Hubungan Depresi Segmen ST pada Sadapan Avr dengan Kejadian Kardiovaskular Mayor selama Perawatan di Rumah Sakit pada Infark Miokard Akut Elevasi Segmen ST Inferior di Rumah Sakit Haji Adam Malik Medan

Abstract

Background. In inferior ST Elevation Myocardial Infarction (STEMI), the ECG lead aVR is frequently ignored, and therefore its clinical significance remains unclear.

Aim. This study examined the relationship between ST-segmen depression in lead

aVR on ECGs obtained at hospital admission and Mayor Adverse Cardiovascular

Events (MACE) in patients with inferior STEMI

Methods. This retrospective study involved 105 patients with inferior STEMI

According to ST-segmen depression in lead aVR on admission ECG, patients were divided in two groups, group I. ST segmen depression 21 mm 41 patients) and group II: no ST segmen depression (64 patients). All patients were followed up during their hospital stay for death, cardiogenic shock, heart failure and arrhythmias.

Results. Forty two (40%) among patients with inferior STEMI experienced MACE during hospitalization. The incidence of MACE was found higher in group I than group II (59,5 % and 40.5 %, p<0.001), eventhough only cardiogenic shock (OR: 2,897, 95% CI: 1,065-7,879, p=0,033) and arrhythmia rates (OR:3,169: 95% C11,219-8,240, p=0,015) which were statistically significant according to ST segmen depression in lead aVR among patients with inferior STEMI Mutivariate analysis showed that ST segmen depression in lead aVR were associated with increased risk of in-hospital MACE in patients with inferior STEMI (OR: 3,102 95% CI 1.061-9,073, p-0,039)

Conclusion. There was relationship between the presence of ST segmen depression in lead aVR and in-hospital MACE ST segmen depression in lead AVR can be an independent predictor for MACE during hospitalization in patients with inferior STEMI

Latar Belakang, Pada Infark Miokard Elevasi Segmen ST (IMAEST) inferior, sadapan aVR sering pada EKG sering diabaikan, sehingga manfaatnya secara klinis masih belum jelas.

Tujuan. Penelitian ini menilai hubungan antara depresi segmen ST di sadapan aVR pada EKG saat masuk rumah sakit dan Kejadian Kardiovaskular Mayor (KKVM) pada pasien IMAEST inferior.

Metode. Penelitian retrospektif ini melibatkan 105 pasien dengan IMAEST inferior Berdasarkan penilaian depresi segmen ST (DST) di sadapan aVR pada pemeriksaan EKG saat masuk RS, pasien dibagi dalam dua kelompok, kelompok 1: DST 21 mm (41 pasien) dan kelompok II: tidak ada DST (64 pasien). Semua pasien dipantau secara klinis selama perawatan di rumah sakit untuk menilai adanya kematian, syok kardiogenik, gagal jantung dan aritmia.

Hasil. Empat puluh dua (40%) pada pasien dengan IMAEST inferior mengalami KKVM selama perawatan di RS. Insiden KKVM ditemukan lebih tinggi pada kelompok I dibandingkan kelompok II (59.5% dan 40,5%, p <0.001), walaupun hanya syok kardiogenik (RO: 2897; IK 95% 1,065-7,879, p 0,033) dan aritmia M maligna (RO: 3169, IK 95% 1,219-8,240, p-0,015) yang menunjukkan hubungan yang signifikan berdasarkan pengelompokan depresi segmen ST di sadapan aVR Hasil analisis mutivariat menunjukkan bahwa DST di sadapan aVR berhubungan dengan peningkatan risiko KKVM di rumah sakit pada passen dengan IMAEST inferior (RO: 3,102; IK 95% 1,061-9,073, p=0,039)

Kesimpulan. Terdapat hubungan antara depresi segmen ST (DST) di sadapan aVR dan KKVM. DST di sadapan aVR dapat menjadi prediktor independen untuk risiko KKVM selama perawatan di RS pada pasien dengan IMAEST inferior