Doctor of Medicine Study: Atorvastatin Therapy Shows a Significant Effect on Inflammatory Marker Levels in Heart Failure Patients with Acute Kidney Failure

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• Selasa, 19 Maret 2024
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Doctor of Medicine Study: Atorvastatin Therapy Shows a Significant Effect on Inflammatory Marker Levels in Heart Failure Patients with Acute Kidney Failure

Located in the Hall of the Postgraduate Program Building, Fl. III Unud Sudirman Denpasar Bali Campus, the Doctoral Promotion exam took place with Promovendus candidate Dr. I Gede Bagus Gita Pranata Putra, M.Biomed, Sp.JP, FIHA, FAPSC, FESC with the dissertation title "The Effect of 40 Milligram Atorvastatin Therapy on Levels of Soluble Interleukin 6 Receptor (sIL-6R), Tumor Necrosis Factor Alpha (TNFα) and High Serum C Reactive Protein (HS CRP) Sensitivity and Length of Hospital Stay, Recurrent Acute Kidney Failure and Mortality in Heart Failure Patients."

(18/3/2024)

Acute renal failure secondary to heart failure increases mortality 5-fold. Atorvastatin is an antilipidemic drug that has pleiotrophic effects such as anti-inflammatory, antithrombotic and improving endothelial function. Does this pleiotrophic effect affect several main markers that play a role in the inflammatory cascade process in the pathomechanism of heart failure complicated by acute renal failure such as Soluble Interleukin 6 Receptor (sIL-6R), Tumor Necrosis Factor α (TNFα) and High Sensitivity C Reactive Protein (CRP) ) is still not clearly known. The aim of this research at the biomolecular level in heart failure patients is to compare the effect of administering atorvastatin versus without atorvastatin on the biomarkers sIL 6R, TNF α and HS CRP as markers of inflammation, as well as length of treatment, the incidence of recurrent acute renal failure and the mortality rate.

This research was conducted at Sanjiwani General Hospital Gianyar using a Quasi Experimental Design with a pre-test and post-test approach to compare the effect of administering atorvastatin 40 mg for 8 weeks in heart failure patients on changes in sIL6R, TNFα and HS CRP levels as well as length of hospital stay. , the incidence of recurrent acute renal failure and mortality. The administration of atorvastatin 40 mg is adjusted to the guideline indications, after the patient agrees they will be included in the group with atorvastatin therapy. Meanwhile, patients who are contraindicated or have no etiological indication for heart failure or who refuse administration of atorvastatin will be included in the group without atorvastatin therapy.

The results of this study showed that 40 mg atorvastatin therapy reduced serum SIL6R levels (pre: 198.38 ± 47.97 ng/ml v.s post: 158.05 ± 57.27 ng/ml; p=0.006), reduced serum TNFα levels (pre :5.10 ± 2.44 pg/ml v.s post :2.52 ± 1.14 pg/ml; p=0.000) and reduced serum HS CRP levels (pre :30.42 ± 14.33 ng/ml v.s post :8 .67 ± 10.32 ng/ml; p< 0.001). In addition, atorvastatin therapy reduced length of hospital stay (p< 0.005), the incidence of recurrent acute renal failure (p< 0.005), but did not significantly affect mortality (p< 0.636). This study proves that atorvastatin 40 mg therapy significantly reduces levels of SIL6R, TNFα and HS CRP, as well as reducing length of hospital stay and reducing the incidence of recurrent acute kidney failure but is not related to the mortality rate in heart failure patients who experience acute kidney failure. Keywords: Atorvastatin 40 mg, heart failure, acute renal failure, SIL6R, TNFα, HS CRP

This exam was led by the Coordinator of the Medical Sciences Doctoral Study Program, FK Unud, Prof. Dr. Dr. I Made Jawi, M.Kes., with the examining team:

1. Prof. Dr. Dr. I Wayan Wita, Sp.JP (K) (Promoter)

2. Prof. Dr. Dr. I Made Bakta, Sp.PD-KHOM (Copromotor I)

3. Prof. Dr. Dr. I Wayan Sudarsa, Sp.B (K) Onk (Copromotor II)

4. Prof. Bambang Budi Siswanto, Sp.JP(K), MD, PhD, FESC, FIHA, FAsCC, FAPSC, FACC

5. Prof. Dr. Dr. I Made Jawi, M. Kes

6. Prof. drh. I Nyoman Mantik Astawa, Ph.D

7. Prof. Dr. Dr. I Wayan Putu Sutirta Yasa, M.Si

8. Prof. Dr. I Made Ady Wirawan, S.Ked, MPH., Ph.D

9.Dr. Dr. Urged Made Wihandani, M.Kes

10.Dr. Dr. I Nyoman Wande, S.Ked.,Sp.PK(K)

Meanwhile, academic invitations are:

1.Dr. Dr. Luh Putu Ratna Sundari, S.Ked., M.Biomed

2.Dr. Dr. I Made Krisna Dinata, M. Erg

3. dr. Agus Eka Darwinata, S.Ked., Ph.D

4.Dr. Dr. Luh Gde Sri Yenny, Sp.PD, FINASIM

5.Dr. Dr. Luh Oliva Saraswati Suastika, Sp.JP Eko (K) FIHA

In this exam, Dr. Dr. I Gede Bagus Gita Pranata Putra, M.Biomed, Sp.JP, FIHA, FAPSC, FESC., was declared to have graduated as the 408th Doctoral Graduate of the Medical Science Doctoral Degree Study Program with cum laude predicate

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