Prediksi Skor Timi dan Killip Berdasarkan Kalsifikasi Arkus Aorta pada Pemeriksaan Foto Toraks Pasien Infark Miokard Akut Elevasi Segmen St (IMAEST) di RS. Adam Malik

Abstract

Background: Coronary Artery Disease (CAD) is the most common heart disease and contributes for 1/3 to 1/2 of all cardiovascular events. CAD is caused by the formation of atherosclerotic plaques in the lumen of the coronary arteries, which disrupts blood flow and oxygen supply to the myocardium, potentially leads to angina and myocardial infarction. ST-Elevation Myocardial Infarction (STEMI) occurs due to changes in plaque composition and thinning of the fibrous cap, which leads to rupture of the coronary blood vessels. If this lasts more than 20 minutes, it can increase patient mortality and morbidity. Thrombolysis in Myocardial Infarction (TIMI) and Killip stratification based on history and physical examination can be used to determine the prognosis for STEMI patients. Aortic Arch Calcification (AAC) can be easily detected with a Chest X-ray and is strongly associated with the incidence of CAD. AAC can provide prognostic information on clinical outcomes in patients with CAD. Objective : This study aim to analyze the AAC predicts TIMI and Killip scores based on chest X-ray examinations in patients with STEMI. Method: This study is an observational analytical research with a diagnostic test design on 100 STEMI patients who had chest X-rays at Adam Malik Hospital and were evaluated for AAC scores semi-quantitatively. Analyzing the prediction of TIMI and Killip scores based on aortic arch calcification. Results: Based on the analysis results, AAC in predicting TIMI score has a sensitivity of 48.6% and a specificity of 72.3% (AUC: 0.644). The Killip score has a sensitivity of 37.1% and a specificity of 78.5% (AUC: 0.562). The Positive Predictive Values of TIMI and Killip, respectively, are 64.6% and 64.2% and Negative Predictive Values are 57.5% and 54.5%. Conclusion: AAC is inadequate in predicting TIMI and Killip scores for patients with STEMI.