Hubungan Kadar Elektrolit Dengan Petanda Jantung Pada Sindrom Koroner Akut

Abstract

Pendahuluan: Sindrom koroner akut (SKA) merupakan masalah kardiovaskular utama yang menyebabkan angka perawatan dan kematian yang tinggi. Enzim jantung seperti troponin dan Creatinin Kinase-MB (CKMB) dilepaskan ke peredaran darah dan meningkat pada infark miokard. Elektrolit adalah zat berfungsi untuk menghantarkan listrik. Aktivitas listrik jantung diatur oleh kalsium, kalium dan natrium; kontraksi jantung membutuhkan kalsium, magnesium dan fosfor. Elektrolit berguna sebagai indikator AMI. Penelitian ini bertujuan menganalisis kadar serum elektrolit dengan petanda jantung pada SKA.
 Metode: Penelitian belah lintang pada 35 pasien SKA pada bulan Desember - Januari 2018. Kadar elektrolit serum diperiksa dengan metode Ion selective electrode (ISE) dan photometric, kadar CKMB diperiksa dengan metode Enzyme-linked immuno assay (ELISA), kadar Troponin I (cTnI) diperiksa dengan metode Enzyme-linked fluorescence assay (ELFA). Uji Korelasi spearman digunakan untuk menganalisis data, signifikan jika p <0.05.
 Hasil: Terdapat korelasi negatif kuat antara natrium, kalium, clorida, dan magnesium baik dengan CKMB (p 0,000/ 0,000/ 0,001/ 0,014 dan r= -0,631/ -0,634/ -0,557/ -0,412) maupun cTnI (p 0,000/ 0,000/ 0,001/ 0,000 dan r= -0,746/ -0,574/ -0,545/ -0,564). Tidak terdapat korelasi antara kalsium baik dengan CKMB (p= 0,475 dan r= -0,125) maupun cTnI (p= 0,086 dan r= -0,294).
 Simpulan: Terdapat hubungan negatif antara natrium, kalium, clorida, dan magnesium dengan petanda jantung, tidak terdapat hubungan antara kalsium dengan petanda jantung pada SKA. Temuan ini menunjukkan bahwa rendahnya kadar serum elektrolit pada SKA dapat berarti adanya area infark yang lebih luas. Hasil penelitian ini perlu divalidasi dalam penelitian berskala besar dengan metodologi yang lebih baik dan diharapkan dapat menjadi dasar penelitian lebih lanjut.
 Kata Kunci: SKA, Elektrolit, CKMB, cTnI
 
 Introduction: Acute coronary syndrome (ACS) is a major cardiovascular problem that causes significant morbidity and mortality burden. Cardiac enzymes, such as troponin and Creatinin Kinase-MB (CKMB), are released into the bloodstream and increase in acute myocardial infarction (AMI). Electrolytes involving calcium, potassium and sodium regulate heart electrical activity, while calcium, magnesium and phosphorus regulate its contraction. Electrolytes serve as AMI indicators. This study aims to analyze serum electrolyte levels with cardiovascular markers in ACS.
 Methods: a coss sectional study of 35 ACS patients was conducted from December to January 2018. Serum electrolyte levels were examined by the Ion selective electrode (ISE) and photometric method, CKMB levels were examined by the enzyme-linked immuno assay (ELISA), Troponin I (cTnI) were examined by the Enzyme-linked fluorescence assay (ELFA) method. Spearman test was perfomed for analyzing data with significant level of <0.05.
 Results: a strong negative correlation was found between sodium, potassium, chloride, and magnesium and both CKMB (p 0,000 / 0,000 / 0,001 / 0,014 and r = -0,631 / -0,634 / -0,557 / -0,412) and cTnI (p 0,000 / 0,000 / 0.001 / 0,000 and r = -0,746 / -0,574 / -0,545 / -0,564). No correlation was found between calcium and both CKMB (p = 0.475 and r = -0.125) and cTnI (p = 0.086 and r = -0.294).
 Conclusion: There is significant negative correlation between sodium, potassium, chloride, and magnesium and cardiac markers, there is no correlation between calcium and cardiac markers in ACS. These findings indicate low serum electrolytes values in ACS may have higher area of infarction. These finding need to be validated in large-scale studies with better methodologies and are expected to be the basis for further research.
 Keywords: ACS, Electrolytes, CKMB, cTnI.

Correlation Between Troponin I Levels and Electrolytes of Sodium and Potassium in Acute Coronary Syndrome Patients at Budhi Asih Hospital

“…Low sodium levels are caused by hypoxia, ischemia, and infarction in acute coronary syndromes that affect the contractility of the heart muscle so that the pressure in the atria of the heart will decrease and left ventricular dysfunction in response to pain, nausea and stress, this results in the release of the hormone vasopressin in the kidneys. which will increase water reabsorption in the kidney tubules, resulting in a decrease in sodium levels (Wijayanti & Adipireno, 2020). The effect of ischemia on cardiac muscle cells will also affect sodium channels in the cardiac muscle cell membrane, causing increased permeability to sodium and easier diffusion into cells, then decreased function of Na+ & K+ pumps so sodium cannot be pumped out of cells (Freddy & Muji, 2017).…”