Tantangan dan Peluang Terapi Penurun Lipid dalam Pengendalian Penyakit Kardiovaskular: Tinjauan Sistematis dari Perspektif Kesehatan Masyarakat

Moch. Tabriz Azenta; Intan Astrida; Lintang Andini; Heigy Averosa Fitriani Bakri; Gilang Raihan Adi Nugraha; Aurora Revi Samantha; Nadyne Candra Diana Anugraheni; Rengganis Sungsang Kosala; Rona Nasywa Mahira; Ayunissa Mirella Lestari

doi:10.56211/pubhealth.v5i1.1688

Authors

Moch. Tabriz Azenta Universitas Muhammadiyah Surakarta
Intan Astrida Universitas Muhammadiyah Surakarta
Lintang Andini Universitas Muhammadiyah Surakarta
Heigy Averosa Fitriani Bakri Universitas Muhammadiyah Surakarta
Gilang Raihan Adi Nugraha Universitas Muhammadiyah Surakarta
Aurora Revi Samantha Universitas Muhammadiyah Surakarta
Nadyne Candra Diana Anugraheni Universitas Muhammadiyah Surakarta
Rengganis Sungsang Kosala Universitas Muhammadiyah Surakarta
Rona Nasywa Mahira Universitas Muhammadiyah Surakarta
Ayunissa Mirella Lestari Universitas Muhammadiyah Surakarta

DOI:

https://doi.org/10.56211/pubhealth.v5i1.1688

Keywords:

Aterosklerosis; Inhibitor PCSK9; Kardiovaskular; LDL-C; Terapi

Abstract

Aterosklerosis merupakan penyebab utama penyakit kardiovaskular global yang menyebabkan sekitar 17,9 juta kematian setiap tahun. Peningkatan kadar kolesterol lipoprotein densitas rendah (LDL-C) berperan penting dalam pembentukan plak aterosklerotik melalui retensi lipoprotein, disfungsi endotel, dan pembentukan sel busa. Artikel ini bertujuan mengevaluasi perkembangan terapi penurun lipid dan dampaknya terhadap progresi aterosklerosis berdasarkan bukti ilmiah terkini. Metode yang digunakan adalah Systematic Literature Review (SLR) melalui PubMed dan Google Scholar dengan mengikuti alur PRISMA. Proses identifikasi menghasilkan 581 rekaman; setelah penghapusan duplikasi tersisa 531 artikel untuk tahap skrining. Sebanyak 372 artikel dieliminasi pada tahap judul dan abstrak, diikuti evaluasi full-text terhadap 51 artikel yang dapat diakses. Seleksi akhir menghasilkan 8 studi yang dianalisis, dengan tambahan 10 referensi pendukung untuk memperkuat latar belakang dan diskusi. Hasil menunjukkan statin tetap menjadi terapi utama dengan penurunan LDL-C sebesar 30-60% dan penurunan kejadian kardiovaskular hingga 30%. Ezetimibe memberikan tambahan reduksi 15-25%, sementara inhibitor PCSK9 menurunkan LDL-C lebih dari 60% disertai regresi plak. Terapi baru seperti bempedoic acid dan inclisiran efektif pada pasien intoleran statin. Disimpulkan bahwa terapi penurun lipid berperan krusial dalam pengendalian aterosklerosis; namun demikian, kesenjangan akses terhadap terapi modern, rendahnya kepatuhan pengobatan di masyarakat, serta beban ekonomi yang ditanggung sistem pembiayaan kesehatan nasional menuntut perhatian serius dari pembuat kebijakan kesehatan masyarakat.

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