Korelasi Kadar Serum Kreatinin dengan Left Ventricle Ejection Fraction (LVEF) pada Pasien Gagal Jantung Akut dengan DM Tipe 2 di RS Adam Malik Medan

Abstract

Background: Acute heart failure in patients with type 2 diabetes mellitus (T2DM) is often accompanied by renal and left ventricular dysfunction. Investigating the relationship between serum creatinine and left ventricular ejection fraction (LVEF) is essential to guide prognosis and treatment. Methods: This cross-sectional study involved 52 patients with acute heart failure and T2DM at Adam Malik Hospital, Medan, from January to June 2025. Clinical and laboratory data were analyzed, including LVEF (Biplane Simpson) and serum creatinine. Results: Most patients were male (78.8%) with a mean age of 55 years. Smoking history was present in 61.5%, and most were in stages 2–3 of CKM (Cardio- Kidney-Metabolic) syndrome. Average blood pressure was 140/83 mmHg. Poor glycemic control was reflected by elevated glucose levels and mean A1C of 7.0%. Renal impairment was evident with a mean creatinine of 1.58 mg/dL and eGFR of 50.05 mL/min. The average LVEF was 33.19%, indicating severe systolic dysfunction. Serum creatinine showed a significant negative correlation with LVEF (r = –0.693; p = 0.015). Creatinine levels differed significantly across LVEF categories (p = 0.041), highest in the mildly reduced group (40–49%). Inter-rater agreement for LVEF measurement was excellent (ICC = 0.916; p < 0.001). Conclusion: Serum creatinine is significantly negative associated with LVEF in patients with acute heart failure and T2DM. Impaired renal function is closely linked to reduced left ventricular performance.