Variasi Time In Therapeutic Range (TTR) Penggunaan Warfarin Pada Pasien Atrial Fibrilasi di Rumah Sakit X Banten

Sitepu, Chelseata Ria Rebeka Br (2023) Variasi Time In Therapeutic Range (TTR) Penggunaan Warfarin Pada Pasien Atrial Fibrilasi di Rumah Sakit X Banten. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Atrial Fibrilasi merupakan aritmia jantung berkelanjutan yang paling umum terjadi pada orang dewasa. Komplikasi stroke akibat tromboembolisme paling sering terjadi dan dihindari pada pasien atrial fibrilasi. Pencegahan stroke dapat dilakukan dengan pemberian antikoagulan dan diketahui warfarin merupakan antikoagulan yang paling umum digunakan. Penggunaan warfarin dapat memberikan efek samping pendarahan yang membahayakan sehingga diperlukan pamantauan secara rutin dan ketat. Time in Therapeutic Range (TTR) merupakan alat pengukuran monitoring kualitas manajemen warfarin yang menunjukkan waktu pasien ada pada rentang terapi yang sesuai yaitu INR dua hingga tiga. Variasi TTR pada pasien dihitung menggunakan metode Rosendaal. Potensi resiko komplikasi pendarahan dianalisa menggunakan HAS-BLED dan potensi stroke menggunakan CHA2DS2VASc Penelitian ini menggunakan desain restrospektif bersifat observational kepada 78 pasien atrial fibrilasi yang menggunakan warfarin yang diambil melalui medical record pada periode Januari 2022- Desember 2022. Data diolah dalam bentuk tabel dan chart kemudian dianalisa secara deskriptif. Dari hasil penelitian menunjukkan pasien yang memiliki nilai TTR sesuai target (>70%) ada sebesar 15.38% (12 pasien) serta 84.62% (66 pasien) ada di bawah target. Sebagian besar pasien dengan TTR rendah memiliki nilai HAS-BLED serta CHA2DS2VASc pada kategori sedang dan tinggi./Atrial Fibrillation is the most common continuous cardiac arrhythmia in adults. Stroke complications due to thromboembolism are the most common and avoidable in patients with atrial fibrillation. Stroke prevention can be done by administering anticoagulants and it is known that warfarin is the most commonly used anticoagulant. The use of warfarin can have dangerous bleeding side effects, so regular and strict monitoring is required. Time in Therapeutic Range (TTR) is a measurement tool for monitoring the quality of warfarin management that shows when a patient is in the appropriate therapeutic range, namely INR two to three. The variation in TTR in patients was calculated using the Rosendaal method. The potential risk of bleeding complications was analyzed using HAS-BLED and the potential for stroke using CHA2DS2VASc This study used a retrospective observational design for 78 atrial fibrillation patients using warfarin who were taken through medical records in the period January 2022- December 2022. The data was processed in the form of tables and charts then analyzed descriptively. The results of the study showed that 15.38% (12 patients) had TTR values on target (> 70%) and 84.62% (66 patients) were below target. Most patients with low TTR have HAS-BLED and CHA2DS2VASc values in the medium and high categories.

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