Kadar Immature Platelet Fraction (IPF) pada Pasien Sindroma Koroner Akut (SKA)

Abstract

Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem causes high rates of hospital care and mortality. ACS is divided into three conditions: unstable angina pectoris (UAP), myocardial infarction without ST-segment elevation (NSTEMI), and myocardial infarction with ST-segment elevation (STEMI). In addition to changes in heart injury biomarkers, the platelet index (immature platelet fraction=IPF) will also experience changes in levels of difference between ACS patients who are STEMI and NSTEMI/UAP. Objective: To describe the characteristics of ACS patient in HAM Hospital in 2019, to determine the difference of IPF levels in ACS patients who are STEMI and NSTEMI/APTS, to determine the IPF cut-off value of ACS patients with STEMI. Method: Analytical observational study with a cross-sectional approach using primary data. The sample in this study were all patients in The Hospital HAM who came to The Emergency Unit of Integrated Cardiovascular with a diagnosis of ACS that has been classified as STEMI or NSTEMI/UAP from May 2019 to September 2019. In this study, we were using 3 ml of venous blood to measure the IPF level using Sysmex XN-1000 hematology analyzer. Results: Based on demographic characteristics of this study, we found men more in STEMI group (77,5%) and NSTEMI/UAP group (87,5% than women in STEMI group (22,5%) and NSTEMI/UAP group (12,5%). IPF level of STEMI group compare to NSTEMI/UAP group were median 6,2 (3,5-16,8) with 2,9 (0,7-12) witth p-value 0,0001 and the IPF cut-off value of STEMI group were 4,15. Conclusion: ACS patient characteristics based on their gender were found men in NSTEMI/UAP group more than in STEMI group and women in STEMI group were found more than NSTEMI/UAP group. There was a significant difference between the IPF levels of STEMI patients compare to NSTEMI/UAP and the IPF cut-off value was 4,15.

Latar belakang : Sindroma Koroner Akut (SKA) merupakan suatu masalah kardiovaskular yang utama karena menyebabkan angka perawatan rumah sakit dan angka kematian yang tinggi. SKA di bagi menjadi tiga yaitu : angina pektoris tidak stabil (APTS), infark miokard tanpa elevasi segment ST (NSTEMI), dan infark miokard dengan elevasi segmen ST (STEMI). Selain terjadinya perubahan pada biomarker cedera jantung, indeks trombosit (IPF=immature platelet fraction) juga akan mengalami perubahan perbedaan kadar antara pasien SKA yang STEMI dengan NSTEMI/APTS. Tujuan : Untuk mendeskripsikan karakteristik pasien SKA di RSUP HAM tahun 2019, mengetahui adanya perbedaan kadar IPF pada pasien SKA yang STEMI dengan NSTEMI/APTS dan mengetahui nilai cut-off IPF pasien SKA yang STEMI. Metode : Observasional analitik dengan pendekatan cross sectional dengan menggunakan data primer. Sampel dalam penelitian dari pasien yang datang ke IGD PJT RSUP. HAM Medan dan di diagnosis SKA yang sudah di klassifikasikan menjadi STEMI dengan NSTEMI/APTS bulan Mei 2019 s/d September 2019. Kemudian di ambil 3 ml darah vena dan di periksakan nilai IPF nya dengan menggunakan hematology analyzer Sysmex XN-1000. Hasil Penelitian : Pada penelitian ini karakteristik demografis subjek penelitian pasien SKA berdasarkan jenis kelamin diperoleh laki-laki 77,5% STEMI dan 87,5% NSTEMI/APTS sedangkan wanita 22,5% STEMI dan 12,5% NSTEMI/APTS. Hasil kadar IPF pasien STEMI dibandingkan dengan NSTEMI/APTS yaitu median 6,2 (3,5-16,8) dengan 2,9 (0,7-12) dengan p-value 0,0001 dan nilai cut-off IPF SKA yang STEMI 4,15. Kesimpulan : Karakteristik pasien SKA berdasarkan hasil jenis kelamin diperoleh laki-laki penderita NSTEMI/APTS lebih banyak dibandingkan yang STEMI dan wanita penderita STEMI lebih banyak dibandingkan yang NSTEMI/APTS. Terdapat perbedaan yang signifikan antara kadar IPF pasien yang STEMI dengan NSTEMI/APTS dan didapati nilai cut-off 4,15.