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dc.contributor.advisorKasiman, Sutomo
dc.contributor.advisorSafri, Zainal
dc.contributor.authorSiregar, Yasmine F.
dc.date.accessioned2019-05-06T02:45:47Z
dc.date.available2019-05-06T02:45:47Z
dc.date.issued2019
dc.identifier.urihttp://repositori.usu.ac.id/handle/123456789/13850
dc.description95 Halamanen_US
dc.description.abstractLatar Belakang: Infark miokard akut non ST elevasi (IMANEST) memliki komplikasi yang lebih jarang, namun kejadian berulang yang lebih sering dan prognosis jangka panjang lebih buruk dibandingkan infark miokard akut dengan ST elevasi (IMAEST). Angka mortalitas IMANEST lebih rendah dibandingkan IMAEST namun setelah 6 bulan mortalitas keduanya berimbang. Dalam jangka panjang mortalitas IMANEST lebih tinggi. Tujuan dari penelitian ini adalah untuk mengetahui kesintasan 2 tahun pada pasien IMAyang dirawat di RSUP H. Adam Malik Medan tahun 2015. Metode: Didapati 264 penderita IMA yang dirawat sejak Januari 2015 - Desember 2015. Sampel penelitian dibagi berdasarkan diagnosis IMAEST dan IMANEST. Data penelitian dicatat berdasarkan rekam medis. Seluruh pasien dihubungi melalui telepon untuk mengetahui keadaan pasien 2 tahun setelah mengalami IMA. Analisis statistik Chi square digunakan untuk menilai korelasi karakteristik penelitian terhadap kejadian IMAEST dan IMANEST. Analisis multivariat dilakukan untuk menilai faktor-faktor yang mempengaruhi kesintasan 2 tahun. Kesintasan 2 tahun IMAEST dan IMANEST dibandingkan menggunakan plot Kaplan Meier. Hasil: Dari 264 sampel penelitian, didapati 216 (81.8%) orang laki-laki dengan usia rata-rata 56 tahun. Didapati 147 pasien IMAEST dan 117 pasien IMANEST. Dibandingkan kelompok IMAEST, IMANEST cenderung memiliki riwayat penyakit jantung koroner dan dislipidemia, tekanan darah lebih tinggi, lebih sedikit menjalani revaskularisasi, rawatan lebih lama dan jumlah komplikasi IMA yang lebih rendah. Angka kesintasan dan angka mortalitas IMA dalam 2 tahun adalah 58% dan 28%. Dari analisis multivariat, didapati bahwa tekanan darah sistolik yang lebih tinggi saat masuk (OR 1.023, IK 95%, 1.003 – 1.044) dan tindakan IKP selama rawatan (OR 8.604, IK 95%, 2.264 – 32.702) memberikan kesintasan 2 tahun yang lebih baik. Tidak ditemukan perbedaan kesintasan 2 tahun yang bermakna antara kedua grup (log rank 0.136). Kesintasan 2 tahun yang lebih baik ditemukan pada pasien dengan hasil angiografi single vessel disease (log rank 0.001), mendapatkan revaskularisasi (log rank 0.001) dan tidak mengalami komplikasi gagal jantung atau syok kardiogenik (log rank 0.001). Kesimpulan: Tidak dijumpai perbedaan kesintasan 2 tahun antara pasien IMAEST dengan IMANEST yang dirawat di RSUP H. Adam Malik Medan pada tahun 2015. Kesintasan 2 tahun lebih baik pada pasien dengan hasil angiografi koroner single vessel disease, mendapatkan revaskularisasi dan tidak mengalami komplikasi gagal jantung atau syok kardiogenik selama rawatan.en_US
dc.description.abstractBackground: Non-ST segment elevation myocardial infarction (NSTEMI) has less frequent complications, but has recurrent events more often and worse longterm prognosis than ST segment elevation acute myocardial infarction (STEMI). Mortality rates of NSTEMI were lower than STEMI but after 6 months both mortality were similar. Mortality of NSTEMI was higher in the long term. The purpose of this study was to determine the 2-year survival in patients with acute myocardial infarction (AMI) who were treated at H. Adam Malik General Hospital in 2015. Methode: There were 264 IMA patients treated from January to December 2015. The study sample was divided based on the diagnosis of STEMI and NSTEMI. All patient characteristics were recorded based on medical records. All patients were contacted by phone to determine the condition of the patient 2 years after experiencing AMI. Then Chi square statistical analysis was conducted to assess the correlation of the characteristics of the study with the occurrence of STEMI and NSTEMI. Multivariate analysis was performed to assess the factors that affect the survival of 2 years. The 2-year survival of STEMI and NSTEMI was compared using the Kaplan Meier plot. Result: From 264 study samples, there were 216 (81.8%) men with an average age of 56 years. We found 147 STEMI patients and 117 NSTEMI patients. Compared to the STEMI group, NSTEMI patients tended to have a history of coronary heart disease and dyslipidemia, higher blood pressure, undergo less revascularization, experience longer hospitalization and less number of post IMA complications. Survival and mortality rates in 2 years were 58% and 28%. From multivariate analysis, higher blood pressure (OR 1.023, CI 95%, 1.003 – 1.044) dan PCI during hospitalization (OR 8.604, CI 95%, 2.264 – 32.702) showed better 2-year survival. There were no significant 2-year survival differences between the two groups (log rank 0.136). A better 2-year survival was found in patients with single vessel disease (log rank 0.001), patients who received revascularization (log rank 0.001) and patients who did not experience heart failure or cardiogenic shock during hospitalization (Log Rank 0.001). Conclusion: There was no difference in 2-year survival between STEMI and NSTEMI patients who were admitted to H. Adam Malik Medan General Hospital in 2015. The 2-year survival apperead better in patients with single vessel disease, received revascularization and did not experience heart failure or cardiogenic shock during hospitalization.en_US
dc.language.isoiden_US
dc.publisherUniversitas Sumatera Utaraen_US
dc.subjectKesintasanen_US
dc.subjectMortalitasen_US
dc.subjectIMAen_US
dc.subjectIMAESTen_US
dc.subjectIMANESTen_US
dc.titleAnalisis Kesintasan Pasien Infark Miokard Akut Selama 2 Tahun dan Faktor-Faktor yang Mempengaruhinya di Rumah Sakit Umum Pusat Haji Adam Malik Medanen_US
dc.typeTesis Magisteren_US
dc.identifier.nimnipnik147041046


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