Infark Miokard Akut (IMA) menjadi penyebab kematian tertinggi di Indonesia. Studi tahun 2022 mendapatkan mortality rate pasien IMA di Indonesia mencapai 8,9%. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor demografi, faktor risiko, komorbiditas, parameter klinis, parameter laboratorium, pemberian terapi inisial, dan pemberian tindakan revaskularisasi dengan kejadian kematian intrahospital pada pasien IMA di RS Jantung dan Pembuluh Darah Harapan Kita Jakarta Tahun 2019 – 2023. Desain studi cross sectional dengan populasi penelitian pasien IMA yang tercatat dalam registri Sindroma Koroner Akut (SKA) di RSJPDHK pada Januari 2019 – Agustus 2023. Analisis multivariat dengan menggunakan regresi logistik berganda untuk menemukan prediktor kematian, dan analisis skoring dilakukan dengan menggunakan ROC Curve untuk mengetahui kualitas diskriminasi skor. Sampel penelitian berjumlah 3593 pasien IMA dengan kejadian kematian intrahospital sebesar 9,6%.Variabel yang dapat dijadikan prediktor kejadian kematian intrahospital pada pasien IMA adalah Usia ≥65 tahun (AOR 1,64; 95% CI=1,24 – 2,18; p=0.001), kejadian gagal ginjal akut (AOR 1,80; 95% CI=1,32 – 2,44; p<0.001), gagal jantung akut (AOR 2,76; 95% CI=1,95 – 3,92; p<0.001), syok kardiogenik (AOR 24,45; 95% CI=16,85 – 35,47; p<0.001), FEVKi ≤ 40% (AOR 1,54; 95% CI=1,14 – 2,08; p=0.005), Hs Troponin ≥ 9 ng/dL (AOR 2,01; 95% CI=1,19 – 3,40; p=0.009), kreatinin > 2 mg/dL (AOR 1,83; 95% CI=1,26 – 2,65; p=0.001), GDS ≥ 200 mg/dL (AOR 1,71; 95% CI=1,30 – 2,25; p<0,001), riwayat dislipidemia (AOR 0,57; 95% CI=0,40 – 0,81; p=0,002), ticagrelor (AOR 0,63; 95% CI=0,41 – 0,99; p=0,043), statin (AOR 0,38; 95% CI=0,25 – 0,57; p<0,001), dan tindakan revaskularisasi (AOR 0,71; 95% CI=0,52 – 0,98; p=0,035). Hasil penilaian skoring menunjukkan nilai diskriminasi yang baik (AUC 0,886).
Acute myocardial infarction (AMI) is the leading cause of death in Indonesia. A study in 2022 found that the mortality rate of AMI patients in Indonesia reached 8.9%. This study aimed to know the relationship between demographic factors, risk factors, comorbidities, clinical parameters, laboratory parameters, administration of initial therapy, and provision of revascularization procedures with the incidence of in-hospital mortality in AMI patients at National Cardiovascular Center Harapan Kita from 2019 to 2023. The study design was cross-sectional with a population of AMI patients who were recorded in the Acute Coronary Syndrome (ACS) registry at RSJPDHK from January 2019 to August 2023. Multivariate analysis used multiple logistic regression to find predictors of in hospital mortality, and scoring analysis was carried out using the ROC Curve to determine the quality of score discrimination. Sample of this study consisted of 3593 AMI patients with an in-hospital mortality rate of 9.6%.Variables that can be used as predictors of inhospital mortality in AMI patients are age ≥65 years (AOR 1.64; 95% CI=1.24 – 2.18; p=0.001), acute kidney injury (AOR 1.80; 95% CI=1.32 – 2.44; p<0.001), acute heart failure (AOR 2.76; 95% CI=1.95 – 3.92; p<0.001), cardiogenic shock (AOR 24.45; 95% CI=16.85 – 35.47; p<0.001), left ventricular ejection fraction (LVEF) ≤ 40% (AOR 1.54; 95% CI=1.14 – 2.08; p=0.005), Hs Troponin ≥ 9 ng/dL (AOR 2.01; 95% CI=1.19 – 3.40; p=0.009), creatinine > 2 mg/dL (AOR 1.83; 95% CI=1.26 – 2.65; p=0.001), blood glucose (BG) ≥ 200 mg/dL (AOR 1.71; 95% CI=1.30 – 2.25; p<0.001), history of dyslipidemia (AOR 0.57; 95% CI=0.40 – 0.81; p=0.002), ticagrelor (AOR 0.63; 95% CI=0.41 – 0.99; p=0.043), statin (AOR 0.38; 95% CI=0.25 – 0.57; p<0.001), and revascularization (AOR 0.71; 95% CI=0.52 – 0.98; p=0.035).The results of the scoring assessment showed good discrimination values (AUC 0.886).
Fadhila Nafilah Azzahra - Tesis - FKM - Full Text - 2024.pdf ::