Hubungan Profil Lipid dan Kadar High-Sensitivity C-Reactive Protein dengan Outcome Pasien Stroke Iskemik Akut
Authors: Putra Stefanus Erdana , Tyas Fauzi Novia Isnaening , Hafizhan Muhammad , Prabaningtyas Raden Ajeng Hanindia Riani , Mirawati Diah Kurnia 
Published: December 2020

<p><strong>Pendahuluan:</strong><strong> </strong><em>Stroke</em> adalah penyebab utama kecacatan jangka panjang dengan dampak klinis dan sosial ekonomi yang signifikan di seluruh dunia. Hiperlipidemia dan inflamasi memainkan peranan penting dalam patofisiologi <em>stroke</em> iskemik. Meskipun <em>high-sensitivity C-Reactive Protein </em>(hs-CRP) dan kadar lipid merupakan penentu risiko penyakit pembuluh darah, kekuatan penggunaan <em>biomarker</em> ini dalam penentuan prognosis <em>stroke </em>iskemik belum dapat dipastikan. Penelitian ini bertujuan untuk mengetahui hubungan kadar hs-CRP dan profil lipid pada pasien <em>stroke </em>iskemik akut di Rumah Sakit Universitas Sebelas Maret dan memahami hubungan antara <em>biomarker</em> tersebut dengan <em>outcome</em> jangka pendek.</p><p><strong>Metode penelitian:</strong><strong> </strong>Penelitian <em>cross-sectional</em> dilakukan pada 34 pasien dengan serangan <em>stroke</em> iskemik pertama kali. Profil lipid dan hs-CRP diukur pada hari pertama masuk rumah sakit. Defisit neurologis diukur menggunakan <em>National Institutes of Health Stroke Scale</em> (NIHSS) dan <em>outcome</em> diukur menggunakan Barthel <em>Index</em> pada hari ke-7 perawatan di unit <em>stroke</em>. Selanjutnya, kadar serum hs-CRP dan profil lipid dianalisis korelasinya dengan defisit neurologis dan <em>outcome</em> jangka pendek.</p><p><strong>Hasil penelitian:</strong><strong> </strong>Pasien <em>stroke</em> iskemik memiliki kadar hs-CRP, kolesterol total (TC), trigliserida (TG), <em>low-density lipoprotein</em> (LDL) yang lebih tinggi; serta kadar <em>high-density lipoprotein</em> (HDL) yang lebih rendah dari kriteria normal. Berdasarkan uji korelasi Pearson, LDL memiliki korelasi signifikan dengan NIHSS (r = 0,447; p = 0,008) sedangkan hs-CRP memiliki korelasi signifikan yang lebih kuat dengan Barthel <em>Index </em>daripada NIHSS (r = -0,412; p = 0,015). TC dan HDL juga memiliki korelasi signifikan dengan NIHSS.</p><p><strong>Kes</strong><strong>impulan:</strong><strong> </strong>Penelitian ini menunjukkan bahwa profil lipid dan hs-CRP dapat digunakan sebagai prediktor prognosis <em>outcome stroke </em>iskemik akut.</p><p> </p><p>Introduction: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. While high-sensitivity C-Reactive Protein (hs-CRP) and lipid levels are established risk determinants for vascular disease, the relative strength of these biomarkers for ischemic stroke is uncertain. The purpose of this study is to investigate the association of hs-CRP levels and lipid profile in acute ischemic stroke patients and understand correlation between those markers and short-term outcome.</p><p>Methods: This was a cross-sectional study of 34 first-timer ischemic stroke patients. Lipid profiles and hs-CRP were measured on admission day. The neurological deficit was quantified using National Institutes of Health Stroke Scale (NIHSS) and outcome was quantified using Barthel Index at the 7th day in stroke unit. Serum level of hs-CRP and lipid profile were estimated and correlated with neurological deficit and short-term outcome.</p><p>Results: Ischemic stroke patients had higher levels of hs-CRP, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL); and lower level of high-density lipoprotein (HDL) than normal criteria. Based on Pearson correlation test, LDL had significant correlation with NIHSS (r=0.447; p=0.008) while hs-CRP had stronger significant correlation with Barthel Index than NIHSS (r=-0.412; p=0.015). TC and HDL also had significant correlation with NIHSS.</p><p>Conclusions: This research suggests that lipid profile and hs-CRP can be used as predictors of prognosis for acute ischemic stroke outcome. Keywords: Barthel index, C-reactive protein, National Institutes of Health Stroke Scale, lipid profile, ischemic stroke.</p>