Hubungan Kadar Low-Density Lipoprotein Cholesterol dengan Kejadian dan Keparahan Stroke Akut

Abstract

Latar Belakang : Peranan kolesterol serum sebagai penyebab stroke masih belum pasti. Penelitian mengenai hubungan kadar low-density lipoprotein cholesterol (LDL-C) dengan stroke akut masih sangat sedikit, dengan hasil yang tidak konsisten. Penelitian ini bertujuan untuk mengetahui hubungan kadar LDL-C dengan kejadian dan korelasinya dengan keparahan stroke akut. Metode : Penelitian ini merupakan penelitian potong lintang terhadap 51 orang pasien stroke akut yang dirawat di RSUP H. Adam Malik Medan. Subyek dikategorikan berdasarkan tipe strokenya, yaitu: stroke iskemik dan hemoragik. Semua pasien menjalani penilaian skor NIHSS saat masuk, skor SKG, penilaian volume lesi, pemeriksaan kadar lipid darah dan penilaian keluaran dilakukan setelah 30 hari onset stroke. Hasil : Subyek terdiri dari 26 (51%) laki-laki dan 25 (49%) perempuan dengan rerata umur 59.4+10.3 tahun. Dijumpai korelasi positif sangat lemah antara kadar LDL-C dengan kejadian stroke iskemik dan hemoragik akut (r=0.178, p=0.472). Dijumpai korelasi negatif antara kadar LDL-C dengan skor NIHSS (r=-0.279, p=0.048), juga dengan skor mRS dalam 30 hari (r=-0.343, p=0.014). Subyek dengan kadar LDL-C <130 mg/dl memiliki peningkatan rasio odds 6 kali lipat (RO=6.0; IK 95%, 0.941-42.8) untuk kematian dalam 30 hari dibandingkan dengan subyek dengan kadar LDL-C>130 mg/dl (p=0.037). Kesimpulan : Dijumpai korelasi positif sangat lemah yang tidak signifikan antara kadar LDLC dengan kejadian stroke iskemik dan hemoragik akut. Dijumpai pula korelasi negatif lemah yang signifikan antara kadar LDL-C dengan keparahan dan keluaran stroke akut dalam 30 hari.

Introduction : The role of serum cholesterol as the stroke etiology is still uncertain. Studies that focused on the association between low-density lipoprotein cholesterol (LDLC) and acute stroke was still rare, with inconsistent results. The aim of this study is to evaluate the correlation between LDL-C level and the acute stroke occurance and severity. Methods : We conducted a cross-sectional study of 51-acute stroke patients in Adam Malik General Hospital, Medan. Subjects was categorized according to their stroke type: ischemic and hemorrhagic stroke. All subjects underwent evaluation of NIHSS score on admission, Glasgow Coma Scale score, lesion volume and measurement of blood lipid level. The outcome was assessed in 30-days after stroke onset. Results : Subjects consists of 26 (51%) male and 25 (49%) female, with mean age of 59.4+10.3 years. There was a positive correlation between LDL-C level and the occurance of acute ischemic and hemorrhagic stroke (r=0.178,p=0.472). There were negative correlations between LDL-C level and NIHSS score on admission (r=-0.279, p=0.048), and mRS score in 30 days (r=-0.343, p=0.014). There was an increase in odds ratio for mortality in 30 days (OR=6.0;95%CI,0.941-42.8) in subjects with LDL-C level <130 mg/dl compared to subjects with LDL-C level >130 mg/dl (p=0.037). Conclusions : There was an insignificant very weak positive correlation between LDL-C level and the occurance of acute ischemic and hemorrhagic stroke. There were also a significant weak negative correlation between LDL-C level and stroke severity and outcome in 30-days.