EFFECTS OF N-ACETYLCYSTEIN ON HSCRP LEVEL IN ACUTE MYOCARDIAL INFARCTION PATIENTS RECEIVING FIBRINOLYTIC THERAPY
Authors: Indriani Savithri , Yasa Ahmad , Wasyanto Trisulo 
Published: September 2019

EFFECTS OF N-ACETYLCYSTEIN ON HSCRP LEVEL IN ACUTE MYOCARDIAL INFARCTION PATIENTS RECEIVING FIBRINOLYTIC THERAPY

Savithri Indriani1, Ahmad Yasa1, Trisulo Wasyanto1
1Department of Cardiology and Vascular Medicine, Faculty of Medicine,
Universitas Sebelas Maret, RS Dr. Moewardi, Surakarta, Indonesia

Background: Worldwide, coronary heart disease (CHD) is a leading cause of death. Inflammation in CHD and acute myocardial infarction (AMI) is a trigger due to the formation of atheroma plaques in the coronary arteries. N-Acetylcysteine ​​(NAC) can prevent inflammation, remodeling and left ventricular dysfunction, interstitial fibrosis, and improve survival.
Objective: To determine the effect of NAC on hsCRP levels in patients with acute myocardial infarction who received fibrinolytic therapy.
Methods: This study was an experimental study with pre and post, single blind and randomization methods on the effect of NAC on hsCRP levels compared to controls carried out in July - August 2018 on the incidence of ST Elevation Myocardial Infarction (STEMI) came to Dr Moewardi Hospital and get fibrinolytic therapy.
Results: A total of 33 patients were included in this study, there were 15 patients (mean age 58.80 ± 8.54 years) of the control group and 18 patients (mean age 55.45 ± 9.92 years) the treatment group receiving additional therapy of NAC evervescent 600 mg three times a day for three days . This study showed that hsCRP levels after intervention in the control and treatment groups were significantly different with p = 0.001. The level of hsCRP in the control group after administration of NAC had a median of 114.50 mg / L (18.60 - 300.00) while in the treatment group had a median of 18.75 mg / L (5.50 - 102.90).
Conclusion: The addition of NAC 600 mg of therapy three times daily for 3 days can reduce hsCRP levels in patients with STEMI receiving fibrinolytic therapy compared to patients with acute myocardial infarction with ST segment elevation who did not receive additional NAC therapy.
Keywords: hsCRP, N-Acetylcysteine, acute myocardial infarction
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PENGARUH N-ACETYLCYSTEIN TERHADAP HSCRP PADA PASIEN INFARK MIOKARD AKUT DENGAN ELEVASI SEGMEN ST YANG MENDAPAT TERAPI FIBRINOLITIK

Savithri Indriani1, Ahmad Yasa1, Trisulo Wasyanto1
Departemen Ilmu Penyakit Jantung dan Pembuluh Darah, Fakultas Kedokteran
Universitas Sebelas Maret, RS Dr. Moewardi, Surakarta, Indonesia

Latar Belakang: Di seluruh dunia, penyakit jantung koroner (PJK) merupakan penyebab utama kematian. Inflamasi pada PJK dan infark miokard akut (IMA) merupakan pemicu akibat terbentuknya plak ateroma pada arteri koroner. N-Acetylcysteine (NAC) dapat mencegah inflamasi, remodeling dan disfungsi ventrikel kiri, fibrosis interstisial, dan meningkatkan survival.
Tujuan: Untuk mengetahui pengaruh NAC terhadap kadar hsCRP pada pasien infark miokard akut yang mendapatkan terapi fibrinolitik.
Metode: Penelitian ini merupakan penelitian eksperimental dengan metode pre dan post, single blind dan randomisasi mengenai pengaruh NAC terhadap kadar hsCRP dibandingkan dengan kontrol yang dilakukan pada bulan Juli - Agustus 2018 terhadap paien Infark Miokard Akut dengan Elevasi Segmen ST (IMA-EST) yang datang ke Rumah Sakit Dr Moewardi dan mendapat terapi fibrinolitik.
Hasil: Sebanyak 33 pasien diikutsertakan pada penelitian ini, terdapat 15 pasien (rerata usia 58.80±8.54 tahun) kelompok kontrol dan 18 pasien (rerata usia 55.45±9.92 tahun) kelompok perlakuan yang mendapat terapi tambahan NAC evervescent 600 mg tiga kali sehari selama tiga hari. Penelitian ini menunjukkan bahwa kadar hsCRP sesudah dilakukan intervensi pada kelompok kontrol dan perlakuan berbeda bermakna dengan nilai p = 0.001. Kadar hsCRP pada kelompok kontrol sesudah pemberian NAC memiliki median 114.50 mg/L(18.60 – 300.00) sedangkan pada kelompok perlakuan memiliki median 18.75 mg/L(5.50 – 102.90).
Kesimpulan: Pemberian terapi tambahan NAC 600 mg tiga kali sehari selama 3 hari dapat menurunkan kadar hsCRP pada pasien infark miokard akut dengan elevasi segmen ST yang mendapat terapi fibrinolitik dibanding pasien infark miokard akut dengan elevasi segmen ST yang tidak mendapat terapi tambahan NAC.
Kata Kunci: hsCRP, N-Acetylcysteine, infark miokard akut