PENGAMATAN 6 BULAN TERHADAP KEJADIAN KARDIOVASKULAR MAYOR PADA PASIEN DENGAN INFARK MIOKARD AKUT DENGAN ELEVASI SEGMEN ST (STEMI) DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI-DESEMBER 2017
Abstract
Abstract Major Adverse Cardiovascular Events (MACE) are the end result of cardiovascular events consisting of cardiovascular and non-cardiovascular death, stroke, recurrent myocardial infarction (reinfarction), revascularization of percutaneous coronary intervention and rehospitalization. There has not been many study reporting MACE in STEMI patients in Indonesia but it is considered important due to high mortality in STEMI patients. Objective: To do a six-month observation of MACE in STEMI patients at Prof. DR. R. D. Kandou General Hospital Manado in the period of January to December 2017. Methods: This study is a descriptive observational study with a retrospective approachment and was conducted on October to December 2018. This study samples were 58 patients that fulfill the inclusion criteria out of 132 STEMI patients in total. Patients’ data were obtained from medical record and processed to determine the MACE found in patients during six-month observation. Results: 58 patients were enrolled in this study, 24 patients experienced MACE (41,4%) and 34 patients did not experience MACE (58,6%). The most frequently found MACE in STEMI patients is all-cause mortality (33,3%), followed by revascularization (29,2%), rehospitalization (29,2%), and reinfarction (8,3%). 43 patients were received Primary PCI (74,14%), 17 of them experienced MACE (70,8%) and revascularization is mostly found in these patients. 6 patients were received fibrinolytic therapy (10,34%) and one of them experienced MACE which is reinfarction (4,2%). 9 patients did not receive reperfusion therapy (15,52%) and 6 of them experienced MACE (25%) with the most common MACE is all-cause mortality. The high rate of MACE in STEMI patients who received Primary PCI may caused by the delay management of the patients. Conclusion: All-cause mortality is mostly found in STEMI patients with MACE during six-month observation.     Â
Keywords: Major Adverse Cardiovascular Events, STEMI
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Abstrak Kejadian Kardiovaskular Mayor (KKM) merupakan hasil akhir dari kejadian kardiovaskular yang terdiri dari kematian kardiovaskular dan non-kardiovaskular, stroke, infark miokard berulang, revaskularisasi intervensi koroner perkutan primer berulang dan rehospitalisasi. Penelitian mengenai KKM pada pasien STEMI di Indonesia masih jarang dilakukan namun dinilai penting dikarenakan tingginya mortalias pasien STEMI meski telah mendapat perawatan di rumah sakit. Tujuan: Penelitian ini bertujuan untuk mengamati KKM selama 6 bulan yang terdapat pada pasien STEMI di RSUP Prof. DR. R. D. Kandou Manado periode Januari-Desember 2017. Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan pendekatan retrospektif yang dilaksanakan pada Oktober 2018–Desember 2018. Sampel penelitian sebanyak 58 pasien yang memenuhi kriteria inklusi dari 132 pasien STEMI. Data pasien didapatkan dari data rekam medik dan kemudian diolah untuk diketahui kejadian kardiovaskular mayor pada pasien selama 6 bulan. Hasil: Dari 58 pasien yang diteliti, 24 pasien mengalami KKM (41,4%) dan 34 pasien tidak mengalami KKM (58,6%). KKM terbanyak adalah kematian (33,3%), diikuti revaskularisasi (29,2%), rehospitalisasi (29,2%), dan infark miokard berulang (8,3%). Jumlah pasien yang mendapat terapi IKP Primer adalah sebanyak 43 pasien dan yang mengalami KKM adalah sebanyak 17 pasien dengan KKM terbanyak adalah revaskularisasi. Jumlah pasien yang mendapat terapi fibrinolitik adalah 6 pasien dan yang mengalami KKM sebanyak 1 pasien dengan KKM infark miokard berulang. Jumlah pasien yang mendapat terapi non-farmakologi adalah sebanyak 9 pasien, yang mengalami KKM sebanyak 6 pasien dengan KKM terbanyak adalah kematian. Tingginya angka KKM pada pasien yang menerima IKP primer disebabkan oleh kelalaian tim medis dalam menangani pasien. Kesimpulan: Kematian adalah KKM yang paling sering ditemukan pada pasien STEMI selama 6 bulan pengamatan.
Kata kunci: Kejadian Kardiovaskular Mayor, STEMI
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