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)
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Latar Belakang: Skor Global Registry of Acute Coronary Events (GRACE) adalahmodel stratifikasi risiko yang secara luas telah digunakan untuk memprediksi luaranpada pasien infark miokard akut (IMA). Pasca IMA dapat terjadi disfungsi miokardbaik sistolik maupun diastolik. Myocardial Performance Index (MPI) merupakanparameter ekokardiografi yang mampu menggambarkan fungsi sistolik dandiastolik ventrikel kiri secara bersamaan dan merupakan prediktor independenkejadian Major Adverse Cardiovascular Event (MACE) pasca IMA.Tujuan: Mengetahui peranan penambahan MPI ke dalam skor GRACE untukmemprediksi MACE selama lima hari perawatan rumah sakit.Metode: Penelitian kohort prospektif pada 75 pasien IMA di ruang perawatanintensif jantung RSCM antara Juli-November 2020. Dilakukan perhitungan totalskor GRACE saat pasien masuk rumah sakit dan pemeriksaan ekokardiografi untukmendapatkan nilai MPI dilaksanakan dalam 72 jam perawatan rumah sakit.Observasi terhadap kejadian MACE selama 5 hari perawatan rumah sakit dilakukanpada seluruh pasien. Peranan penambahan parameter MPI ke dalam skor GRACEdinilai 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 performamodel kombinasi (AUC 0,801 IK 95% 0,699-0,902 p=0,354, LRT 4,65 p=0,03 dancNRI 0,515 IK 95% 0,008-1,021 p=0,046).Simpulan: Penambahan MPI ke dalam skor GRACE signifikan meningkatkankemampuan skor kombinasi untuk memprediksi MACE selama lima hari perawatanrumah sakit pada pasien IMA. Background: The Global Registry of Acute Coronary Events (GRACE) risk scoreis widely recommended for risk assessment in patients with acute myocardialinfarction (AMI). Myocardial infarction induces variable degrees of impairment inleft ventricular (LV) systolic and diastolic function. Myocardial Performance Index(MPI) is an echocardiography parameter that capable of estimating combinedsystolic and diastolic LV performance and can independently predict MajorAdverse Cardiovascular Events (MACE) post AMI.Objective: To investigate whether MPI has incremental predictive value over theGRACE risk score in predicting MACE during five days of hospitalization afterAMI.Methods: A prospective cohort study was conducted in 75 patients presented withAMI in Intensive Cardiac Care Unit Cipto Mangunkusumo Hospital between Julyto November 2020. Total GRACE score was calculated on patient admission andechocardiography was conducted within 72 hours of hospitalization formeasurement of MPI. All patients were observed for the incidence of MACE duringfive days of hospitalization. The incremental predictive value of the GRACE riskscore alone and combined with MPI was assessed by the change in area undercurve (AUC) by DeLong’s method, likelihood ratio test (LRT) and continuous netreclassification 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 improvedmodel performance significantly (AUC 0.801 95% CI 0.699-0.902 p=0.354, LRT4.65 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 riskprediction of MACE during five days of hospitalization after AMI. |
T-Naomi Niari Dalimunthe.pdf :: Unduh
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No. Panggil : | T-Pdf |
Entri utama-Nama orang : | |
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Penerbitan : | Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021 |
Program Studi : |
Bahasa : | ind |
Sumber Pengatalogan : | LibUI ind rda |
Tipe Konten : | text |
Tipe Media : | computer |
Tipe Carrier : | online resource |
Deskripsi Fisik : | xix, 74 pages : illustration + appendix |
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Lembaga Pemilik : | Universitas Indonesia |
Lokasi : | Perpustakaan UI |
No. Panggil | No. Barkod | Ketersediaan |
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T-Pdf | 15-22-66750770 | TERSEDIA |
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