Pengaruh Polimorfisme I/D Gen Angiotensin Converting Enzyme dan Kadar Angiotensin II terhadap Coronary Slow Flow Phenomenon di RSUP Dr. Mohammad Hoesin Palembang

Abstract

Pendahuluan. Adanya polimorfisme gen angiotensin converting enzyme (ACE) diduga berperan terhadap penyakit kardiovaskular, termasuk coronary slow flow phenomenon (CSFP). Polimorfisme gen ACE juga merupakan faktor penting dalam peningkatan kadar angiotensin II. Penelitian ini bertujuan untuk mengetahui pengaruh polimorfisme insersi/delesi (I/D) 287 bp alu repetitive sequence pada intron 16 gen ACE dan kadar angiotensin II terhadap CSFP di RSUP Dr. Mohammad Hoesin Palembang. Metode. Studi kasus kontrol dimulai dari Juli 2019 sampai Juli 2020 di RSMH Palembang dengan masing-masing 32 subjek pada kelompok kasus (pasien CSFP) dan kontrol (non-CSF). Penelitian ini menggunakan sepasang primer dan satu kali PCR untuk deteksi polimorfisme I/D gen ACE. Analisis genetik dilakukan di Laboratorium Bioteknologi Fakultas Kedokteran Universitas Sriwijaya. Data yang terkumpul dianalisis dengan uji korelasi Spearman. Hasil. Dari 32 subjek kelompok CSFP, didapatkan distribusi genotip II pada 17 subjek (53,1%), genotip ID pada 14 subjek (43,8%), dan  genotip  DD pada 1 subjek (3,1 %). Sementara dari 32 subjek kelompok non-CSF, didapatkan distribusi genotip II pada 11 subjek (34,4%), genotip ID pada 13 subjek (42,2%), dan genotip DD pada 9 subjek (14,1%). Nilai median kadar angiotensin II pada kelompok CSFP 58 pg/mL dan pada kelompok Non-CSF 32,8 pg/mL. Hasil analisis menunjukkan terdapat pengaruh kadar angiotensin II terhadap kejadian CSFP (p=0,001). Analisis lebih lanjut menunjukkan adanya korelasi kadar angiotensin II dengan polimorfisme I/D 287 bp alu repetitive sequence pada intron 16 gen ace (p=0,030, r=0,822). Simpulan. Terdapat korelasi antara polimorfisme I/D 287 bp alu repetitive sequence pada intron 16 gen ACE dan kadar angiotensin II terhadap kejadian coronary slow flow phenomenon di Rumah Sakit Dr. Mohammad Hoesin Palembang.   Kata Kunci: Angiotensin II, CSFP, polimorfisme gen ACE The Effect of Angiotensin-Converting Enzyme Gene Polymorphism and Angiotensin II Levels in Coronary Slow Flow Phenomenon at Mohammad Hoesin General Hospital Palembang Introduction. The presence of ACE gene polymorphism is expected to have a role in cardiovascular diseases, including coronary slow flow phenomenon (CSFP). Angiotensin converting enzyme (ACE) gene polymorphism also plays an essential role in increasing angiotensin II levels. Therefore, this study aimed to analyze the effect of angiotensin-converting enzyme gene polymorphism and angiotensin II levels in the coronary slow flow phenomenon in Mohammad Hoesin General Hospital Palembang. Methods. This case-control study was started from July 2019 to July 2020 at RSMH Palembang with 32 subjects for each case (CSFP patients) and the control group (non-CSF patients). This study used a pair of primers and one-timed PCR to detect ACE gene polymorphism. Genetic analysis was carried out in the Biotechnology Laboratory Faculty of Medicine, Universitas Sriwijaya. Statistical analysis was performed using the Spearman correlation test. Results. There were 17 subjects with II genotypes (53.1%), 14 subjects with ID genotypes (43.8%), and 1 subject with DD genotypes (3.1 %) in the CSFP group. While in the non-CSFP group, there were 11 subjects with II genotypes (34.4%), 13 subjects with ID genotypes (42.2%), and 9 subjects with DD genotypes (14.1%). The median value of angiotensin II levels in CSFP and Non-CSF group was 58 pg/mL and 32.8 pg/mL, respectively. The results of the analysis showed that there was an effect of angiotensin II levels on the incidence of CSFP (p=0.001). Further analysis showed that there was a correlation between angiotensin II levels and the I/D 287 bp alu repetitive sequence polymorphism in the intron 16 ACE gene (p=0.030, r=0.822). Conclusions. There was a correlation between I/D 287 bp alu repetitive sequence polymorphism in the intron 16 ACE gene and angiotensin II levels in the coronary slow flow phenomenon at Mohammad Hoesin General Hospital Palembang.