Kadar Glukosa Darah pada Penderita Infark Miokard Akut dengan Diabetes Melitus sebagai Faktor Prediktor Kematian

Rina Puspita Sari, Agus Widyatmoko

Abstract


Infark miokard akut (IMA) merupakan penyebab kematian pertama di Indonesia. Insiden IMA tergantung pada risiko terjadinya aterosklerosis, salah satunya diabetes melitus (DM). Pada pasien DM, kadar glukosa akan meningkat dan beberapa penelitian melaporkan hubungan antara abnormalitas glukosa dan mortalitas tetapi hingga saat ini belum jelas. Penelitian ini bertujuan untuk mengetahui peran kadar glukosa darah terhadap mortalitas pada penderita IMA dengan DM. Penelitian ini menggunakan desain cross sectional dengan melihat data rekam medis 2006-2011 di rumah sakit. Pada 70 kasus yang didiagnosis IMA dengan DM hanya terdapat 38 kasus yang memenuhi kriteria inklusi dan eklusi. Pasien dibagi dua kelompok berdasarkan kadar glukosa darah saat masuk yaitu Grup 1 (<200 mg/dL) dan Grup 2 (> 200 mg/dL). Outcome pasien juga dilihat dan dibagi menjadi 2 kelompok yaitu baik dan meninggal. Hasil analisis Chi square menunjukkan tidak ada hubungan yang signifikan antara kadar glukosa darah dengan kematian pada penderita IMA dengan DM (p = 0.653, PR=2.4, CI=0.354-16.258). Pemeriksaan laboratorium juga tidak menunjukkan perbedaan rata-rata yang signifikan kecuali pemeriksaan leukosit. Disimpulkan kadar glukosa darah tidak berhubungan dengan kematian sehingga tidak dapat digunakan sebagai faktor prediktor kematian pada penderita IMA dengan DM. Kata kunci: infark miokard akut, diabetes melitus, glukosa darah, kematian

 

Acute Myocardial Infarction (AMI) is the the first cause of mortality in Indonesia. The incidence of AMI depends on the risk of atheroschlerosis, one of them is diabetes melitus (DM). In DM’s patient, blood glucose level will increase and some research reported the correlation of glucose abnormal with mortality, but it’s not clear. The research aims to know correlation of blood glucose level to mortality in acute myocardial infarction with diabetes melitus patients. This research used cross sectional design by looked at the medical record datas 2006-2011 in hospital. There are 70 cases which diagnosed as AMI with DM, but only 38 cases which fulfilled inclusion and exclusion criterias. Patients divided into 2 Grups depend on the blood glucose level on admission, Grup 1 (<200 mg/dL), Grup 2 (>200mg/dL). We also looked out the patient’s outcome and divided into 2 Grups, recovered and dead. This result by using Chi square analysis does not show a significant correlation between blood glucose level with death in AMI with DM patients (p = 0.653, PR=2.4, CI=0.354-16.258). Laboratory examination also did not show a significant difference of mean except for leucocyte count. The conclusion is blood glucose level has no correlation with death in AMI with DM, so it can’t used as predictor factor of death in patients AMI with DM.


Keywords


infark miokard akut; diabetes melitus; glukosa darah; kematian; acute myocardial infarction; diabetes melitus; blood glucose; death

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