Skor Selvester yang Disederhanakan Sebagai Predoktor Kejadian Kardiovaskular Mayor dalam 30 Hari pada Pasien Infark Miokard Akut Elevasi Segmen ST Tanpa Reperfusi Dini

Abstract

Latar Belakang: Skor Selevester yang disederhanakan merupakan penanda EKG yang dapat memprediksi ukuran infark miokard, dan kejadian kardiovaskular Mayor (KKvM) pada pasien infark miokard akut elevasi segmen ST (IMAEST) setelah reperfusi dini. Penelitian ini dilakukan untuk melihat apakah ada hubungannya Skor Selvester yang disederhanakan dengan KKvM pada IMAEST tanpa reperfusi dini. Metode: Penelitian ini adalah studi retrospektif yang melibatkan 71 pasien IMAEST tanpa reperfusi dini dan menguji Skor Selvester yang disederhanakan sebagai prediktor KKvM selama dalam 30 hari. Nilai cutoff skor didapatkan dari kurva ROC. Uji Chi-Square, Fisher’s exact dan regresi logistik dilakukan dalam menilai hubungan antara dua variabel atau lebih untuk mendapatkan rasio odds, p<0,05 dianggap signifikan. Hasil: Pasien dengan KKvM dalam 30 hari memiliki Skor Selvester yang disederhanakan hari ke-4 rawatan yang lebih tinggi (12±2,3 vs 8±2,3; p<0,001). Nilai Cutoff yang didapatkan adalah 10,5. Uji regresi logistik menunjukkan bahwa Skor Selvester yang disederhanakan >10 merupakan faktor independen terhadap KKvM dalam 30 hari (p = 0,003; OR 4,9 ; 95% IK: 1,247 – 24,385). Kesimpulan: Skor QRS yang disederhanakan merupakan prediktor independen KKvM 30 hari paska IMAEST tanpa reperfusi dini.

Background: Selvester Score is a simple ECG markers that correlates with myocard infark size, and mayor adverse cardiac event (MACE) in ST Elevation Myocardial Infarction (STEMI) patient who performed early reperfusion. This Study carried out to see if there was any association between Simplified Selvester Score and MACE in 30- days after acute STEMI patients who were not performed early reperfusion therapy. Method: We conducted a retrospective study among 71 STEMI patients who were not performed early reperfusion therapy and examined the relationship between Simplified Selvester Score and 30 days MACE. Cutoff point were taken from ROC curve. Chi- Squere, Fisher’s exact, and logistic regression test were used to examine the association between two variables and obtained odds ratio (OR). A value of p<0,05 was considered statistically significant. Result: Patients with in-hospital MACE have higher Simplified Selvester Score at day- 4 hospitalization (12±2,3 vs 8±2,3; p<0,001). The optimum cutoff value in this study for Simplified Selvester Score was 10.5. In multivariate analysis, Simplified Selvester Score >10 remained significantly associated for MACE in 30-days after STEMI and appears to be strong predictor for MACE (p = 0,003; OR 4,9 ; 95% IK: 1,247 – 24,385). Conclusion: This study showed relationship between Simplified Selvester Score and short-term MACE in STEMI patients who were not performed early reperfusion. Simplified Selvester Score was independent predictor of short-term MACE in STEMI patients who were not performed early reperfusion.