PERANAN RASIO MONOSIT TERHADAP LIMFOSIT (MLR) SEBAGAI PREDIKTOR KEJADIAN NSTEMI
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Abstract
Infark miokard akut (IMA) merupakan salah satu penyakit jantung paling mematikan dan berkontribusi terhadap morbiditas dan mortalitas secara global. Berdasarkan laporan WHO tahun 2019, sekitar 17,9 juta orang meninggal dunia karena penyakit kardiovaskular, yang mencakup sekitar 32% dari total kematian di seluruh dunia. Peningkatan jumlah dan jenis monosit berhubungan erat dengan kejadian penyakit kardiovaskular. Rasio monosit terhadap limfosit (MLR) adalah hasil bagi antara jumlah monosit absolut dibagi dengan jumlah limfosit absolut, parameter tersebut telah terbukti menjadi parameter hematologis dan inflamasi. Penelitian ini bertujuan untuk menyelidiki akurasi diagnostik dari MLR pada kasus NSTEMI. Studi cross-sectional ini dilakukan di RSUD Depati Hamzah dari juni 2020 sampai juli 2020. Variabel penelitian meliputi usia, hemoglobin, trombosit, leukosit, limfosit, monosit, MLR, dan hasil EKG. Sebelum analisis statistik, dilakukan uji normalitas menggunakan tes Kolmogorov-Smirnov dan Shapiro Wilk serta tes Levene. Analisis statistik menggunakan Independent T-Test untuk data standar dan uji alternatif data yang tidak normal menggunakan tes Mann-Whitney. 30 rekam medis memenuhi kriteria inklusi. Setelah dilakukan analisis ROC, tiga variabel memiliki kemampuan prediktif yang cukup baik. Variabel tersebut antara lain usia (AUC: 0,738 / p-value: 0,029), leukosit (AUC: 0,775 / p-value: 0,012), dan MLR (AUC: 0,963 / p-value: 0,029). Kemampuan prediktif MLR sangat baik (AUC >0,8), tertinggi dari variabel lainnya. MLR dapat digunakan sebagai penilaian faktor risiko terhadap kejadian NSTEMI karena didapatkan perbedaan yang signifikan antara kelompok sehat dengan kelompok NSTEMI. Penggunaan marker ini bisa membantu dalam mendiagnosis pasien yang mengalami nyeri dada, terutama di pelayanan kesehatan yang terbatas.
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