFFECT OF INTERLEUKIN-6 AND NEURON SPECIFIC ENOLASE LEVEL ON ACUTE ISCHEMIC STROKE OUTCOME WITH PACS AND LACS SUBTYPEABSTRACTIntroduction: Brain blood flow disruption  in ischemic stroke will trigger  cells damage  cascade  and  caused infarction. Interleukin-6 (IL-6) and neuron specific enolase (NSE) are brain cells damage marker that can be markers of acute ischemic stroke outcome.Aim: To investigate the effect of IL-6 and NSE levels on acute ischemic stroke outcome and its interacting factors.Methods: An observational cohort study on ischemic stroke patients with onset ≤3 days in several hospitals in Jakarta and Depok in 2014. Medical history and physical examination were carried out as well as laboratory parameters; hematocrit, fibrinogen, low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride, IL-6, and NSE. The National Institute of Health Stroke Scale (NIHSS) were assessed ≤72 hours of onset and 7 days along with Modified Rankin Scale (mRS) at 1 month of onset. Bivariate and multivariate logistic regression were done to investigate the association of IL-6 and NSE with stroke outcome and other factors.Results: One-hundred thirty-five subjects were included, mostly male (62%), with age mean 59,4±10,7 years and subtype PACS (76%). Interleukin-6 and NSE level were elevated in 61,5% and 21,5% subjects. Interleukin-6 and fibrinogen influenced the mRS, while diabetes and fibrinogen influenced the NIHSS. NSE serum didn’t show any association with mRS nor NIHSS, but influenced by dyslipidemia.Discussion: There was a tendency of worse outcome on high IL-6 level patients, although by multivariate analysis IL-2 alone was not sufficient enough as prognostic marker in acute ischemic stroke outcome. Neuron specific enolase serum didn’t show any association with acute stroke outcome due to also influenced by sex, smoking, and fibrinogen levels.Keywords: Acute ischemic stroke, IL-6, NSE, outcomeABSTRAKPendahuluan: Gangguan aliran darah otak pada stroke iskemik akut akan memicu kaskade kerusakan sel otak yang menyebabkan infark dan inflamasi. Interleukin-6 (IL-6) dan neuron specific enolase (NSE) merupakan penanda kerusakan sel otak yang dapat menjadi penanda luaran stroke iskemik akut.Tujuan: Mengetahui pengaruh kadar IL-6 dan NSE pada luaran stroke iskemik akut serta faktor-faktor yang memengaruhinya.Metode: Penelitian kohort observasional terhadap pasien stroke iskemik akut dengan awitan ≤3 hari yang dirawat di beberapa RS di Jakarta dan Depok pada tahun 2014. Dilakukan anamnesis dan pemeriksaan fisik serta pemeriksaan hematokrit, fibrinogen, low density lipoprotein (LDL), high density lipoprotein  (HDL), trigliserida, IL-6, dan NSE serum. Dilakukan pemeriksaan National Institute of Health Stroke Scale (NIHSS) awal awitan ≤72 jam dan 7 hari serta modified rankin scale (mRS) pada 1 bulan. Analisis statistik bivariat dan regresi logistik multivariat dilakukan untuk mengetahui hubungan kadar IL-6 dan NSE dengan luaran stroke serta hubungannya terhadap faktor-faktor lainnya.Hasil: Didapatkan 135 subjek yang mayoritas laki-laki (62%) dengan rerata usia 59,4±10,7 tahun dan subtipe PACS (76%). Peningkatan kadar IL-6 dan NSE ditemukan pada 61,5% dan 21,5% subjek. Luaran berdasarkan skor mRS dipengaruhi oleh kadar IL-6 dan fibrinogen, sedangkan  berdasarkan NIHSS dipengaruhi oleh diabetes melitus dan fibrinogen. Kadar NSE tidak berhubungan dengan mRS dan NIHSS, namun dipengaruhi oleh status dislipidemia.Diskusi: Terdapat kecenderungan luaran buruk pada kadar IL-6 tinggi, namun dengan analisis multivariat IL-6 belum bisa menjadi penanda prognosis luaran stroke iskemik akut. Kadar NSE serum tidak berperan terhadap luaran stroke iskemik akut, oleh karena juga dipengaruhi oleh jenis kelamin, merokok, dan kadar fibrinogen.Kata kunci: Stroke iskemik akut, IL-6, neuron specirefic enolase, luaran


2021 ◽  
Vol 18 (1) ◽  
pp. 45-48
Author(s):  
Rabindra Simkhada ◽  
Sanjay Singh KC ◽  
Dharma Nath Yadav ◽  
Ravi Sahi

Background and Aims: Postmenopausal diabetic female are at increased risk of cardiovascular disease. The objective of this study was to study their lipid profile and prevalence of dyslipidemia and assess relation of control of lipid components with various risk factors. Methods: A cross sectional prospective study conducted at Shahid Gangalal National Heart Centre from 15th July 2020 to 14th October 2020 including 109 postmenopausal diabetic female. Detailed history along with clinical examination were conducted. Fasting lipid profile and other relevant investigations were obtained. Results: Mean age of participants was 63.48±9.26 years. Mean age of menopause was 48.59±1.88 years. A total of 37 (33.9%) were hypertensive, 17 (15.6%) were smoker, 67 (61.5%) were physically inactive. A total of 91 (83.5%) were non-vegetarian. Thirty eight (34.9%) had their blood sugar controlled with hemoglobin A1c of <7%. The mean total cholesterol and high density lipoprotein were 5.21±0.97 mmol/l and 1.02±0.13 mmol/l. Similarly mean triglyceride and low density lipoprotein were 2.24±0.75 mmol/l and 3.04±0.12 mmol/l. Dyslipidemia was present in 82.6%. Significant correlation of control of blood sugar with total cholesterol control status (R=0.28, P=0.01), low density lipoprotein control status (R=0.38, P=0.01), high density lipoprotein control status (R=0.36, P=0.04) and triglyceride control status (R=0.30, P=0.04) were seen. Conclusion: Dyslipidemia was common in post menopausal diabetic female. Blood sugar control status showed significant correlation with lipid profile parameters. A good sugar control and evaluation for lipid abnormalities is recommended in postmenopausal diabetic female.


2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Aditya N. Batara ◽  
Erwin Pangkahila ◽  
Hedison Polii

Abstract: Alcohol consumption has some effect on myocardial infarction (heart attack), and could decrease low density lipoprotein (LDL) level as well as increase high density lipoprotein (HDL) level. This study was aimed to determine the relationship between alcohol consumption and HDL level. This was an analytical study with a cross sectional design. Subjects were students of Faculty of Social and Political Sciences at Sam Ratulangi University. Data were analyzed by using the Spearman correlation test (significancy <0.05). The results showed that 31 students were involved in this study. There were 26 students (83.87%) with normal HDL levels and 5 students (16.13%) with abnormal HDL levels. The Spearman test of the correlation between alcohol consumption (frequency, duration, and the amount of alcohol consumption) and HDL level showed the P values, as follows: P=0.256, P=0.410, and P=0.459. Conclusion: There was no correlation between alcohol consumption and HDL level.Keywords: alcohol, HDL levels Abstrak: Konsumsi alkohol diketahui memiliki efek terhadap infark miokard, penurunan kadar low density lipoprotein (LDL), dan peningkatan kadar high density lipoprotein (HDL). Penelitian ini bertujuan untuk mengetahui hubungan konsumsi alkohol dengan kadar HDL. Jenis penelitian ialah analitik dengan desain potong lintang. Subyek penelitian ialah mahasiswa Fakultas Ilmu Sosial dan Politik di Universitas Sam Ratulangi. Analisis data menggunakan uji korelasi Spearman dengan nilai signifikansi P<0,05. Hasil penelitian mendapatkan 31 mahasiswa laki-laki sebagai subyek penelitian. Subyek yang memiliki kadar HDL normal sebanyak 26 orang (83,87%) dan yang tidak normal sebanyak 5 orang (16,13%). Uji korelasi Spearman terhadap hubungan antara konsumsi alkohol (frekuensi konsumsi, lama konsumsi, jumlah konsumsi alkohol) dengan kadar HDL memiliki nilai P berturut-turut ialah P=0,256, P=0,410, dan P=0,459. Simpulan: Tidak terdapat hubungan bermakna antara konsumsi alkohol dengan kadar HDL.Kata kunci: alkohol, kadar HDL


1976 ◽  
Vol 35 (01) ◽  
pp. 178-185 ◽  
Author(s):  
Helena Sandberg ◽  
Lars-Olov Andersson

SummaryHuman plasma lipoprotein fractions were prepared by flotation in the ultracentrifuge. Addition of these fractions to platelet-rich, platelet-poor and platelet-free plasma affected the partial thromboplastin and Stypven clotting times to various degrees. Addition of high density lipoprotein (HDL) to platelet-poor and platelet-free plasma shortened both the partial thromboplastin and the Stypven time, whereas addition of low density lipoprotein and very low density lipoprotein (LDL + VLDL) fractions only shortened the Stypven time. The additions had little or no effect in platelet-rich plasma.Experiments involving the addition of anti-HDL antibodies to plasmas with different platelet contents and measuring of clotting times produced results that were in good agreement with those noted when lipoprotein was added. The relation between structure and the clot-promoting activity of various phospholipid components is discussed.


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