Korelasi Kadar Asam Urat Serum dengan Keparahan Stenosis Arteri Koroner Pasien Sindrom Koroner Akut: Studi Meta-Analisis

Diding Heri Prasetyo, Sally Aman Nasution, Idrus Alwi, Murdani Abdullah

Abstract

Pendahuluan. Hubungan antara asam urat serum dengan penyakit jantung iskemik masih kontroversial dan belum ditetapkan sebagai faktor risiko kardiovaskular. Interaksi kooperatif antara keduanya tidak sepenuhnya dipahami. Beberapa bukti epidemiologis hubungan kausal tersebut masih kontroversial. Sering sekali penelitian dengan kasus yang sama dan menggunakan metode yang sama tetapi hasilnya berbeda. Penelitian ini bertujuan untuk melakukan meta-analisis untuk mensintesis hasil-hasil penelitian yang berbeda tersebut agar diperoleh data baru yang bersifat kuantitatif dan lebih akurat.
Metode. Protokol penelitian didaftarkan dengan PROSPERO (CRD42020210948) dan telaah sistematis mengikuti pedoman preferred reporting items for systematic reviews and meta-analyses (PRISMA), dengan menelusuri studi yang dipublikasikan dalam rentan waktu dari Januari 2010 hingga Mei 2020. Cochrane Library, EBSCO, Medline/PubMed, ProQuest dan Sience Direct adalah sumber dari studi yang dipublikasikan. Meta-analisis dilakukan untuk mensintesis korelasi antara kadar asam urat serum dan keparahan stenosis arteri koroner, menggunakan model efek acak untuk menjelaskan kemungkinan heterogenitas penelitian. Heterogenitas dinilai menggunakan I2, dan meta-analisis menggunakan perangkat lunak comprehensive meta-analysis version 3 (CMA3).
Hasil. Lima studi (n = 601 pasien) diidentifikasi dan didapatkan korelasi antara kadar asam urat serum dan skor Gensini (r = 0,548; p <0,001) pada pasien SKA. Bias heterogenitas ditemukan dalam analisis, sedangkan bias publikasi tidak ditemukan.Terdapat korelasi positif antara kadar asam urat serum dengan keparahan stenosis arteri koroner, dengan koefisien korelasi sebesar 0,548 yang dapat dikategorikan memiliki hubungan yang sedang (nilai p <0,001).
Simpulan. Keparahan stenosis arteri koroner pada pasien dengan SKA berkorelasi positif dengan kadar asam urat serum.
Kata Kunci: Asam urat, sindrom koroner akut, skor Gensini

 

Correlation of Serum Uric Acid Levels with The Severity Of Coronary Artery Stenosis in Patients with Acute Coronary Syndrome: Meta Analysis Study

Introduction. The relationship between serum uric acid  (SUA) level and ischemic heart disease abides controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between those two factors is not fully understood. Prior epidemiological evidences of the causal relationship is still argumentative. There were various studies using the same methods yet the outcome were different. This study aims to conduct a meta-analysis to synthesize the results of recent studies in order to obtain data quantitatively and also accurately.

Methods. This study protocol was registered with PROSPERO (CRD42020210948), and conducted according to PRISMA guidelines, tracing studies published in vulnerable periods from January 2010 to May 2020. The Cochrane Library, EBSCO, Medline/PubMed, ProQuest and Science Direct are sources of published studies. Meta-analysis was conducted to synthesize the associations between SUA level and severity of coronary artery stenosis, using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2, and the meta-analysis was performed using Comprehensive Meta-Analysis Version 3 (CMA3) software.

Results. Five studies (n = 601 patients) identified a correlation between serum uric acid levels and Gensini scores (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis, whereas publication bias was not found. There was a moderate positive correlation between serum uric acid levels and the severity of coronary artery stenosis, with a correlation coefficient of 0.548 (p value <0.001).

Conclusion. The severity of coronary artery stenosis in patients with ACS is positively correlated with serum uric acid levels.

Keywords

Acute coronary syndromes, Gensini score, uric acid

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