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Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit perifer

Abstract

Introduction: Acute myocardial infarction is coronary heart disease that causes an increase in length of stay in hospital and a high mortality rate. Reperfusion strategy is the main modality in treating ST-elevation myocardial infarction (STEMI), but a limitation in facilities and human resources in peripheral hospitals has made it impossible to do. This study aims to observe the characteristics and course of disease in patients diagnosed by STEMI without reperfusion strategy in peripheral hospitals.

Method: This study is a descriptive observational study with a cross sectional research design--retrieving research data using the total sampling method, using secondary data from medical records at Ade M Djoen Sintang Public Hospital in March - December 2021.

Results: 56 samples fulfilled inclusion and exclusion criteria, with the majority of the sample being male, the average age was 53 years. Most of the patients had the same complaint during their stay in the hospital, most of the patients were able to discharge from the hospital, and 57,14% of the patients were admitted back to the hospital with the same chief complaints after less than six months of follow-up.

Conclusion: Management of patients with STEMI without a reperfusion strategy leads to remain of chief complaints and increase of readmission within 6 months follow-up after discharge.

 

Latar Belakang: Infark miokard akut adalah suatu penyakit jantung koroner yang mengakibatkan peningkatan angka perawatan di rumah sakit dan angka kematian yang tinggi. Strategi reperfusi merupakan modalitas utama dalam penanganan infark miokard akut dengan elevasi segmen ST (IMA-EST), namun pada rumah sakit di perifer, keterbatasan sarana dan prasarana serta sumber daya manusia menyebabkan hal tersebut tidak memungkinkan. Tujuan penelitian ini adalah untuk mengetahui karakteristik dan perjalanan penyakit pasien yang terdiagnosis IMA-EST tanpa tatalaksana reperfusi di rumah sakit di perifer.

Metode:  Penelitian ini merupakan penelitian observasional dengan desain penelitian potong lintang. Data penelitian diambil menggunakan metode total sampling, melalui data sekunder dari rekam medis selama periode Maret - Desember 2021 di Rumah Sakit Umum Daerah (RSUD) Ade M Djoen Sintang.

Hasil: Terdapat 56 sampel yang memenuhi kriteria inklusi dan eksklusi, mayoritas sampel adalah laki-laki, rata-rata usia 53 tahun. Sebagian besar pasien mengakami keluhan yang menetap selama perawatan, sebagian besar boleh pulang dari rumah sakit. Dalam periode kurang dari 6 bulan, sebanyak 57,14% pasien masuk kembali ke rumah sakit dengan keluhan yang sama.

Simpulan: Tatalaksana pasien dengan IMA-EST tanpa strategi reperfusi menyebabkan keluhan yang menetap selama perawatan dan peningkatan pasien masuk kembali ke rumah sakit dengan keluhan yang sama setelah 6 bulan dipulangkan dari rumah sakit.

References

  1. Khan, MA. Hashim, MJ. Mustafa, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020;12(7):e9349. doi: 10.7759/cureus.9349.
  2. Ibanez, Borja, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal, 2018;39(2):119-177. doi:10.1093/eurheartj/ehx393
  3. Thygesen, K. Alpert, JS., et al. Fourth Universal Definition of Myocardial Infarction. Circulation. 2018;138:e618–e651. DOI: 10.1161/CIR.0000000000000617.
  4. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman Tatalaksana Sindrom Koroner Akut 2018. Jurnal Kardiologi Indonesia www.inaheart.org. Diakses 01 Maret 2022.
  5. Li, X. Murugiah, K., et al. Urban–Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment–Elevation Myocardial Infarction in China From 2001 to 2011. Circulation: Cardiovascular Quality and Outcomes. 2017;10:e003905. https://doi.org/10.1161/CIRCOUTCOMES.117.003905
  6. Orvad, H. Savage, L., et al. Disparity in Management of STEMI--Factors Leading to Missed Acute Myocardial Infarction in Rural Area. Heart, Lung and Circulation. 2021;30:S220. DOI:10.1016/j.hlc.2021.06.276.
  7. Jalal, A. Salh, RW. Impact of Age on Risk Factors and Clinical Manifestation of Acute Coronary Syndrome: Observation From the Coronary Care Unit of Sulaimani, Iraq. Hospital Practices and Research. 2020;5(1):28-34. DOI:10.34172/hpr.2020.06.
  8. Al-Saif, SM. AlHabib, KF., et al. Age and its relationship to acute coronary syndromes in the Saudi Project for Assessment of Coronary Events (SPACE) registry: The SPACE age study. J Saudi Heart Assoc. 2012;24(1): 9–16.
  9. Otaal, Parminder Singh, et al. Clinical and Angiographic Prophesy of Hemodynamic Status in Patients with Acute Anterior Wall ST-Segment-Elevation Myocardial Infarction and Totally Occluded Left Anterior Descending Artery. Integrated Blood Pressure Control. 2021;14:89. https://doi.org/10.2147/IBPC.S315050.
  10. Patil, Shivanand, et al. Tombstone ST-segment elevation in acute anterior wall myocardial infarction. IHJ Cardiovascular Case Reports (CVCR). 2018;2:S11-S13.
  11. Kim, L., et al. Thirty?Day Readmission Rates, Timing, Causes, and Costs after ST?Segment–Elevation Myocardial Infarction in the United States: A National Readmission Database Analysis 2010–2014. Journal of American Heart Association. 2018;7(18):e009863 . https://doi.org/10.1161/JAHA.118.009863
  12. Dubey, G., Verma, S. K., Bahl, V. K. Primary percutaneous coronary intervention for acute ST elevation myocardial infarction: Outcomes and determinants of outcomes: A tertiary care center study from North India. Indian Heart Journal. 2017;69(3):294-298. https://doi.org/10.1016/j.ihj.2016.11.322
  13. Shaheen, Sameh, et al. Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology Registry on ST elevation myocardial infarction. The Egyptian Heart Journal. 2020;72(1):1-10. https://doi.org/10.1186/s43044-020-00069-x
  14. Petroni, T. Zaman, Azfar., et al. Primary percutaneous coronary intervention for ST elevation myocardial infarction in nonagenarians. Heart. 2016;102:1648-1654.

How to Cite

Simanungkalit, A. P., & Supit, A. I. (2022). Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit perifer. Intisari Sains Medis, 13(1), 148–152. https://doi.org/10.15562/ism.v13i1.1322

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Arina Papita Simanungkalit
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ISM Journal


Alice Inda Supit
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ISM Journal