Wasyanto, Trisulo
Masters Program In Public Health, Universitas Sebelas Maret, Indonesia

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Association between hsCRP Levels, Glycemic Control and Total Interatrial Conduction Time in Patients with Type 2 Diabetes Mellitus K, Isyana Miranti; Wasyanto, Trisulo; Murti, Bhisma
Indonesian Journal of Medicine Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Type 2 Diabetes Mellitus (T2DM) represents one of the most important risk factors for atrial fibrillation (AF). Numerous studies have shown that T2DM and poor glycemic control reflected by glycated hemoglobin A1c (HbA1c) levels are independently associated with new onset AF. Recent experimental studies reported that the increased susceptibility to AF in the diabetic patients was presumably due to the slowing of conduction associated with increased interstitial fibrosis. Systemic inflammation cam play role in the development of atrial fibrillation. High-sensitivity C-reactive protein (hsCRP) is an inflammatory biomarker that independently predicts the cardiovascular risk. This study aimed to determine the association between hsCRP level and glycemic control with total interatrial conduction time in T2DM patients.Subjects and Methods: This was an analytic study with cross-sectional design. A total of samples were 41 patients with T2DM. Peripheral venous blood samples to measure hsCRP and HbA1c were drawn in all study population. The total interatrial conduction time was measured by tissue Doppler echocardiography. Multivariate analysis was performed using multiple regression analysis. P < 0,050 was considered to indicate a statistically significant difference. Results: The high-sensitivity C-reactive protein level was higher in the T2DM patients with HbA1c≥7% than in the T2DM patients with HbA1c<7%, but not statistically significant (0,44±0,30 vs 0,32±0,22; p = 0,183). The total atrial conduction time was longer in the T2DM patients with HbA1c≥7% than in T2DM patients with HbA1c<7%, but not statistically significant (100,29±28,53 vs 94,88±16,50; p = 0,449). Multiple regression analysis showed that hsCRP levels and glycemic control had significant positive correlation with total interatrial conduction time in T2DM patients (r = 0,51; p = 0,004).Conclusions: The hsCRP levels and glycemic control were significant positively correlated with total interatrium conduction time in patients with type 2 diabetes.Keywords: hsCRP, glycemic control, HbA1c, total interatrial conduction time.Correspondence: Isyana Miranti K. Biomedic, Family Medicine Program, Sebelas Maret University, Surakarta. Indonesian Journal of Medicine (2016), 1(1): 58-70https://doi.org/10.26911/theijmed.2016.01.01.08
Association Between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarction Alfa Alfin Nursidiq; Niniek Purwaningtyas; Trisulo Wasyanto
ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.40852

Abstract

Background: High neutrophil to lymphocyte ratio (NLR) is independently associated with lower EF, in hospital complications, and higher mortality rates in acute myocardial infarction (AMI). Global longitudinal strain (GLS) measurement after AMI demonstrated specific benefit compared with LVEF in evaluation of the extent of post MI left ventricular myocardial injury. The aim of this study was to determine the association between NLR and left ventricular GLS in AMI patients.Methods: An analytic observational study was conducted on August-December 2017 to patients who admited to Dr. Moewardi General Hospital which diagnosed STEMI or NSTEMI. Blood examination and transthoracic echocardiography were performed. They were divided into two groups according to GLS measurement result, GLS>-13.8% and GLS≤-13.8%. The cut-off value of NLR to predict GLS>-13.8%was determined by ROC curve analysis. Bivariate and multivariate analysis to assess whether high NLR was associated with GLS>-13.8% were performed.Results: As many as 57 patients were included in this study, 24 patients (mean age 56,21±9,43) in GLS ≤-13.8% group and 33 patients (mean age 56.67±8.24) in GLS >-13.8%. NLR was significantly higher in GLS>-13.8% group 6.06 (5.36-6.86) compare 4.20 (3.49-5.04),in GLS≤-13.8%, p=0.001. The cut-off value of NLR was 4.69. The bivariate analysis showed that NLR>4.69 associated with GLS>-13.8%, OR 2.70 (CI 95% 1.41-5.17, p=0.001). Multivariate analysis shown that higher NLR have more probability to develop GLS>-13.8%, OR 8.53 (CI 95% 2.38-30.60, p<0.001).Conclusion: There is an association between NLR and left ventricular GLS in AMI patients. AMI patients with high NLR are more likely to have worse GLS.