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Abstract

Introduction. Apolipoproteins are structural components of plasma lipoproteins that are involved in lipoprotein metabolism and lipid transport, reflecting the number of circulating atherogenic particles. The degree of coronary artery stenosis can be assessed by calculating the Synergy between PCI with TAXUS/paclitaxel-eluting stent and Cardiac Surgery (SYNTAX) score, which is an angiographic scoring system used to evaluate the complexity of coronary artery lesions. This study aimed to investigate the profile of apolipoprotein B and lipids, as well as their correlation with the SYNTAX score in patients with chronic coronary syndrome.

Methods. An observational analytic study with a cross-sectional design was conducted from July to September 2024 in the cardiac catheterization laboratory of the Department of Internal Medicine, Mohammad Hoesin General Hospital, Palembang. A total of 69 samples were obtained using consecutive sampling. Samples that met the inclusion and exclusion criteria were analyzed using SPSS version 22. Data were presented in tables and figures. Data analysis was performed using correlation tests with a significance level of p < 0.05. This study received ethical approval from the Ethics Committee of Dr. Mohammad Hoesin General Hospital, Palembang.

Results. Among the 34 analyzed subjects, the mean total cholesterol, LDL cholesterol, and apolipoprotein B levels were 175.88 (SD 36.01) mg/dL, 123.59 (SD 35.54) mg/dL, and 141.41 (SD 25.06) mg/dL, respectively. HDL cholesterol and triglyceride levels were not normally distributed and were therefore expressed as medians (range): 42 (29–80) mg/dL and 89 (40–289) mg/dL, respectively. The mean SYNTAX score was 24.09 (SD 2.69). Overall, 20.59% of subjects had a SYNTAX score

Conclusions. Patients with chronic coronary syndrome demonstrated elevated apolipoprotein B levels and high SYNTAX scores. Higher apolipoprotein B levels were independently and positively associated with the SYNTAX score. Further studies are needed to investigate additional factors influencing apolipoprotein B levels, lipid profiles, and the SYNTAX score.

Bahasa Abstract

Pendahuluan. Apolipoprotein adalah komponen struktural dari lipoprotein plasma yang terlibat dalam metabolisme lipoprotein dan transportasi lipid, mencerminkan jumlah partikel aterogenik yang beredar. Derajat stenosis pembuluh darah koroner dapat dinilai dengan menghitung skor Synergy between PCI with TAXUS/paclitaxel-eluting stent and Cardiac Surgery (SYNTAX) yang merupakan sistem skoring angiografi untuk menilai kompleksitas lesi pembuluh darah koroner. Penelitian ini bertujuan mencari profil apolipoprotein B dan lipid, serta korelasinya dengan skor SYNTAX pada pasien sindrom koroner kronik.

Metode. Penelitian ini merupakan studi analitik observasional dengan desain potong lintang, dilaksanakan pada Juli–September 2024 di ruang katerisasi jantung Bagian Penyakit Dalam Rumah Sakit Umum Pusat (RSUP) Dr. Mohammad Hosein Palembang. Sebanyak 69 sampel diambil dengan teknik consecutive sampling. Sampel yang memenuhi kriteria inklusi dan eksklusi dianalisis menggunakan SPSS versi 22. Data disajikan dalam bentuk tabel dan gambar. Analisis data menggunakan uji korelasi dengan nilai p

Hasil. Dari 34 subjek, rerata nilai kolesterol total 175,88 [simpang baku (SB) 36,01] mg/dL, rerata low density lipoprotein (LDL) 123,59 (SB 35,54) mg/dL, dan apolipoprotein B 141,41 (SB 25,06) mg/dL, sedangkan parameter lainnya memiliki data dengan distribusi tidak normal. Nilai median high density lipoprotein (HDL) 42 (rentang 29-80) mg/dL, sedangkan median trigliserida 89 (median 40-289) mg/dL. Rerata hasil skor SYNTAX adalah 24,09 (SB 2,69) mg/dL. Didapatkan sebanyak 7 subjek (20,59%) dengan nilai skor SYNTAX(79,41%) subjek dengan nilai skor ≥23. Uji Pearson menunjukkan korelasi signifikan antara apolipoprotein B dan skor SYNTAX (p = 0,029 dan r = 0,376). Setelah dilakukan analisis multivariat, didapatkan nilai p apolipoprotein B sebesar 0,017 dengan nilai koefesien regresi bernilai positif.

Kesimpulan. Pasien sindrom koroner kronik memiliki kadar apolipoprotein B dan skor SYNTAX yang tinggi. Kenaikan kadar apolipoprotein B tetap berkorelasi signifikan dan berbanding lurus dengan skor SYNTAX. Penelitian lebih lanjut diperlukan untuk mengkaji faktor-faktor lain yang memengaruhi biomarker apolipoprotein B, lipid, dan skor SYNTAX.

Kata Kunci: aterokslerosis, sindrom koroner kronik, Skor SYNTAX

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