Electronic Theses and Dissertation

ABSTRAK
KORELASI ANTARA VOLTAGE QRS DAN KADAR NT-PROBNP
DENGAN DERAJAT KEPARAHAN ANGINA STABIL
Latar Belakang: Penyakit arteri koroner (CAD) merupakan salah satu penyebab
utama morbiditas dan mortalitas di dunia, terutama pada pasien dengan angina
stabil. Deteksi dini terhadap keparahan CAD sangat penting guna meningkatkan
penatalaksanaan dan prognosis pasien. Parameter elektrokardiogram (EKG) seperti
voltase QRS telah banyak digunakan untuk menilai viabilitas miokard, sedangkan
NT-proBNP merupakan biomarker yang telah terbukti berguna dalam menilai stres
miokard dan disfungsi ventrikel. Penelitian ini bertujuan untuk mengevaluasi
korelasi antara voltase QRS dan kadar NT-proBNP dengan keparahan angina stabil
dengan angina stabil menggunakan skor SYNTAX.
Metode: Penelitian potong lintang ini melibatkan 62 pasien dengan angina stabil
yang menjalani angiografi koroner. Keparahan angina stabil dinilai dengan
menggunakan skor SYNTAX. Voltase QRS diukur pada 12 lead EKG standar,
sedangkan kadar NT-proBNP ditentukan melalui metode imunofluoresensi.
Analisis korelasi dilakukan dengan menggunakan uji Spearman karena distribusi
data tidak normal, maka. Selanjutnya, analisis kurva ROC dilakukan untuk
menentukan kemampuan diskriminatif NT-proBNP dalam memprediksi CAD berat
serta menetapkan nilai cutoff optimal.
Hasil: Hasil analisis menunjukkan bahwa tidak terdapat korelasi signifikan antara
voltase QRS dan skor SYNTAX pada 12 lead EKG (p > 0,05). Namun kadar NT
proBNP menunjukkan korelasi positif sedang dengan skor SYNTAX (r = 0,598, p
< 0,001). Analisis ROC menghasilkan nilai area under the curve (AUC) sebesar
0,904 (95% CI: 0,829–0,979; p

ABSTRACT Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, particularly among patients with stable angina. Early identification of severe CAD is crucial for effective management and prognosis. While electrocardiographic markers such as QRS voltage have been proposed as indicators of myocardial viability, natriuretic peptides—specifically N-terminal pro-B-type natriuretic peptide (NT-proBNP)—are established biomarkers of myocardial stress. This study aimed to evaluate the correlation between QRS voltage and NT-proBNP levels with the severity of CAD, as assessed by the SYNTAX score, in patients with stable angina. Method: A cross-sectional study was conducted on 62 patients with stable angina who underwent coronary angiography. The severity of stable angina was quantified using the SYNTAX score. QRS voltage was measured across the standard 12-lead electrocardiogram, while serum NT-proBNP levels were obtained via immunoassay. Given the non-normal distribution of the SYNTAX score, Spearman’s rank-order correlation was employed to assess the relationships between variables. Additionally, receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative performance of NT-proBNP in predicting severe stable angina. Results: The analysis revealed no significant correlation between QRS voltage and the SYNTAX score across all 12 ECG leads. In contrast, NT-proBNP levels demonstrated a moderate positive correlation with the SYNTAX score (ρ = 0.535, p < 0.001). ROC analysis further confirmed the utility of NT-proBNP, yielding an area under the curve (AUC) of 0.904 (95% CI: 0,829–0,979, p =