Mahardika, Wisnu Pradana
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Heart Fatty Acid Binding Protein sebagai Biomarker Potensial Kerusakan Miokardium Sukmadja, Andy; Mahardika, Wisnu Pradana
Cermin Dunia Kedokteran Vol 42, No 9 (2015): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1212.644 KB) | DOI: 10.55175/cdk.v42i9.972

Abstract

Diagnosis dan pengobatan yang tepat dan cepat dapat menurunkan morbiditas dan mortalitas sindrom koroner akut. Troponin masih menjadi pilihan utama dalam mendiagnosis menurut guideline di Amerika dan Eropa. Namun, troponin plasma baru meningkat 6-9 jam setelah onset iskemia. Penelitian menunjukkan adanya suatu biomarker baru, heart fatty acid binding protein (H-FABP) yang dapat mendeteksi kerusakan miokardium setelah 1 jam timbulnya gejala iskemik. H-FABP merupakan protein ukuran kecil pada otot jantung dan skeletal dengan fungsi biologis utama memfasilitasi translokasi asam lemak rantai panjang intraseluler. Karena ukurannya yang kecil, H-FABP lebih cepat dikeluarkan ke sirkulasi jika intergritas membran terganggu. Batas ambang atas HFABP pada beberapa penelitian didapatkan 6 ug/L dengan variasi biologis tergantung umur, jenis kelamin, dan ritme sirkadian. H-FABP dapat dideteksi 2 – 3 jam setelah iskemia, dan turun ke kadar normal dalam 12 – 24 jam. Beberapa penelitian telah mendapatkan hasil sensitivitas H-FABP lebih tinggi dibandingkan troponin pada 3 jam setelah onset iskemia. Penggunaan H-FABP dan troponin secara bersamaan akan memberikan hasil lebih baik. Fungsi H-FABP lain dalam klinis adalah dalam melihat efek terapi reperfusi, mengetahui ukuran infark, diferensiasi cedera miokardium dan otot skeletal, juga sebagai nilai prognostik.Early and precise diagnosis and treatment could reduce the morbidity and mortality of acute coronary syndrome. According to European and United States` guidelines, troponin is the primary choice to diagnose acute coronary syndrome. Unfortunately, cardiac troponin levels elevated only 6-9 hours after the onset of ischemia. Researches have shown a new biomarker, heart fatty acid binding protein (H-FABP) which able to detect myocardial damage as soon as one hour after the onset of ischemia. H-FABPs are relatively small intracellularproteins in myocardium and skeletal muscle primary biological function is to facilitateintracellular translocation of long-chain fatty acids. Owing to its small size, H-FABP can be rapidly released to the circulation in respond to impairment of membrane integrity. Upper reference limit of H-FABP in several researches is 6 ug/L with biological variation attributable to age, sex, andcircadian rhythm. H-FABP level can be detected within 2-3 hours after ischemia, and return to normal level within 12-24 hours. Several researches have shown that the sensitivity of H-FABP is higher than troponin within 3 hours after the onset of ischemia. The simultaneous use of H-FABP and troponin will give better results. Other clinical uses of H-FABP are to examine the result of reperfusion therapy, size of infarct, differentiate damage to myocardium and skeletal muscle, and also as a prognostic value.Â