Gambaran Penggunaan Fibrinolitik Pada Pasien Stemi (St-Segment Elevation Myocardial Infarction) Di Rumah Sakit “X” Di Kota Tarakan

Marizka Anggreani; Irma Novrianti; Sari Wijayanti

doi:10.32382/mf.v18i1.2450

Gambaran Penggunaan Fibrinolitik Pada Pasien Stemi (St-Segment Elevation Myocardial Infarction) Di Rumah Sakit “X” Di Kota Tarakan

Marizka Anggreani, Irma Novrianti, Sari Wijayanti

Abstract

Fibrinolytics Administration To Patients With Stemi (St-Segment Elevation Myocardial Infarction)

Although non-communicable, cardiovascular diseases cause the highest global mortality rate, i.e., 16.6%. Tarakan is one of the cities in the province of North Kalimantan. Based on the results of the 2018 Riskesdas, the highest prevalence of coronary heart disease (CHD) is in the province of North Kalimantan. Cardiac catheterization laboratory facilities are not yet available, so fibrinolytic therapy is still the first line of reperfusion therapy for STEMI. This research is aimed at analyzing fibrinolytics administration at “X” Hospital in Tarakan. This is descriptive retrospective research to examine fibrinolytics administration in 39 in-patients with STEMI at “X” Hospital in Tarakan, on January 2017-December 2018. The fibrinolytic agents used were fibrin-specific and non-fibrin-specific. Alteplase was administered to 13 patients (33.33%). Alteplase was administered in three dosages, i.e., 15 mg administered in a bolus in the early stage, 50 mg administered by an intravenous infusion for 30 minutes, and 35 mg administered for 60 minutes. 26 patients (66.66%) were administered Streptokinase. Streptokinase was intravenously administered at 1.5 million IU in 100 mL of salt solution for 30-60 minutes. The result demonstrates that the non-fibrin-specific agent, administered to 26 patients (66.66%), was mostly used here.

KEYWORDS: fibrinolytics, Alteplase, Streptokinase, STEMI

Penyakit kardiovaskuler adalah penyakit tidak menular yang menyebabkan angka kematian tertinggi di dunia mencapai 16,6 %. Kota Tarakan merupakan salah kota yang berada di provinsi Kalimantan Utara. Berdasarkan hasil data Riskesdas Tahun 2018, prevalensi penyakit jantung koroner paling tinggi berada di provinsi Kalimantan Utara. Fasilitas laboratorium kateterisasi jantung belum tersedia, sehingga terpai fibrinolitik masih merupakan terapi reperfusi utama untuk pasien STEMI. Tujuan dari penelitian ini untuk melihat gambaran penggunaan fibrinolitik di Rumah Sakit “X” di Kota Tarakan. Metode penelitian ini merupakan suatu penelitian deskriptif retrospektif untuk mengetahui penggunaan fibrinolotik pada pasien penyakit STEMI yang menjalani rawat inap di Rumah Sakit ‘X” di Kota Tarakan periode Januari 2017 – Desember 2018. Berdasarkan penelitian diperoleh sebanyak 39 pasien yang didiagnosa STEMI. Golongan fibrinolitik yang digunakan adalah golongan spesifik fibrin dan golongan non spesifik fibrin. Penggunaan obat Alteplase sebanyak 13 pasien (33,33%). Pemberian Alteplase dibagi menjadi 3 dosis yaitu 15 mg diberikan secara bolus pada tahap awal, selanjutnya 50 mg diberikan secara infus intravena dengan dosis 50 mg selama 30 menit, dan terkahir 35 mg selama 60 menit. Pasien yang menggunakan Streptokinase sebanyak 26 orang (66,66%), penggunaan Streptokinase diberikan secara intravena dengan dosis 1,5 juta IU dalam 100 mL larutan NaCl selama 30-60 menit. Dari penelitian ini disimpulkan bahwa fibrinolitik yang paling banyak digunakan dalam penelitian ini adalah golongan non-spesifik fibrin sebanyak 26 pasien (66,66%).

Kata kunci : fibrinolitik, Alteplase, Streptokinase, STEMI

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DOI: https://doi.org/10.32382/mf.v18i1.2450