HUBUNGAN ANTARA AKTIVITAS SERUM MATRIKS METALLOPROTEINASE-9 (MMP-9) DAN POLIMORFISME NUKLEOTIDA TUNGGAL (SNP) MMP-9 -1562C>T PADA PASIEN INFARK MIOKARD AKUT ELEVASI SEGMEN ST (STEMI) DIBANDINGKAN DENGAN SINDROM KORONER AKUT NON ELEVASI SEGMEN ST (SKA NON STE)
| Main Authors: | , Budi Yuli Setianto, dr., Sp.PD(K)., Sp.JP(K), , Prof. dr. Sofia Mubarika, M.Med.Sc., PhD. |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2012
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/99340/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=55946 |
Daftar Isi:
- Background: Acute coronary syndrome (ACS) caused by plaque rupture or erosion. Plaque rupture or erosion occurs because of damage to the extracellular matrix by MMP (matrix metalloproteinase). SNP frequency of MMP-9-1562 C> T in the promoter region of the IMA higher than controls. In vitro activity of the T allele promoter is higher than the C allele, and is associated with increased expression of MMP-9 in plaque and serum. Objectives: To prove the difference in the activity of MMP-9 in STEMI compared to NSTEACS, differences in SNP frequency of MMP-9-1562 C> T in STEMI compared to NSTEACS and the relationship between levels of MMP-9 by MMP-SNP 9-1562 C> T in STEMI compared to NSTE-ACS. Methods: Examination of samples performed on 70 patients with ACS (31 STEMI and 39 with NSTE-ACS). Study was conducted with the cross-sectional design and sampling carried out by consecutive sampling. To analyze the differences in levels of MMP-9 from each group used unpaired Student t test. frequency of MMP-9 SNP 1562C> T of each group were compared using Chi-square test analysis. To identify independent risk factors used logistic multiple regression analysis, and to extrapolate genetic populations using Hardy Weinberg formula. Said to be significant when P values <0.05 Results: Onset, leukocyte count and activity of MMP-9 were statistically significant associated with STEMI compared with NSTE-ACS, with each contributed to the sequentialonset (P = 0.02), the leucocytes count (P = 0.000), and MMP-9 (P = 0026). STEMI group had MMP-9 levels were significantly higher compared with NSTE-ACS group (P = 0012). High levels of MMP-9 (> 1334.5 ng / ml) to give STEMI prevalence ratio of 1.96 (95% CI = 1.3 - 9.5). At high levels of MMP-9 in the presence of MMP-9 SNP 1562C> T will have an estimated risk of STEMI by 4 times (P = 0.048, 95% CI = 0.733 to 21.838). Population genetic studies can be extrapolated to the general population (P = 0.25). -1562 T allele tends to increase as much as 1.46 times the incidence of STEMI (OR = 1464, 95% CI = 0812- 2638). The existence of a patient in the group of NSTE-ACS with SNP MMP-9-1562T> T, needs to be assessed further in-1562T allele is an allele that has a higher activity compared transkriptional-1562C allele. So it would theoretically increase the activity of MMP-9 which would alter the clinical manifestations of NSTE-ACS a STEMI.