Stable Angina Pectoris(SAP)dan Unstable Angina Pectoris(UAP) sebagai manifestasi klinis penyakit jantung koroner yang merupakan salah satu penyebab utama kematian di negara maju maupun di negara berkembang, termasuk Indonesia. Diagnosis penyakit jantung koroner ditegakkan berdasarkan gejala klinis, EKG dan parameter biokimiawi berupa aktivitas enzim CK, CK-MB, mioglobin dan cardiac troponin (cTn) T dan cTn I. Namun pada pasien SAP dan UAP kadar aktivitas enzim jantung tersebut dalam serum belum meningkat. Serum amyloid Asebagai protein fase akut yang muncul sebagai respon inflamasi kronis dan akut yang diproduksi hepar namun spesifik terhadap proses atherosklerosis. Pemeriksaan Serum Amyloid A menggunakan metode ELISA untuk mendeteksi SAA manusia. Tujuan penelitian ini untuk mengetahui perbedaan kadar SAA pada pasien SAP dan UAP di RSUP Dr. Sadjito Yogyakarta. Penelitian cross sectional, dipilih secara konsekutif pasien dengan keluhan nyeri dada substernal atau kadang-kadang epigastrium,menjalar ke leher, bahu kiri, lengan kiri yang dibagi menjadi 2 kelompok yaitu kelompok stable angina pectoris dan unstable angina pectoris.Uji beda dua kelompok menggunakan independent t test bila distribusi data normal atau Mann Whitney U test bila data tidak normal dengan kemaknaan p < 0,05 dan interval kepercayaan 95%. Penelitian inimelibatkan 60 pasien,proporsi subjek dengan diabetes mellitus (63,3% vs 71% p=0,037), merokok aktif (30% vs 54,8%, p=0,037), jumlah lekosit (10,32x103sel/mmk vs 6,79x103sel/mmk, p=0,001) dan presentase netrofil (74,75% vs 57,45%, p=0,001). Perbedaan proporsi derajat stenosis pada pada penelitian ini menunjukkan perbedaan yang signifikan antara kelompok subjek stable angina pectorisdan unstable angina pectoris dengan proporsi 43,3% vs 73,3% (p<0,003). Pemeriksaan EKG pada kelompok pasien unstable angina pectoris 64,5% abnormal sedangkan pada kelompok stable angina pectoris 16,7% abnormal (p<0,001). Kadar SAA subjek unstable angina pectorisdan stable angina pectorisdengan med (min-mak) 21,48(10,21-38,69) μg/dL vs 5,57(1,56-9,67) μg/dL, interval kepercayaan 95% 15,91(10,53-25,54)μg/dLp=0.001. Terdapat perbedaan bermakna antara kadar serum amyloid A pada pasien Unstable Angina Pectoris dan stable angina pectoris

Unstable angina pectoris and stable angina pectoris as a clinical manifestation of coronary heart disease which is one of the leading causes of death in developed countries and in developing countries, including Indonesia. Diagnosis of coronary heart disease is made based on clinical symptoms, ECG and biochemical parameters such as enzyme activity of CK, CK-MB, myoglobin and cardiac troponin (cTn) cTn T and I. However, in patients with SAP and UAP levels of the cardiac enzyme activity in serum has not been increased. Serum amyloid A as an acute phase protein that appears as a chronic and acute inflammatory response produced by the liver, but specific to the process of atherosclerosis. Examination of Serum Amyloid A ELISA method for detecting human SAA in plasma, serum and cell culture supernatant. The aim of this study was to determine differences in SAA levels in patients with SAP and UAP in the hospital Dr. Sadjito Yogyakarta. This cross-sectional study, consecutively selected patients with typical chest pain (substernal or sometimes epigastric, radiating to the neck, left shoulder, left arm) were divided into 2 groups: stable angina pectoris and unstable angina pectoris. The different test two groups using independent t test when data were normally distributed or Mann Whitney U test if the data is not normal with a significance of p <0.05 and 95% confidence intervals. The result of this study involving 60 patients are as follows, the proportion of subjects with diabetes mellitus (63.3% vs. 71% p = 0.037), active smoking (30% vs. 54.8%, p=0.037), number of leukocytes (10,32x103sel / mmk vs. 6,79x103sel/mmk, p = 0.001) and neutrophil percentage (74.75% vs. 57.45%, p = 0.001). Differences in proportion to the degree of stenosis in this study showed significant differences between groups of subjects stable angina pectoris and unstable angina pectoris with a proportion of 43.3% vs. 73.3% (p <0.003). EKG in patients with unstable angina pectoris group 64.5% showed abnormal, stable angina pectoris 16.7% abnormal (p <0.001). Serum Amyloid A levels significant differences between subjects with unstable angina pectoris and stable angina pectoris with median (minimal-maximal) 21,48(10,21-38,69) μg/dL vs 5,57(1,56-9,67) μg/dL, 95% confidence interval 15,91(10,53-25,54)μg/dL p=0.001. There are significant differences between the mean levels of serum amyloid A in patients with Unstable angina pectoris and stable angina pectoris.

Kata Kunci : Serum Amyloid A, Stable Angina Pectoris, Unstable Angina Pectoris