Analisis Prediktif Lama Masa Menopause dan Kadar HS-CRP terhadap Derajat Keparahan Lesi Arteri Koroner dan Mortalitas pada Wanita Pasca Menopause dengan Infark Miokard Akut

Abstract

Background: The inflammatory process underlying AMI involves arterial thrombus formation and rupture of atheromatous plaques. Estrogen, a sex steroid hormone in women, plays a significant role in modulating this inflammatory process, and the inflammatory marker hs-CRP is utilized through risk stratification in severity of coronary artery lesions but there is no research linking to the population of postmenopausal women. Methods: This research employed observational analytical methods and a cohort study design with a prospective approach to investigate the correlation between length of menopause and hsCRP levels concerning the severity of coronary artery lesions (Coronary Angiography) in post-menopausal women with AMI (STEMI and NSTEMI). The study involved a total of 90 post-menopausal women with AMI undergoing CAG at the Integrated Heart Center of H. Adam Malik General Hospital, Medan, Indonesia. Blood samples were collected from the median cubital vein upon arrival at the Emergency Room. Following data collection, statistical analysis was conducted. Results: The analysis indicates that the duration of menopause and hs-CRP affects coronary artery lesions, while only hs-CRP affects mortality in postmenopausal women. Nagelkerke R Square values of 34.6% and OPM 82.2% for the logistic regression formula as a predictor of coronary artery lesion severity (P(x)=1/(1+e^(- (-1.014+0.148 (Length of Menopause) +2.312 (hs-CRP))) and Nagelkerke R Square values of 57.5% and OPM 88.9% for the logistic regression formula to estimate mortality incidence (P(x)=1/(1+e^(-(-4,910+3,748. hsCRP)) in postmenopausal women with NSTEMI and STEMI. Conclusion: The length of menopause and hs-CRP influenced the severity of coronary artery lesions, while only hs-CRP affected mortality. Additionally, a new predictor model formula was discovered, which can be utilized to calculate the probability of extensive coronary artery lesions and mortality in post-menopausal women with AMI.