Hubungan Rasio Neutrofil dengan Lipoprotein Densitas Tinggi terhadap Kejadian Kardiovaskular Mayor pada Infark Miokard Akut dengan Elevasi Segmen ST yang Menjalani Intervensi Koroner Perkutan Primer di RS Adam Malik Medan

Abstract

Background: Acute myocardial infarction (AMI) that causes morbidity and mortality is Acute Myocardial Infarction with ST Segment Elevation (AMI-EST). The course of IMA-EST can lead to complications in the form of Major Cardiovascular Events (MCEs). The ratio of neutrophils to High-Density Lipoprotein (neutrophil-HDL) is a biomarker for cardiovascular disease, and conditions the balance between inflammation and the protective effects of lipids. Objective: To determine whether there is an association between neutrophil to high-density lipoprotein ratio and MCEs in AMI-EST. Subjects and Methods: This study was an observational analytic study conducted with a cross-sectional approach on 90 patients in the MCEs group and 90 patients who did not have MCEs. All study subjects underwent anamnesis, and laboratory examination. Then the neutrophil-HDL ratio value was calculated. The relationship between neutrophil-HDL ratio and major cardiovascular events in acute myocardial infarction with ST segment elevation was analyzed using the Chi-Square test and was significant (p<0.05). Normality test of numerical variables in all study subjects used Kolmogorov Smirnov (n>50) or Shapiro Wilk (n<50) test. Results: In 180 study subjects who underwent coronary intervention. patients with neutrophil-HDL ratio ≤0.205, 87 patients (96.7%) had MCEs, while the remaining 0 patients (0%) did not experience MCEs. In patients with neutrophil-HDL ratio values >0.205, 3 (3.3%) patients had MCEs, while 90 patients (100.0%) did not have MCEs. This difference was statistically significant (p = 0.0001; OR = 31.00; 95% CI: 10.184 - 94.365; Chi Square test). Conclusion: There is an association between neutrophil-HDL ratio and the incidence of MCEs in acute myocardial infarction with ST-segment elevation undergoing primary percutaneous coronary intervention.