Hubungan Antara Plak Non Obstruktif di Arteri Koroner Proximal dengan Kejadian Sindrom Koroner Akut pada Pasien Penyakit Jantung Koroner Stabil yang Menjalani Coronary Computed Tomography Angiography (CCTA) di Rumah Sakit Adam Malik Medan

Abstract

Objective: To determine the relationship between non-obstructive plaque in the proximal coronary artery and acute coronary syndrome (ACS) in stable coronary artery disease (CAD) patients undergoing coronary computed tomography angiography (CCTA) at Adam Malik Hospital Medan Method: This is an observational analytical study with a retrospective cohort study design. The number of samples used in this study was 416 people. The sample was selected using consecutive sampling that met the inclusion and exclusion criteria. Stable CAD patients will undergo CCTA and then divided into non-obstructive lesion groups with proximal involvement and without proximal involvement. ACS assessment was carried out for a period of 18 months. Results: A total of 416 patients were included in this study. Acute coronary syndrome (ACS) was unstable angina pectoris occurred in 20 patients (9.6%) with non-obstructive CAD with proximal involvement. The basic characteristics of stable CAD patients with non-obstructive plaque and proximal involvement were predominantly male, had an older mean age (58.11 ± 9.66 years), more diabetes (23.1%) and dyslipidemia (33.7%), had a mean CAC score of 113.73 ± 144.1, more (29.8%) had moderate stenosis severity, the most common location was in the LAD (88.9%) and more had an SIS value > 4 (13.5%). There was a significant relationship between proximal involvement, moderate stenosis severity, CAC score and SIS in patients with ACS. (P < 0.001). Conclusion: Patients with extensive non-obstructive CAD (SIS > 4) with proximal involvement are associated with ACS. Higher stenosis severity and CAC score also increase the risk of ACS.