Electronic Theses and Dissertation

Gagal jantung dan inflamasi saling berkaitan. angiotensin converting enzyme inhibitor (ace-i) dan angiotensin receptor nephrilysin inhibitor (arni) dapat menurunkan inflamasi melalui mekanisme penghambatan produksi netrofil. rasio neutrofil terhadap limfosit (nlr) adalah penanda sederhana inflamasi. belum banyak penelitian yang membuktikan nlr dapat menjadi prediktor prognosis pada penderita gagal jantung dengan penurunan fraksi ejeksi ventrikel kiri (hfref). tujuan penelitian ini adalah sebagai prediktor prognosis terhadap kematian dan kejadian rehospitalisasi pada penderita hfref yang diterapi dengan ace-i maupun arni. penelitian ini merupakan studi kohort observasional prospektif dengan metode double blind yang dilakukan di rsud zainoel abidin banda aceh. terdapat dua kelompok yaitu kelompok ace-i dan kelompok arni, masing-masing kelompok memiliki 40 sampel. pertama dilakukan pemeriksaan darah untuk menilai nlr. sampel diobservasi setiap minggunya selama tiga bulan untuk mengevaluasi kejadian kematian dan rehospitalisasi. setelah tiga bulan sisa sampel yang hidup dilakukan pemeriksaan nlr ulangan. dari hasil penelitian, ditemukan kejadian kematian (arni n:3, ace-i n:4). didapatkan bahwa nlr pre hr: 1,454, ik 95%:1,266-1,670, p = 0,000. kejadian rehospitalisasi dapat diprediksi oleh nlr pada kelompok ace-i (rr:6,56) dan arni (rr:8,33). ace-i (p=0,014) dan arni (p=0,032) dapat menurunkan kadar nlr. dapat disimpulkan bahwa, nlr dapat menjadi prediktor prognosis pada hfref baik yang diterapi dengan ace-i maupun arni, serta ace-i dan arni dapat menurunkan kadar nlr. kata kunci: nlr, prognosis, ace-i, arni, suku aceh

Heart failure(HF) and inflammation is related each other. Angiotensin Converting Enzyme Inhibitor (ACE-I) and Angiotensin Receptor Nephrilysin Inhibitor (ARNI) could reduce the inflammation by lowering neutrophil. Neutrophil-lymphocyte ratio (NLR) is a simple marker of inflammation. The data is still lack for the study to reveal NLR could be a predictor of prognosis patient with HFrEF and need further investigation. The aim of this study was to reveal whether NLR could be a prognostic indicator for mortality and rehospitalization in patients with heart failure and reduced ejection fraction receiving treatment with ACE-I or ARNI. This was prospective observational cohort study with double blind methods undertaken in Zainal Abidin General Hospital, Banda Aceh. There were two groups that was ACE-I and ARNI, each group had 40 samples. At first, blood sampling was performed for NLR. Sample was observed every once a week during three months periodically for prognosis (death and rehospitalization). After three months, the rest of participants invited to re-evaluation the NLR. There were incident of death (ARNI n:3, ACE-I n:4). This study found that NLR pre HR: 1.454, CI 95%: 1.266-1.670, p = 0.000. Risk ratio from abnormal NLR pre in rehospitalization was 6,56 in ACE-I and 8,33 in ARNI. Nevertheless, ACE-I (p = 0.014) and ARNI (p = 0.032) could decreased NLR levels. High NLR could be as a predictor of prognosis in patients with heart failure with a decrease in left ventricular ejection fraction that treated with ACE-I or ARNI, also ACE-I and ARNI could reduce NLR levels. Keywords: NLR, Prognosis, ACE-I, ARNI, Acehnese