Korelasi kadar high-sensitivity C-reactive protein dengan gangguan kognitif pada pasien stroke iskemia akut

Abstract

The incidence of acute cognitive impairment in stroke patients occurred in about 80% of patients and 38-73% of them became impaired permanently. Increased of inflammatory markers as a response to stroke inflamation are associated with poor outcomes in stroke patients. HsCRP level is one of the vascular cognitive impairment predictor in ischemic stroke patients.

This study aims to determine the correlation of hsCRP levels in determining the occurrence of cognitive function disorder in patients with acute ischemic stroke at RSUP Sardjito Yogyakarta. The design was prospective cohort observational study with the subject of the first acute ischemic stroke patients. Cognitive impairment was assessed using the Montreal Cognitive Assessment versi Indonesia (MoCA-Ina) score at discharge. The hsCRP level was examined at <72h onset. All data was processed with computerized statistical analysis.

A total of 30 subjects followed the study with mean age 61.93±11.916 years and hsCRP levels of 3.35±2.23 g/dL. The result of bivariate analysis showed that one factor significantly influence cognitive impairment of ischemic stroke patients, that is hsCRP levels (r =-0.538, p =0.002). Multivariate analysis showed that hsCRP levels (β =-0.5, p =0.003) were independent factors affecting cognitive impairment of acute ischemic stroke.

Based on this study, there is a correlation between hsCRP levels with acute ischemic stroke cognitive impairment, that is, the higher hsCRP levels, the lower MoCA-Ina values.

ABSTRAK

Kejadian gangguan kognitif secara akut pada penderita stroke terjadi pada sekitar 80% pasien dan 38-73% di antaranya menjadi menetap. Peningkatan penanda inflamasi sebagai respons inflamasi stroke berhubungan terhadap luaran yang buruk pada pasien stroke. Kadar hsCRP merupakan salah satu yang dapat dijadikan prediktor gangguan kognitif vaskular pada pasien stroke infark.

Penelitian ini bertujuan untuk mengetahui korelasi kadar hsCRP dalam menentukan terjadinya gangguan fungsi kognitif pada pasien stroke iskemia akut di RSUP Dr. Sardjito Yogyakarta. Rancangan penelitian ini adalah observasional kohort prospektif dengan subjek pasien serangan stroke iskemia akut pertama. Gangguan kognitif dinilai menggunakan skor Montreal Cognitive Assessment versi Indonesia (MoCA-Ina). Kadar hsCRP diperiksa pada <72 jam sejak serangan stroke. Seluruh data kemudian diolah untuk analisis statistik secara komputerisasi.

Sebanyak 30 subjek mengikuti penelitian dengan rerata usia 61,93±11,916 tahun dan kadar hsCRP 3,35±2,23 g/dL. Pada hasil analisis bivariat didapatkan 1 faktor bermakna secara signifikan memengaruhi gangguan kognitif pasien stroke iskemia yaitu kadar hsCRP (r =-0,538, p =0,002). Setelah dilakukan analisis multivariat didapatkan bahwa kadar hsCRP (β =-0,5, p =0,003) merupakan faktor independen yang mempengaruhi gangguan kognitif stroke iskemia akut.

Berdasarkan penelitian ini, terdapat korelasi kadar hsCRP dengan ganguan kognitif stroke iskemia akut yaitu makin tinggi kadar hsCRP, makin rendah nilai MoCA-Ina