UI - Tesis Membership :: Kembali

UI - Tesis Membership :: Kembali

Peranan penambahan Myocardial Performance Index ke dalam skor Global Registry of Acute Coronary Events untuk memprediksi Major Adverse Cardiovascular Events selama lima hari perawatan rumah sakit pada pasien infark miokard akut = The Role of Myocardial Performance Index added on Global Registry of Acute Coronary Events score in predicting Major Adverse Cardiovascular Events during five days of hospitalisation in patients with acute myocardial infarction

Naomi Niari Dalimunthe; Idrus Alwi, supervisor; Nasution, Sally Aman, supervisor; Hamzah Shatri, supervisor; Irsan Hasan, examiner; Taufik Indrajaya, examiner; Dadang Makmun, examiner; Eka Ginanjar, examiner; C. Rinaldi Lesmana, examiner; Marbun, Maruhum Bonar H., examiner (Fakultas Kedokteran Universitas Indonesia, 2021)

 Abstrak

Latar Belakang: Skor Global Registry of Acute Coronary Events (GRACE) adalah
model stratifikasi risiko yang secara luas telah digunakan untuk memprediksi luaran
pada pasien infark miokard akut (IMA). Pasca IMA dapat terjadi disfungsi miokard
baik sistolik maupun diastolik. Myocardial Performance Index (MPI) merupakan
parameter ekokardiografi yang mampu menggambarkan fungsi sistolik dan
diastolik ventrikel kiri secara bersamaan dan merupakan prediktor independen
kejadian Major Adverse Cardiovascular Event (MACE) pasca IMA.
Tujuan: Mengetahui peranan penambahan MPI ke dalam skor GRACE untuk
memprediksi MACE selama lima hari perawatan rumah sakit.
Metode: Penelitian kohort prospektif pada 75 pasien IMA di ruang perawatan
intensif jantung RSCM antara Juli-November 2020. Dilakukan perhitungan total
skor GRACE saat pasien masuk rumah sakit dan pemeriksaan ekokardiografi untuk
mendapatkan nilai MPI dilaksanakan dalam 72 jam perawatan rumah sakit.
Observasi terhadap kejadian MACE selama 5 hari perawatan rumah sakit dilakukan
pada seluruh pasien. Peranan penambahan parameter MPI ke dalam skor GRACE
dinilai menggunakan perubahan area under curve (AUC) metode DeLong,
likelihood ratio test (LRT) dan continous net reclassification improvement (cNRI).
Hasil: Kemampuan prediksi skor GRACE baik (AUC 0,753 IK 95% 0,639-0,868).
Penambahan MPI ke dalam skor GRACE secara signifikan meningkatkan performa
model kombinasi (AUC 0,801 IK 95% 0,699-0,902 p=0,354, LRT 4,65 p=0,03 dan
cNRI 0,515 IK 95% 0,008-1,021 p=0,046).
Simpulan: Penambahan MPI ke dalam skor GRACE signifikan meningkatkan
kemampuan skor kombinasi untuk memprediksi MACE selama lima hari perawatan
rumah sakit pada pasien IMA.

Background: The Global Registry of Acute Coronary Events (GRACE) risk score
is widely recommended for risk assessment in patients with acute myocardial
infarction (AMI). Myocardial infarction induces variable degrees of impairment in
left ventricular (LV) systolic and diastolic function. Myocardial Performance Index
(MPI) is an echocardiography parameter that capable of estimating combined
systolic and diastolic LV performance and can independently predict Major
Adverse Cardiovascular Events (MACE) post AMI.
Objective: To investigate whether MPI has incremental predictive value over the
GRACE risk score in predicting MACE during five days of hospitalization after
AMI.
Methods: A prospective cohort study was conducted in 75 patients presented with
AMI in Intensive Cardiac Care Unit Cipto Mangunkusumo Hospital between July
to November 2020. Total GRACE score was calculated on patient admission and
echocardiography was conducted within 72 hours of hospitalization for
measurement of MPI. All patients were observed for the incidence of MACE during
five days of hospitalization. The incremental predictive value of the GRACE risk
score alone and combined with MPI was assessed by the change in area under
curve (AUC) by DeLong’s method, likelihood ratio test (LRT) and continuous net
reclassification improvement (cNRI).
Results: The GRACE risk score demonstrated good discrimination for MACE
(AUC 0.753 95% CI 0.639-0.868). Adding MPI to the GRACE risk score improved
model performance significantly (AUC 0.801 95% CI 0.699-0.902 p=0.354, LRT
4.65 p=0.03 and cNRI 0.515 95% CI 0.008-1.021 p=0.046).
Conclusions: Adding MPI to the GRACE risk score significantly improves risk
prediction of MACE during five days of hospitalization after AMI.

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 Metadata

Jenis Koleksi : UI - Tesis Membership
No. Panggil : T-Pdf
Entri utama-Nama orang :
Entri tambahan-Nama orang :
Entri tambahan-Nama badan :
Program Studi :
Subjek :
Penerbitan : Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
Bahasa : ind
Sumber Pengatalogan : LibUI ind rda
Tipe Konten : text
Tipe Media : computer
Tipe Carrier : online resource
Deskripsi Fisik : xix, 74 pages : illustration + appendix
Naskah Ringkas :
Lembaga Pemilik : Universitas Indonesia
Lokasi : Perpustakaan UI
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No. Panggil No. Barkod Ketersediaan
T-Pdf 15-22-66750770 TERSEDIA
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Tidak ada ulasan pada koleksi ini: 20516111
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