PERBEDAAN KADAR NITRIC OXIDE DAN DERAJAT STENOSIS PADA PENDERITA PENYAKIT JANTUNG KORONER DENGAN DAN TANPA DIABETES MELITUS DIFFERENCE OF NITRIC OXIDE CONCENTRATION AND STENOSIS DEGREE IN CONGESTIVE HEART FAILURE PATIENT WITH AND WITHOUT DIABETES MELLITUS

Abstract

ABSTRACT Background. Coronary Heart Disease (CHD) is a disease that was caused by total or partial stenosis from one or more coronary vessel. Endothelial dysfungtion is the first sign of atherosclerosis that caused of CHD. Endothelial disfungtion marked by decreasing of production or and releasing Nitric Oxide (NO.) Role NO as mediator neurotransmision endothel and stimulated coroner dilatation. Diabet Mellitus (DM) is the one of main risk factor CHD. There was a few of study about difference NO concentration and stenosis degree on CHD patient with Diabet Mellitus . Objective : To analize the difference between nitric oxide concentration and degree of stenosis on CHD patients with and without DM. Material and method : Cross sectional approach, 40 specimen from CHD patient with DM and without DM who had coronary angiography. Measuring concentration NO, stenosis degree, stenosis length, and vessel number. NO concentration was measured quantitatively with colorimetric method. Statistical analysis difference test with non parametric test Mann whitney. Result : Mean NO concentration CHD patient with DM was lower than CHD patient without DM (296.8 and 343.7 µg/ml with p = 0.141). Stenosis degree of CHD patient with DM was worse than CHD patient without DM with p = 0.018. Conclusions : Mean NO concentration CHD patient with DM was not different to CHD without DM and stenosis degree of CHD patient with DM was worse than CHD without DM significantly. Key words : Nitric Oxide, DM, CHD, degree of stenosis ABSTRAK Latar belakang. Penyakit jantung koroner (PJK) merupakan penyakit akibat stenosis pada pembuluh darah koroner . Stenosis arteri koroner terjadi akibat aterosklerosis dengan petanda dini berupa disfungsi endotel. Disfungsi endotel ditandai dengan pengurangan sintesis dan pelepasan Nitric Oxide (NO). Peran NO pada penderita PJK sebagai mediator neurotransmisi sel endotel dan merangsang dilatasi koroner. Diabetes melitus (DM) merupakan salah satu faktor risiko utama PJK. Saat ini penelitian tentang perbedaan kadar NO dan derajat stenosis pada penderita PJK dengan DM belum banyak dilakukan. Tujuan : Mengetahui perbedaan kadar NO dan derajat stenosis penderita PJK dengan dan tanpa DM Material dan metode: Pendekatan belah lintang. 40 spesimen penderita PJK dengan DM dan tanpa DM yang menjalani angiografi koroner. Dilakukan pemeriksaan kadar NO, derajat stenosis, panjang stenosis, dan jumlah vessel. Kadar NO diukur secara kuantitatif menggunakan metode kolorimetrik. Analisis statistik uji beda non parametrik dengan Mann Whitney. Hasil : rerata kadar NO penderita PJK dengan DM lebih rendah dari penderita PJK tanpa DM. (296,8 dan 343,7 µg/ml dengan p=0,414. Derajat stenosis penderita PJK dengan DM lebih berat dibandingkan penderita PJK tanpa DM dengan p = 0,018. Kesimpulan : Rerata kadar NO penderita PJK dengan DM tidak berbeda dibandingkan penderita PJK tanpa DM dan derajat stenosis penderita PJK dengan DM lebih berat secara bermakna dibandingkan penderita PJK tanpa DM. Kata kunci : Nitric oxide, DM, penyakit jantung koroner, angiografi koroner.