IRMA NOVRIANTI, 051715153012 (2019) ANALISIS KEBERHASILAN TERAPI DAN KEAMANAN PENGGUNAAN FIBRINOLITIK PADA PASIEN STEMI (ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION) AKUT (Penelitian Dilaksanakan di RSUD Tarakan Kalimantan Utara). Thesis thesis, Universitas Airlangga.

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Abstract

BACKGROUND : Acute coronary syndrome (ACS) is a condition that occurs when there is a blockage of blood flow to the heart. STEMI (ST Elevation Myocardial Infarct) is one form of ACS. Fibrinolytic therapy is recommended by ACC/AHA and PERKI in STEMI when Percutaneous Coronary Intervention (PCI) cannot be performed. OBJECTIVES: This study aims to analyze the effectiveness or successfull of fibrinolytic therapy in patients with STEMI in RSUD Tarakan North Kalimantan in terms of chest pain reduction, ST segment resolution ≥50%, and the presence of reperfusion arrhythmias. This study also identified the safety of fibrinolytic therapy in terms of bleeding occurrences, hypotension and allergic reaction. METHODS: This was an observational retrospective study with a total sampling method, which was conducted at Tarakan District Hospital in North Kalimantan Province in September to October 2019. A review of medical record of the patients was conducted for the period of Januari 2016 sampai Desember 2018. RESULT: Samples that met the inclusion criteria were 55 patients. There were 2 fibrinolytic use namely alteplase and streptokinase. Alteplase was given to 13 patients while streptokinase was given to 42 patients. Almost all patients experienced a decrease in pain scale (49 patients or 89.1%), 42 patients (76.4%) experienced ST segment resolution, and 23 patients (41.8%) experienced reperfusion arrhythmias. Based on these 3 parameters it was found that on average 80% of patients experienced successful reperfusion. None of the patients had major bleeding. The fibrinolytic therapy is safe while in use with only 8 patients had minor bleeding, 14 had hypotension and 3 patients had allergies. CONCLUSION : The success of fibrinolytic therapy in Tarakan District Hospital in North Kalimantan Province is 80%. Safety is not a concern since only minor adverse events was found.

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