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Abstract

Introduction. Major depression criteria can be found in more than 20% of coronary heart patients and more than 30% acute coronary syndrome patients have significant depressive symptoms. Several studies have shown that reduction of hearth rate variability (HRV) and enhancement of neutrophil lymphocyte ratio (NLR) can cause enhancement of morbidity and mortality in myocardial infarction patients. On the other hand, depression can cause reduction of HRV, enhancement of NLR and reduction of quality of life. This study aimed to determine differences in HRV, NLR and quality of life between acute myocardial infarction (AMI) patients with depressive symptoms and AMI patients without depressive symptoms. Methods. A cross-sectional study was conducted among AMI patients who were treated during the period of March to July 2021 at the Intensive Cardiac Care Unit (ICCU) Cipto Mangunkusumo Hospital Jakarta. Samples were taken consecutively until the amount of sample is met. Data were analyzed using unp aired T test. Results. There was a total of 46 subjects AMI patients in this study, ten subjects with depressive symptoms and 36 subjects without depressive symptoms. From the analysis, it was found that AMI patients with depressive symptoms had lower standard deviation normal to normal (SDNN) average (p=0.447), lower low frequency/high frequency (LF/HF) (p=0.323), and higher NLR average (p=0.438) than AMI patients without depressive symptom, although it was not statistically significant. Analysis showed that the mean value of SF36 total scores (p<0.001), physical function domain scores (p<0.001), energy domain scores (p<0.001), mental health domain scores (p<0.001), social function domain scores (p=0.028), bodily pain domain scores (p=0.002), and general health domain scores (p=0.002) were lower in AMI patients with depressive symptoms. Conclusion. AMI patients with depressive symptoms had lower SDNN, lower LF/HF, and higher NLR than AMI patients without depressive symptoms, although it was not statistically significant. AMI patients with depressive symptoms significantly have lower quality of life than AMI patients without depressive symptoms.

Bahasa Abstract

Pendahuluan. Kriteria depresi mayor dapat ditemukan pada lebih dari 20% pasien jantung koroner dan lebih dari sepertiga pasien sindrom koroner akut memiliki gejala depresi yang jelas. Beberapa penelitian menunjukkan hubungan antara penurunan nilai heart rate variability (HRV), peningkatan neutrophyl lymphocyte ratio (NLR) dengan peningkatan morbiditas dan mortalitas pada pasien infark miokard. Di sisi lain, depresi dapat menyebabkan penurunan nilai HRV, peningkatan NLR dan penurunan kualitas hidup. Studi ini dilakukan untuk mengetahui perbedaan nilai HRV, NLR dan kualitas hidup antara pasien infark miokard akut (IMA) dengan dan tanpa gejala depresi. Metode. Sebuah studi potong lintang dilakukan pada pasien IMA yang dirawat selama periode Maret sampai Juli 2021 di Intensive Cardiac Care Unit (ICCU) Rumah Sakit Cipto Mangunkusumo Jakarta. Sampel diambil secara konsekutif sampai jumlah sampel terpenuhi. Data dianalisis menggunakan uji T tidak berpasangan. Hasil. Pada penelitian ini didapatkan total 46 subjek pasien IMA dengan 10 subjek memiliki gejala depresi dan 36 subjek tidak memiliki gejala depresi. Dari analisis didapatkan pasien IMA dengan gejala depresi mempunyai rerata standard deviation normal to normal (SDNN) lebih rendah (p=0,447), low frequency/high frequency (LF/HF) lebih rendah (p=0,323), dan NLR lebih tinggi (p= 0,438) dibandingkan pasien IMA tanpa gejala depresi walaupun secara statistik tidak bermakna. Hasil analisis secara bermakna juga menunjukkan rerata skor total SF36 (p<0,001), skor domain fungsi fisik (p<0,001), skor domain energi (p<0,001), skor domain kesehatan mental (p<0,001), skor domain fungsi sosial (p=0,028), skor domain nyeri (p=0,002), dan skor domain kesehatan umum (p=0,002) yang lebih rendah pada pasien IMA dengan gejala depresi. Kesimpulan. Pasien IMA yang memiliki gejala depresi mempunyai rerata SDNN dan LF/HF yang lebih rendah serta NLR yang lebih tinggi dibanding pasien IMA yang tidak memiliki gejala depresi, walaupun secara statistik tidak bermakna. Pasien IMA dengan gejala depresi secara bermakna memiliki kualitas hidup lebih rendah dibandingkan pasien IMA tanpa depresi. Kata Kunci: Depresi, heart rate variability, infark miokard akut , kualitas hidup, neutrophil-lymphocyte ratio

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