The Association Between Cardiovascular Risk and Elevated Triglycerides

BACKGROUND: The association between elevated triglycerides and cardiovascular risk has been extensively studied. The elevated level of triglycerides occurs through abnormalities in hepatic very low-density lipoprotein (VLDL) production and intestinal chylomicron synthesis, dysfunctional lipoprotein lipase (LPL)-mediated lipolysis or impaired remnant clearance.CONTENT: Hypertriglyceridemia (HTG) commonly leads to a reduction in high-density lipoprotein (HDL) and increase in atherogenic small dense low-density lipoprotein (LDL) cholesterol, called the atherogenic dyslipidemia (AD). Triglycerides may also stimulate atherogenesis by mechanisms, such excessive release of free fatty acids, and production of pro-inflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia (HTG) and high concentration of triglyceride-rich lipoprotein (TRL) as causal risk factors for cardiovascular disease. Therefore, lipid management is crucial in reducing cardiovascular risk. Combination of lipid lowering drug therapy may be needed to achieve both LDL and non-HDL cholesterols treatment goal for cardiovascular disease prevention in patients with elevated triglyceride levels, particularly those with triglyceride ≥500 mg/dL.SUMMARY: LDL and non-HDL cholesterol can be a promising target therapy in HTG. Additional clinical outcomes data are needed to provide a more evidence-based rationale for clinical lipid management of hypertriglyceridemic patients

The Importance of Managing HbA1c in Coronary Artery Disease: Keep It Low

Coronary Artery Disease (CAD) is the most prevalent cardiovascular disease, which remains the leading cause of death worldwide. In Indonesia, it accounts for approximately 1.5% of the entire population. Diabetes mellitus (DM) is taken into consideration as one of the most potent risk factors for cardiovascular diseases. HaemoglobinA1c (HbA1c) reflects a long-term glycemic control and is used as a valuable diabetes biomarker. High serum glucose levels, expressed as glycated hemoglobin levels in diabetics or non-diabetics, are related to varying degrees of systemic inflammation and promote the release of the proinflammatory cytokines. The association between higher glycated serum HbA1c levels and the severity of the coronary disease is well known. The predictive value of HbA1c for CAD severity, re-hospitalization, and the mortality of cardiovascular disease had been studied extensively since 2004. Numerous previous trials discovered that severity of CAD correlated with the elevation of HbA1c levels, suggesting it as a broad surrogate marker for CAD. Thus, HbA1c is currently considered as an independent risk factor for CAD. A higher level of HbA1c and the presence of factors associated with ongoing atherosclerosis and extensive CAD are concomitantly contributing to the higher major adverse cardiovascular events (MACEs) incidence and long-term mortality

PENELITIAN PSIKONEUROIMUNOLOGI: APAKAH STRESS MEMPENGARUHI IMUNITAS DAN MENYEBABKAN PENYAKIT ARTERI KORONER?

Tulisan ini bertujuan mempelajari pentingnya psikoneuroimunologi (PIN) dalam memahami peran stressorpsikologi akut dan kronis pada system kekebalan dan perkembangan penyakit arteri koroner (CAD).Pertama, PNI mengilustrasikan bagaimana stress psikologi merubah fungsi endotel dan merangsangkemotaksis. Kedua, stress psikologi akut merangsang leukositosis, meningkatkan sitotoksisitas sel NK danmengurangi respons proliferasi mitogen ketika stress psikologi kronik mungkin merangsang efek burukkesehatan. Ini akan menghasilkan perubahan dalam fungsi kardiovaskuler dan perkembangan CAD. Ketiga,stress psikologi akut dan kronis akan meningkatkan factor hemostasis dan protein fase akut, kemungkinanmerangsang pembentukan thrombus dan miokard infark. Bukti untuk pengaruh stress psikologi akut dankronis pada onset dan progres CAD adalah konsisten dan meyakinkan. Tulisan ini juga menyoroti daerahpenelitian potensial dan akibatnya dar

Perkembangan Implikasi Biologi dan Klinis Proprotein Convertase Subtilisin-Kexin 9

Pada tahun 2003 Proprotein Convertase Subtilisin-Kexin 9 (PCSK9) berhasil diidentifikasi.1 PCSK9 berfungsi meningkatkan kadar LDL Cholesterol (LDL-C) melalui degradasi LDL Receptor (LDLR).2 Penemuan PCSK9 telah merevolusi serta merupakan perkembangan terpenting pada bidang riset kardiovaskular satu dekade terakhir, terutama dalam regulasi LDL-C. 1Pada tahun 2003 Proprotein Convertase Subtilisin-Kexin 9 (PCSK9) berhasil diidentifikasi.1 PCSK9 berfungsi meningkatkan kadar LDL Cholesterol (LDL-C) melalui degradasi LDL Receptor (LDLR).2 Penemuan PCSK9 telah merevolusi serta merupakan perkembangan terpenting pada bidang riset kardiovaskular satu dekade terakhir, terutama dalam regulasi LDL-C.

Hubungan Tim Dinamis Dengan Kemampuan Perawat Igd Melakukan Cpr Di Rumah Sakit Rujukan Pertama Nusa Tenggara Barat

Latar Belakang Peran penting perawat dalam penanganan cardiac arrest dan kemampuan kemampuan melakukan high quality CPR adalah kemampuan yang wajib dimiliki oleh perawat.Tujuan penelitian ini adalah untuk mengetahui hubungan antara tim dinamis dengan kemampuan perawat IGD dalam melakukan CPR. Metode observasional analitik dengan pendekatan cross sectional menggunakan purposive sampling. Jumlah sampel 52 perawat IGD dari tiga rumah sakit rujukan pertama di NTB. Alat ukur lembar observasi dan manequin GD/CPR180S, untuk mengetahui kemampuan CPR dan parameter tim dinamis. Hasil penelitian menunjukkan bahwa rata-rata responden hanya melakukan 4 hal dari indikator CPR yang berkualitas dan 5 dari 6 indikator tim dinamis dalam proses CPR. Hasil analisa bivariat dengan menggunakan korelasi pearson menunjukkan Pv 0,000 dan r 0,637. Tim dinamis mempunyai hubungan yang erat dengan kemampuan perawat melakukan CPR. Berdasar dari penelitian ini, sebaiknya pelatihan CPR dilakukan dengan pendekatan tim

Secretory Phospholipase A2 Tipe II (SPLA II) In Cardiovascular Disease

Inflammatory reactions contribute to the pathogenesis of cardiovascular conditions such as atherosclerosis and ischemic damage in acute myocardial infarction (AMI). Among the mediators involved in inflammation are secretory phospholipase A2 group II (sPLA2-II) enzymes. Though some cells constitutively express Spla2-II, the synthesis by cells such as hepatocytes is typical for an acute-phase reactant. Recent literature suggest multiple roles for sPLA2-II in cardiovascular disease. In this review we discuss the role of sPLA2-II in included that sPLA2-II appears to be an inportant inflammatory mediator of cardiovascular disease

The Differences of Food Compositions in Adolescent Metabolic Syndrome in Malang

BACKGROUND: Obesity, especially obesity in adolescent, is a worldwide health problem needing much of our attention because it can continue to be obesity in adulthood. About 50% obese adolescents grew up to be obese adults. It was a concern since it is one of risk factor associated with cardiovascular events including hypertension, dyslipidemia, insulin resistance and stroke. Visceral obesity is correlated with diabetogenic, atherogenic, prothrombotic, pro-inflammation, and abnormal metabolism. The objective of this study was to assess the prevalence of obese adolescents in Malang and to identitfy the differences in food compositions between metabolic syndrome and non-metabolic adolescents.METHODS: Prevalence of obesity was determined by assessing BMI in 20 Senior and Junior High Schools. Metabolic syndrome was diagnosed using IDF criteria; waist circumference of >80cm and >90cm for female and male, respectively, and increased triglyceride and decreased HDL concentration levels. The food composition was assessed using food recalls, and then regression linier test was done to define the correlation between food intake and the components of metabolic syndrome.RESULTS: The prevalence of adolescent obesity in Malang had reached 3.32%, with the prevalence of obesity in male subjects higher than in female subjects, i.e. 54.1% compared to 45.9%. The boys had higher mean for height and weight than the girls did, however, the BMI was higher in girls rather than boys. The difference of fat in food composition was significantly higher for the metabolic groups (p=0.031), but the carbohydrate did not significantly differ between the two groups (p=0.407).CONCLUSIONS: The prevalence of adolescent obesity in Malang had reached 3.32%, with the prevalence of 54.1% in male and 45.9% in female. From the statistics test, fat intake showed a significant difference between metabolic syndrome and non-metabolic syndrome groups, but other food compositions didn’t.KEYWORDS: obesity, metabolic syndrome, adolescen

Dyslipidemia Aterogenic, antara fakta dan harapan yang akan datang

Disregulasi dari metabolisme lipoprotein merupakan inti dari perkembangan aterosklerosis. Suatu studi epidemi prospektif secara konsisten menunjukkan bahwa kenaikan dari Low Density Lipoprotein Cholesterol (LDL-C) dihubungkan dengan peningkatan risiko dari penyakit kardiovaskular, namun hal tersebut mungkin secara terpisah menyebabkan dislipidemia aterogenik, jika bergabung dengan hipertensi, obesitas sentral dan resistensi insulin, yang secara bersamaan dikenal sebagai sindroma metabolik. Dislipidemia aterogenik ditandai dengan tingginya trigliserid (TG) plasma, rendahnya High Density Lipoprotein Cholesterol (HDL-C) dan tingginya konsentrasi apolipoprotein (apo)-B yang berisi lipoprotein, khususnya peningkatan small dense LDL.Hipertrigliserid (HTG) adalah peningkatan kadar trigliserid (TG) puasa di atas normal (> 150 mg/dl). Pada 2010 di Amerika Serikat ada 74,6 juta penduduk mempunyai peningkatan kadar trigliserid, 36,4 juta diantara mereka memiliki kadar triglsierid yang tinggi (200-499 mg/dl), dengan meningkatnya prevalensi ini secara paralel juga terjadi peningkatan yang tajam terhadap kejadian obesitas.

Hibiscus Sabdariffa Linn) Terhadap NF-ĸβ, TNF-α Dan ICAM-1 Pada Human Umbilical Vein Endothelial Cells (HUVECs) Cultured Yang Dipapar Low Density Lipoprotein (LDL) Teroksidasi

Tujuan penelitian ini adalah mengetahui efek dan mekanisme kerja ekstrak teh Rosella merah (Hibiscus sabdariffa Linn) terhadap aktifasi NF-κβ dan ekspresi protein TNF -α serta ICAM-1 yang menjadi mediator inflamasi pada aterosklerosis. Penelitian ini menggunakan kultur sel endotel yang diisolasi dari vena umbilikalis manusia ( HUVECs). Kelompok kontrol digunakan HUVECs tanpa paparan ox-LDL (kontrol negatif) dan HUVECs yang dipapar 40 µgml-1 Ox-LDL (kontrol positif). Kelompok perlakuan adalah HUVECs yang dipapar dengan berbagai dosis teh Rosella merah (0,01 mgml-1, 0,005 mgml-1 dan 0,001 mgml-1) dan diberikan selama 2 jam sebelum dipapar ox-LDL. Pengukuran aktifasi NF-κβ dilakukan setelah 30 menit paparan Ox-LDL menggunakan imunohistokimia. Ekspresi protein TNF-α dan ICAM-1 diukur setelah 24 jam dipapar Ox-LDL menggunakan imunohistokimia. Berdasarkan analisis ANOVA (p<0.01) terdapat efek penghambatan ekstrak teh Rosella merah (Hibiscus sabdariffa Linn) terhadap aktifasi NF-κβ dan ekspresi protein TNF -α serta ICAM-1 yang manjadi mediator terjadinya inflamasi pada aterosklerosis melalui penghambatan aktifasi NF-κβ. Terdapat hubungan negatif antara aktifasi NF-κβ dan ekspresi protein TNF -α serta ICAM-1 dengan dosis ekstrak teh Rosella merah (Analisis Spearman's [p<0,01, Correlation Coeff = -1])