Perbandingan Skor Risiko Perdarahan Indonesia dan ACUITY-HORIZONS dalam Memprediksi Perdarahan pada Pasien Infark Miokard Akut dengan Elevasi Segmen ST (IMA-EST) yang Dilakukan Intervensi Koroner Perkutan Primer

Abstract

Background: ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular condition with a high incidence rate. Primary percutaneous coronary intervention (PPCI) is effective in improving patient prognosis but increases the risk of bleeding due to antithrombotic therapy. Various scoring systems, including ACUITY-HORIZONS and the Indonesian Bleeding Risk Score (INA-BR), have been developed to predict bleeding. This study aims to compare these two scores in predicting bleeding in STEMI patients undergoing PPCI. Methods: A retrospective cohort analytical study was conducted at RSUP H. Adam Malik Medan from May 2022 to December 2024. Data were collected from medical records of STEMI patients who underwent PPCI. Bleeding risk was evaluated using both scores and compared with actual bleeding events classified according to the Bleeding Academic Research Consortium (BARC) criteria. Statistical analysis was performed to assess sensitivity, specificity, and predictive accuracy using SPSS version 19.0. Results: The study included 245 patients with a mean age of 55.22 ± 9.97 years (82.4% male), with 42.9% experiencing bleeding during PPCI. Both scores demonstrated predictive ability, but the Indonesian Bleeding Risk Score had a significantly higher area under the curve (AUC) (P<0.001) compared to ACUITY-HORIZONS. Conclusion: The Indonesian Bleeding Risk Score shows better predictive performance than the ACUITY-HORIZONS score in predicting bleeding in STEMI patients undergoing PPCI, making it a more accurate tool for risk stratification and optimization of antithrombotic therapy in Indonesia.