Electronic Theses and Dissertation

HUBUNGAN ANTARA INDEKS CASTELLI RISK II DENGAN DERAJAT KEPARAHAN STENOSIS BERDASARKAN SKOR GENSINI PADA PENYAKIT JANTUNG KORONER
Latar Belakang: Penyakit jantung koroner (PJK) merupakan penyebab utama morbiditas dan mortalitas kardiovaskular. Derajat keparahan stenosis arteri koroner dipengaruhi oleh berbagai faktor risiko metabolik, salah satunya dislipidemia. Indeks Castelli Risk II (ICR II), yang merupakan rasio antara kolesterol LDL dan HDL, dianggap mampu mencerminkan keseimbangan lipid aterogenik dan antiaterogenik. Namun, hubungan antara ICR II dan derajat keparahan stenosis arteri koroner berdasarkan skor Gensini masih belum banyak diteliti, khususnya di Indonesia.
Tujuan: Penelitian ini bertujuan untuk menilai hubungan antara Indeks Castelli Risk II dengan derajat keparahan stenosis arteri koroner berdasarkan skor Gensini pada pasien penyakit jantung koroner.
Metode: Penelitian ini menggunakan desain potong lintang (cross-sectional) yang dilakukan di Instalasi Kateterisasi Jantung RSUD dr. Zainoel Abidin Banda Aceh pada bulan Juli–November 2025. Subjek penelitian berjumlah 93 pasien PJK yang menjalani angiografi koroner. Data diperoleh dari rekam medis dan pemeriksaan laboratorium. Analisis bivariat dilakukan menggunakan uji korelasi Spearman Rank, sedangkan analisis multivariat menggunakan regresi logistik ganda.
Hasil: Analisis bivariat menunjukkan tidak terdapat hubungan bermakna antara ICR II dan skor Gensini (r = −0,119; p = 0,545). Namun, analisis multivariat menunjukkan bahwa ICR II merupakan faktor risiko independen yang berhubungan dengan stenosis berat (aOR = 3,90; 95% CI: 1,55–9,85; p = 0,004). Faktor lain yang berhubungan signifikan adalah usia ≥ 60 tahun, jenis kelamin laki-laki, dan diabetes melitus.
Kesimpulan: Indeks Castelli Risk II berhubungan secara independen dengan derajat keparahan stenosis arteri koroner berdasarkan skor Gensini pada pasien penyakit jantung koroner setelah dilakukan analisis multivariat. Parameter ini berpotensi digunakan sebagai alat stratifikasi risiko tambahan dalam praktik klinis.
Kata kunci: Indeks Castelli Risk II, Skor Gensini, Penyakit Jantung Koroner, Stenosis Koroner.

ASSOCIATION BETWEEN CASTELLI RISK INDEX II AND THE SEVERITY OF CORONARY ARTERY STENOSIS BASED ON THE GENSINI SCORE IN PATIENTS WITH CORONARY ARTERY DISEASE Background: Coronary artery disease (CAD) remains a leading cause of cardiovascular morbidity and mortality worldwide. The severity of coronary artery stenosis is influenced by multiple metabolic risk factors, particularly dyslipidemia. Castelli Risk Index II (CRI II), defined as the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), reflects the balance between atherogenic and anti-atherogenic lipid fractions. However, evidence regarding the association between CRI II and the severity of coronary artery stenosis assessed by the Gensini score is still limited, especially in the Indonesian population. Objective: This study aimed to evaluate the association between Castelli Risk Index II and the severity of coronary artery stenosis based on the Gensini score in patients with coronary artery disease. Methods: A cross-sectional study was conducted at the Cardiac Catheterization Unit of RSUD dr. Zainoel Abidin Banda Aceh from July to November 2025. A total of 93 patients diagnosed with CAD who underwent coronary angiography were included. Data were obtained from medical records and laboratory examinations. Bivariate analysis was performed using Spearman’s rank correlation, while multivariate analysis was conducted using multiple logistic regression to identify independent predictors of severe stenosis. Results: Bivariate analysis showed no significant correlation between CRI II and the Gensini score (r = −0.119; p = 0.545). However, multivariate analysis demonstrated that CRI II was independently associated with severe coronary stenosis (adjusted OR = 3.90; 95% CI: 1.55–9.85; p = 0.004). Other significant factors included age ≥ 60 years, male sex, and diabetes mellitus. Conclusion: Castelli Risk Index II is independently associated with the severity of coronary artery stenosis based on the Gensini score in patients with coronary artery disease after multivariate analysis. CRI II may serve as a simple and cost-effective adjunctive risk stratification tool in clinical practice. Keywords: Castelli Risk Index II, Gensini score, coronary artery disease, coronary stenosis.