Peran ketebalan Adiposa Epikardial sebagai prediktor Cardiovascular Adverse Event pada pasien sindrom Koroner Akut di ICCU RS Cipto Mangunkusumo = The role of Epicardial Adipose thickness as predictor of Cardiovascular Adverse Events in Acute Coronary syndrome patients at ICCU of Cipto Mangunkusumo Hospital / Nababan, Saut Horas H
| Main Author: | Nababan, Saut Horas H, author |
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| Format: | Masters Bachelors |
| Terbitan: |
Fakultas Kedokteran Universitas Indonesia
, 2012
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| Subjects: | |
| Online Access: |
http://lib.ui.ac.id/file?file=digital/20329636-T 32758-Saut Horas H Nababan.pdf |
Daftar Isi:
- <b>ABSTRAK</b><br> Pendahuluan Studi sebelumnya menunjukkan tebal adiposa epikardial pasien sindrom koroner akut (SKA) berhubungan dengan cardiovascular adverse event dalam tiga puluh hari. <br><br> Tujuan Mengetahui peran tebal adiposa epikardial dalam memprediksi cardiovascular adverse event pada pasien SKA di ICCU RS Cipto Mangunkusumo. <br><br> Metode Dilakukan studi kohort prospektif berbasis studi prognostik pada seratus dua puluh satu pasien SKA. Tebal adiposa epikardial dinilai dengan ekokardiografi transtorakal pada fase sistolik akhir (end-systole) tampilan parasternal long axis dari tiga siklus jantung. Dilakukan follow-up dalam tiga puluh hari pada semua pasien. <br><br> Hasil Nilai median tebal adiposa epikardial adalah 2,23 mm (kisaran 0,37 – 10,8 mm). Cardiovascular adverse event terjadi pada 23 pasien (19%) dalam 30 hari; 9 subjek mengalami syok kardiogenik, 3 subjek mengalami infark miokard berulang, 4 subjek mengalami stroke iskemik, dan 7 subjek meninggal. Titik potong terbaik tebal adiposa epikardial dalam memprediksi cardiovascular adverse event adalah 2,95 mm dengan sensitivitas 65%, spesifisitas 70%, nilai duga positif 34%, nilai duga negatif 90% dengan AUC sebesar 0,690 (IK 95% 0,564-0,816, p=0,005). <br><br> Simpulan Tebal adiposa epikardial 2,95 mm dapat digunakan untuk memprediksi cardiovascular adverse event dalam tiga puluh hari pada pasien SKA dengan sensitivitas 65%, spesifisitas 70% dan AUC 0,690. <hr> <b>ABSTRACT</b><br> Background Previous study showed that epicardial adipose thickness in acute coronary syndrome (ACS) patients was associated with cardiovascular adverse events during thirty days. <br><br> Objective To determine the role of epicardial adipose thickness in predicting cardiovascular adverse events in ACS patients at ICCU of Cipto Mangunkusumo Hospital <br><br> Method A prospective cohort prognostic study was conducted on one hundred twenty-one ACS patients. Epicardial adipose thickness was measured with transthoracic echocardiography at end-systole from parasternal long-axis view of three cardiac cycles. 30 days follow-up was obtained in all patients. <br><br> Results Median value of epicardial adipose thickness was 2.23 mm (range 0.37-10.8 mm). Cardiovascular adverse events were developed in 23 patients (19%) during 30 days; 9 cases of cardiogenic shock, 3 of recurrent myocardial infarction, 4 of ischemic stroke, and 7 of death. Best cut-off point of epicardial adipose thickness in predicting cardiovascular adverse events was 2.95 mm with a sensitivity of 65%, specificity 70%, positive predictive value 34%, negative predictive value 90% and AUC of 0.690 (95% CI 0.564 - 0.816, p = 0.005). <br><br> Conclusion Epicardial adipose thickness with cut-off point 2.95 mm could be used to predict cardiovascular adverse events during thirty days in ACS patients with a sensitivity of 65%, specificity 70% and AUC of 0.690.