Pengaruh pre hospital loading dose adp inhibitor terhadap derajat trombus pada sindrom koroner akut

Thandy, Catharine Renata (2018) Pengaruh pre hospital loading dose adp inhibitor terhadap derajat trombus pada sindrom koroner akut. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Coronary Artery Disease (CAD) is one of cardiovascular disease that is considered life threatening as it has a high mortality rate. Percutaneous Coronary Intervention (PCI), as a definite treatment of Acute Coronary Syndrome (ACS) is very crucial. In fact, not every hospital in Indonesia is facilitated with PCI and they have different policy in giving loading dose ADP inhibitor to ACS patients. The study about effects of loading dose ADP inhibitor to platelet aggregation has been done on the previous research. However, further study need to be done to find out the impact of giving pre hospital loading dose ADP inhibitor to the grading of thrombus. The grade of thrombus in ACS indicate the severity of coronary occlusion. This study uses a mixed cohort design with secondary data collection (from medical record) by purposive sampling. Sampel of this study is 54 STEMI patients who undergo PCI in Siloam Hospital Karawaci. Sampel was divided into 2 groups, the first group was patients who received pre hospital loading dose ADP inhibitor while the second group didn’t. Result of this study was processed by SPSS with hypothesis testing using Chi Square test. Based on Chi Square test, pre hospital loading dose ADP inhibitor has a significant impact on the grading of thrombus in ACS patients (p value 0.029; OR 0.294). Other factors are also studied and it is found that onset to loading also has relation with the thrombus grading (p value 0.031). Which is why, policy in giving loading dose ADP inhibitor should be applied to every hospital treating ACS patients / Penyakit Jantung Koroner (PJK) merupakan salah satu penyakit kardiovaskular yang menyebabkan kematian terbesar di dunia. Hal ini yang menjadikan tatalaksana Percutaneous Coronary Intervention (PCI) untuk Sindrom Koroner Akut (SKA) sangat krusial. Di sisi lain, tidak semua rumah sakit di Indonesia memiliki fasilitas PCI serta memiliki kebijakan yang berbeda-beda terhadap pemberian loading dose ADP inhibitor untuk pasien SKA. Pada penelitian sebelumnya, dilakukan studi mengenai kerja ADP inhibitor terhadap aggregasi platelet. Meski begitu, perlu dilakukan penelitian lebih lanjut untuk mengetahui pengaruh pemberian pre hospital loading dose ADP inhibitor terhadap derajat trombus pasien. Derajat trombus pada pasien SKA merupakan indikator keparahan oklusi pada arteri koroner. Penelitian ini menggunakan metode cohort campuran yang mengambil data sekunder (dari rekam medis) dengan cara purposive sampling. Jumlah sampel sebanyak 54 sampel dengan subyek penelitian pasien STEMI yang menjalani PCI di Rumah Sakit Siloam Karawaci. Kelompok sampel dibagi 2 menjadi kelompok, yaitu pasien yang menerima pre hospital loading dose ADP inhibitor dan yang tidak menerima. Hasil penelitian diolah dengan SPSS dengan uji hipotesis Chi Square test. Bedasarkan Chi Square test, pre hospital loading dose ADP inhibitor berpengaruh pada derajat trombus pasien SKA (p value 0.029; OR 0.294). Selain itu, dari faktor lain yang diteliti ditemukan onset to loading memiliki hubungan dengan derajat trombus (p value 0.031). Kebijakan untuk memberikan loading dose ADP inhibitor penting untuk ditegakkan oleh semua rumah sakit yang menangani pasien SKA.

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