RISIKO JANTUNG TERSEMBUNYI PADA DIABETES TIPE 2: SKRINING NT-PROBNP MENGUNGKAP PREVALENSI TINGGI KEMUNGKINAN GAGAL JANTUNG DI LAYANAN KESEHATAN PRIMER

Abstrak

Latar Belakang: Gagal jantung merupakan komplikasi kardiovaskular yang sering dijumpai pada penderita diabetes melitus tipe 2 (DMT2). NT-proBNP telah diakui sebagai biomarker diagnostik utama gagal jantung. Tujuan: Membuktikan hubungan antara DMT2 terkontrol dan tidak terkontrol dengan kejadian gagal jantung menggunakan biomarker NT-proBNP. Metode: Penelitian observasional analitik dengan rancangan cross-sectional dilakukan pada 60 pasien DMT2 di Puskesmas Made, Surabaya, periode September–November 2025. Status kontrol DMT2 ditentukan berdasarkan HbA1c (terkontrol <7%, tidak terkontrol ≥7%), dan kejadian gagal jantung dinilai berdasarkan kadar NT-proBNP (≥125 pg/mL). Analisis statistik menggunakan uji Chi-Square dan regresi logistik. Hasil: Sebanyak 44 pasien (73,3%) masuk kategori DMT2 tidak terkontrol. Prevalensi gagal jantung keseluruhan adalah 53,3%. Tidak terdapat hubungan yang bermakna secara statistik antara status kontrol DMT2 dengan kejadian gagal jantung (p=0,755; RP=1,100; IK 95%: 0,611–1,979). Analisis regresi logistik menunjukkan OR sebesar 1,200 (IK 95%: 0,382–3,773; p=0,755). Kesimpulan: Meskipun prevalensi gagal jantung pada pasien DMT2 tinggi, tidak ditemukan hubungan bermakna antara status kontrol glikemik dengan kejadian gagal jantung berdasarkan NT-proBNP. Skrining NT-proBNP direkomendasikan pada seluruh pasien DMT2 tanpa memandang status kontrolnya.

Background: Heart failure is a common cardiovascular complication in type 2 diabetes mellitus (T2DM) patients. NT-proBNP has been established as a primary diagnostic biomarker for heart failure. Objective: To investigate the association between controlled and uncontrolled T2DM and heart failure occurrence using NT-proBNP biomarker. Methods: An analytic observational study with cross-sectional design was conducted on 60 T2DM patients at Puskesmas Made, Surabaya, during September–November 2025. T2DM control status was determined by HbA1c (controlled <7%, uncontrolled ≥7%), and heart failure was defined as NT-proBNP ≥125 pg/mL. Statistical analysis used Chi-Square test and logistic regression. Results: A total of 44 patients (73.3%) had uncontrolled T2DM. Overall heart failure prevalence was 53.3%. No statistically significant association was found between T2DM control status and heart failure (p=0.755; PR=1.100; 95% CI: 0.611–1.979). Logistic regression showed OR=1.200 (95% CI: 0.382–3.773; p=0.755). Conclusion: Despite a high prevalence of heart failure in T2DM patients, no significant association was found between glycemic control status and heart failure based on NT-proBNP. NT-proBNP screening is recommended for all T2DM patients regardless of their glycemic control status.