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ABSTRAK
Nama : Anditha RatnadhiyaniProgram Studi : Magister Ilmu KeperawatanJudul : Pengalaman Wanita Pasca Sindrom Koroner Akut dalam Adaptasi terhadap Perubahan Kemampuan Fungsional Pemulihan pasca sindrom koroner akut mencakup proses adaptasi individu terhadap perubahan kemampuan fungsional. Perkembangan dalam penelitian di bidang kardiovaskular menunjukkan dampak dan prognosis sindrom koroner akut yang lebih buruk pada wanita jika dibanding pria, yang dikaitkan dengan perbedaan dalam persepsi, prediktor klinis, dan status sosioekonomi. Penelitian ini bertujuan untuk mengeksplorasi pengalaman wanita pasca sindrom koroner akut dalam adaptasi terhadap perubahan kemampuan fungsional. Metode kualitatif dengan desain fenomenologi deskriptif digunakan untuk memperoleh gambaran pengalaman sepuluh partisipan dalam penelitian ini. Pengambilan data dilakukan dengan wawancara mendalam, kemudian dilakukan content analysis dengan metode Colaizzi. Teridentifikasi enam tema utama dari penelitian ini yaitu respon ketidaknyamanan setelah mengalami sindrom koroner akut, penurunan kemandirian dan kemampuan melakukan aktivitas sebagai dampak perubahan kondisi fisik, self-adjustment sebagai koping terhadap perubahan kemampuan fisik, revaskularisasi memberikan harapan kesembuhan, pengaruh dukungan terhadap psikologis, dan self-effort untuk memulihkan kemampuan fungsional. Hasil penelitian menunjukkan peran penting faktor psikologis dalam proses adaptasi wanita selama pemulihan, sehingga direkomendasikan peningkatan intervensi yang mendukung psikologis dalam tatalaksana pasien wanita dengan sindrom koroner akut. Kata kunci: adaptasi, kemampuan fungsional, sindrom koroner akut, wanita

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ABSTRACT
Name Anditha RatnadhiyaniStudy Program Master of NursingTitle The Experiences of Women after Acute Coronary Syndrome in Adaptation to Functional Ability Changes Adaptation to functional ability changes is part of recovery after Acute Coronary Syndrome ACS . Earlier studies have indicated that women with ACS have worse impact and prognosis. It is associated with perception differences, clinical predictors and socio economy status. The aim of this study is to explore experiences of women after ACS in adaptation to functional ability changes. A qualitative study using phenomenological description design was conducted. Ten women after ACS participated in individual in depth interview. Data were analysed using Colaizzi rsquo s procedural approach. Women rsquo s experiences in adaptation were formulated into six main themes 1 inconvenience response to ACS 2 decrease in autonomy and ability to perform activities as a result of physical changes 3 self adjustment as a mechanism to cope with physical ability changes 4 being recovered by revascularization 5 social support promotes psychological improvement and 6 self efforts to improve functional abilities. This research denotes a major role of psychological factors in women rsquo s adaptation during recovery process. Therefore, developing a psychological based intervention for women after ACS is an important strategy to improve outcomes. Keywords acute coronary syndrome, adaptation, functional ability, women

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Sindrom koroner akut (SKA) merupakan masalah kesehatan nasional karena tingginya angka morbiditas dan mortalitas serta beban biaya yang dibutuhkan. Intervensi koroner perkutan (IKP) dan terapi antiplatelet seperti klopidogrel merupakan tata laksana yang direkomendasikan oleh organisasi kardiologi internasional. Meskipun demikian, pasien SKA masih dapat mengalami kejadian kardiovaskular mayor (KKM). Kemungkinan, resistensi klopidogrel berperan pada KKM sedangkan resistensi klopidogrel mungkin dipengaruhi oleh faktor genetik dan epigenetik. Penelitian ini bertujuan untuk mengetahui hubungan faktor genetik yaitu polimorfisme gen CYP2C19 dan P2Y12, serta epigenetik yaitu metilasi DNA gen CYP2C19 dan P2Y12 serta ekspresi miRNA-26a dengan resistensi klopidogrel dan pengaruhnya terhadap KKM pada pasien SKA pasca IKP. Untuk menganalisis hubungan faktor genetik dan epigenetik dengan resistensi klopidogrel, penelitian dilakukan dengan desain potong lintang, sedangkan untuk analisis hubungan faktor genetik dan epigenetik dengan KKM dilakukan dengan desain kohort prospektif. Subjek penelitian meliputi 201 pasien SKA pasca IKP dan mendapat terapi klopidogrel di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita dari bulan September 2018 sampai dengan Juni 2020. Resistensi klopidogrel ditentukan dengan pemeriksaan light transmission aggregometry (LTA) apabila hasilnya lebih besar dari 59% dengan agonis ADP 20 mM. Deteksi polimorfisme gen CYP2C19 dan P2Y12 serta ekspresi miRNA-26a dilakukan dengan metode qRT-PCR, sedangkan metilasi DNA gen CYP2C19 dan P2Y12 dikerjakan dengan metode konversi bisulfit. Pasien diobservasi selama satu tahun dan jika ada angina pektoris, infark miokard akut (IMA) rekuren, stroke, atau kematian, dicatat sebagai KKM. Dari 201 subjek, terdapat 45,8% carrier mutant polimorfisme *2 dan *3 gen CYP2C19, 36,8% carrier mutant polimorfisme rs3679479 gen P2Y12, 10% hipometilasi DNA gen P2Y12, 80,1% hipometilasi DNA gen CYP2C19, dan 66,2% ekspresi miRNA-26a up regulated. Proporsi resisten klopidogrel adalah 49,8% dan proporsi KKM adalah 14,9% (kematian 7,5%). Terdapat hubungan antara merokok (p = 0,001; OR 0,37 [IK 95%; 0,20–0,68]), hipometilasi DNA gen CYP2C19 (p = 0,037; OR 2,13 [IK 95%; 1,04–4,37]), dan ekspresi miRNA-26a up regulated (p = 0,020; OR 2,03 [IK 95%; 1,12–3,68]) dengan resistensi klopidogrel. Terdapat hubungan antara jenis kelamin perempuan (p = 0,040; HR 2,73 [IK 95%; 1,05–7,14]), usia ≥ 60 tahun (p = 0,035; HR 2,17 [IK 95%; 1,06–4,48]), eGFR rendah (p = 0,001; HR 3,29 [IK 95%; 1,59–6,84]), dan polimorfisme *2 dan *3 gen CYP2C19 (p = 0,047; HR 2,12 [IK 95%; 1,01–4,46]) dengan KKM dalam satu tahun. Hanya faktor epigenetik berupa metilasi DNA gen CYP2C19 dan ekspresi miRNA-26a yang berhubungan dengan resistensi klopidogrel. Walaupun resistensi klopidogrel tidak berhubungan dengan KKM, terdapat hubungan antara faktor genetik polimorfisme *2 dan *3 gen CYP2C19 dengan KKM. ......Acute coronary syndrome (ACS) is a national health problem due to high morbidity and mortality, and cost burden as well. Percutaneous coronary intervention (PCI) and antiplatelet therapy such as clopidogrel are recommended. However, ACS patients could still experience major adverse cardiovascular events (MACE). Clopidogrel resistance possibly plays a role in MACE whereas it may be affected by genetic and epigenetic factors. Therefore, the objective of this study was to determine the relationship between genetic factors which are CYP2C19 and P2Y12 polymorphisms, as well as epigenetic factors which are DNA methylation of CYP2C19 and P2Y12, and miRNA-26a expression and their effects on MACE in post-PCI patients. To analyze the association between genetic and epigenetic factors and clopidogrel resistance, the study design was cross-sectional, while the study design of relationship between genetic and epigenetic factors and MACE was prospective cohort. The subjects were 201 post-PCI ACS patients who received clopidogrel therapy at Harapan Kita Hospital from September 2018 to June 2020. Clopidogrel resistance was determined by light transmission aggregometry (LTA) if the result was greater than 59% with agonist ADP 20 µM. The detection of CYP2C19 and P2Y12 gene polymorphisms and miRNA-26a expression were carried out by qRT-PCR method, while the DNA methylation of the CYP2C19 and P2Y12 genes were carried out by bisulfite conversion method. Patients were observed for one year and angina pectoris, recurrent acute myocardial infarction (AMI), stroke, or death, were recorded as MACE. From 201 subjects, 45.8% were CYP2C19*2 and CYP2C19*3 polymorphism mutant carrier, 36.8% were rs3679479 P2Y12 polymorphism mutant carrier, 10% were hypomethylated of P2Y12, 80.1% were hypomethylated of CYP2C19, and 66.2% were up regulated in miRNA-26a expression. 49.8% of subjects were clopidogrel resistant and 14.9% of subjects experienced MACE (death was 7.5%). Smoking (p = 0.001; OR 0.37 [CI 95%; 0.20–0.68]), hypomethylated of CYP2C19 (p = 0.037; OR 2.13 [CI 95%; 1.04–4.37]), and up regulated miRNA-26a expression (p = 0.020; OR 2.03 [CI 95%; 1.12–3.68]) were associated with clopidogrel resistance. Female gender (p = 0.040; HR 2.73 [CI 95%; 1.05–7.14]), age over 60 years old (p = 0.035; HR 2.17 [CI 95%; 1.06–4.48]), low eGFR (p = 0.001; HR 3.29 [CI 95%; 1.59–6.84]), and CYP2C19*2 and CYP2C19*3 polymorphisms (p = 0.047; HR 2.12 [CI 95%; 1.01–4.46]) were associated with MACE in one year. Only DNA methylation of CYP2C19 and miRNA-26a expression were associated with clopidogrel resistance. Although clopidogrel resistance was not associated with MACE, there was association between CYP2C19*2 and CYP2C19*3 polymorphisms and MACE.

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Penyakit kardiovaskular juga merupakan penyebab utama kematian secara global. Di Indonesia, penyakit kardiovaskular mengalami peningkatan prevalensi setiap tahunnya dan menempati peringkat tertinggi sebagai penyebab kematian terutama pada usia produktif. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian penyakit kardiovaskular pada penduduk usia produktif di Daerah Istimewa Yogyakarta berdasarkan data Riset Kesehatan Dasar 2018. Desain studi penelitian ini adalah cross-sectional dengan analisis bivariat. Hasil penelitian menunjukan prevalensi penyakit kardiovaskular pada penduduk usia produktif di Provinsi DI Yogyakarta pada tahun 2018 adalah sebesar 2,7%. Faktor yang berhubungan secaara statistik dengan kejadian penyakit kardiovaskular yaitu umur (POR = 4,615; 95% CI: 3,489-6,104), jenis kelamin (POR = 0,751; 95% CI: 0,566-0,995), tingkat pendidikan (POR = 1,405; 95% CI: 1,064 – 1,855), hipertensi (nilai POR = 2,391; 95% CI: 1,810-3,158), diabetes melitus (POR = 8,531; 95% CI: 5,899 – 12,337), status merokok (POR = 1,979; 95% CI: 1,327-2,950; dan POR = 2,794; 95% CI: 1,738-4,492), obesitas (POR = 1,630; 95% CI: 1,206 - 2,204), aktivitas fisik (POR = 1,968; 95% CI: 1,292 – 2,999), gangguan mental emosional (POR = 2,344; 95% CI: 1,661 – 3,307), konsumsi makanan asin (POR = 0,693; 95% CI: 0,519 – 0,927), dan konsumsi makanan lemak/kolesterol/gorengan (POR = 0,698; 95% CI: 0,517 – 0,944). Sementara itu, konsumsi buah dan sayur serta konsumsi alkohol tidak berhubungan secara statistik dengan kejadian penyakit kardiovaskular. Optimalisasi program pengendalian PTM seperti CERDIK dapat membantu pencegahan kejadian penyakit kardiovaskular. ......Cardiovascular disease is the leading cause of death globally. In Indonesia, cardiovascular disease has an increasing prevalence every year and ranks highest as a cause of death, especially in productive age. This study aims to determine the factors associated with the incidence of cardiovascular disease in the productive age population in the Special Region of Yogyakarta based on data from the 2018 Basic Health Research. The design of this research study was cross-sectional with bivariate analysis. The results showed that the prevalence of cardiovascular disease in the productive age population in Yogyakarta Province in 2018 was 2.7%. Statistically related factors to cardiovascular disease incidence were age (POR = 4.615; 95% CI: 3.489-6.104), sex (POR = 0.751; 95% CI: 0.566-0.995), education level (POR = 1.405; 95% CI: 1.064 – 1.855), hypertension (POR value = 2.391; 95% CI: 1.810-3.158), diabetes mellitus (POR = 8.531; 95% CI: 5.899 – 12.337), smoking status (POR = 1.979; 95% CI: 1.327-2.950; and POR = 2.794; 95% CI:  1.738-4.492), obesity (POR = 1.630; 95% CI: 1.206 - 2.204), physical activity (POR = 1.968; 95% CI: 1.292 – 2.999), mental emotional disorders (POR = 2.344; 95% CI: 1.661 – 3.307), consumption of salty foods (POR = 0.693; 95% CI: 0.519 – 0.927), and consumption of fat/cholesterol/fried foods (POR = 0.698; 95% CI: 0.517 – 0.944). Meanwhile, fruit and vegetable consumption and alcohol consumption were not statistically associated with the incidence of cardiovascular disease. Optimization of NCD control programs such as CERDIK can help prevent cardiovascular disease events

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Latar belakang: Infark miokard merupakan sindrom koroner akut yang ditandai dengan nekrosis miokardium. Inflamasi menjadi salah satu proses kunci yang terlibat pada infark miokard. Salah satu molekul yang berperan penting dalam progresi infark miokard adalah Nitrogen Oksida (NO), yang dapat diukur secara tidak langsung sebagai kadar nitrit. Sudah banyak studi tentang peran kardioprotektif ekstrak Centella asiatica, namun masih minim studi terkait perannya dalam memodulasi inflamasi infark miokard, khususnya dalam memodulasi pelepasan NO. Penelitian ini bertujuan untuk menganalisis pengaruh ekstrak daun Centella asiatica terhadap kadar nitrit pada jantung tikus dengan infark miokard akibat induksi isoproterenol. Metode: Penelitian ini menggunakan sampel jaringan jantung tikus jantan galur Wistar yang dibagi dalam tiga kelompok, yaitu kelompok normal, kelompok kontrol negatif yang diberikan isoproterenol 85mg/kgBB, dan kelompok isoproterenol dengan ekstrak etanol-air Centella asiatica 200mg/kgBB telah diberikan oleh peneliti utama sebelumnya. Kadar nitrit diukur pada homogenat jaringan jantung tikus dengan kit uji Griess pada panjang gelombang 540nm. Kadar protein di jaringan jantung diukur dengan uji Bradford pada panjang gelombang 595nm. Hasil: Berdasarkan pengukuran kadar nitrit, rata-rata kadar nitrit tertinggi pada kelompok isoproterenol sebesar 0,082 mM, diikuti dengan kelompok isoproterenol yang diberikan ekstrak Centella asiatica sebesar 0,0707mM, dan terakhir kelompok normal sebesar 0,027mM. Terdapat perbedaan kadar nitrit yang signifikan antara kelompok jaringan jantung isoproterenol dengan kelompok normal (p=0,025). Tidak ada perbedaan kadar nitrit yang signifikan antara kelompok yang diberikan isoproterenol dan ekstrak Centella asiatica dengan kelompok normal (p=0,102). Tidak ada perbedaan kadar nitrit yang signifikan antara kelompok isoproterenol dengan kelompok isoproterenol yang diberikan ekstrak Centella asiatica (p=0,520). Adapun berdasarkan hasil pengukuran kadar protein, tidak ada perbedaan kadar protein yang signifikan antara tiga kelompok percobaan. Kesimpulan: Pemberian isoproterenol meningkatkan kadar nitrit pada jaringan jantung tikus secara signifikan dibandingkan jaringan jantung tikus normal (kontrol). Ekstrak etanol-air Centella asiatica dapat menurunkan kadar nitrit pada jaringan jantung tikus dengan infark miokard akibat induksi isoproterenol. ......Introduction: Myocardial infarction is an acute coronary syndrome with myocardium necrosis. Inflammation becomes one of the principal process in myocardial infarction. One of the molecule with prominent role in myocardial infarction progression is Nitrogen Oxide (NO), which can be measured indirectly as nitrite level. There have been many studies on cardioprotective role of Centella asiatica, but there are still few studies on its role for modulating myocardial infarct inflammation, especially modulating NO release. Therefore, this research aims to analyze the effect of Centella asiatica leave extract toward nitrite level in mouse heart with isoproterenol-induced myocardial infarction. Method: This reseach uses heart tissue samples of male wistar mouse divided into three groups, which are normal group , negative control group with 85mg/kgBB isoproterenol , and isoproterenol group with ethanol-water extract of Centella asiatica 200mg/kgBB given by the main researcher before. Nitrie level measurement of mouse heart tissue homogenate is conducted with Griess kit assay at the wavelength 540nm. Protein level measurement of heart tissue is conducted with Bradford assay at the wavelength 595nm.Result: Based on the nitrite level measurement, isoproterenol group has the highest nitrite level average, which is 0.082 mM, followed by isoproterenol with Centella asiatica group with 0.0707 mM, and control group with lowest nitrite level average of 0.027 mM. There is significant nitrite level difference between isoproterenol group and control group (p=0,025). There is not significant nitrite level difference between isoprotrenol with Centella asiatica group and control group (p=0,102). There is not significant nitrite level difference between isoproterenol group and isoprotrenol with Centella asiatica group (p=0,520). Based on the protein level measurement, there is not significant difference of protein level between all of groups. Conclusion: Isoproterenol increases nitrite level of mouse heart tissues significantly compared to the normal mouse heart tissue (control). Ethanol-water Centella asiatica extract can reduce nitrite level in mouse heart tissue with isoproterenol-induced myocardial infarction.

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Latar Belakang: Kematian pada Penyakit Jantung Koroner (PJK) terutama akibat tindakan revaskularisasi yang tertunda atau lesi koroner kompleks yang biasanya lebih buruk pada populasi pasien PGK. Skor Modified ACEF merupakan sebuah perangkat yang memiliki peran penting dalam prognosis mortalitas PJK. Skor mACEF belum pernah digunakan untuk mengevaluasi kompleksitas lesi koroner. Informasi tersebut berguna dalam menentukan prioritas tindakan angiografi koroner. Tujuan: Mendapatkan nilai diagnostik dan titik potong skor mACEF sebagai prediktor kompleksitas lesi koroner pada pasien PGK stadium 3 dan 4 yang mengalami sindrom koroner akut (SKA). Metode: Penelitian ini merupakan uji diagnostik secara retrospektif terhadap 179 subjek PGK stadium 3 dan 4 yang mengalami SKA yang dirawat di ICCU RSCM tahun 2012 hingga 2014. Analisis titik potong skor mACEF dilakukan dengan menggunakan Receiver Operating Characteristic (ROC) curves dengan interval kepercayaan (IK) sebesar 95%. Akurasi diagnostik skor mACEF dinilai dengan cara menghitung sensitivitas, spesifisitas, RKP, dan RKN. Hasil: Titik potong skor mACEF yang optimal adalah 2,288 dengan sensitivitas 90,9%, spesifisitas 63,7%, RKP 2,5, RKN 0,14 dan prevalens 55,3%. Kesimpulan: Titik potong yang optimal skor mACEF pada populasi pasien PGK stadium 3 dan 4 yang mengalami SKA adalah 2,288. Akurasi diagnostik skor mACEF dinilai baik.ABSTRACT
Background: Cardiovascular disease is one of the main causes of death mainly due to delayed revascularization or complex coronary lesions which are usually worse in CKD patients. Modified ACEF (mACEF) score is well established in determining cardiovascular mortality of patients undergoing revascularization therapy and has never been used to evaluate the complexity of coronary lesions before. mACEF score?s potential as a diagnostic tool needs to be evaluated to help stratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as a predictor of coronary lesion complexity in patients with CKD stages 3 and 4 with ACS. Methods: This study is a diagnostic test conducted retrospectively involving 179 subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012 to 2014. Cut-off analysis was performed using ROC curve with confidence intervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed to generate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of 90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainly due to delayed revascularization or complex coronary lesions which are usually worse in CKD patients. Modified ACEF (mACEF) score is well established in determining cardiovascular mortality of patients undergoing revascularization therapy and has never been used to evaluate the complexity of coronary lesions before. mACEF score?s potential as a diagnostic tool needs to be evaluated to help stratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as a predictor of coronary lesion complexity in patients with CKD stages 3 and 4 with ACS. Methods: This study is a diagnostic test conducted retrospectively involving 179 subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012 to 2014. Cut-off analysis was performed using ROC curve with confidence intervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed to generate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of 90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainly due to delayed revascularization or complex coronary lesions which are usually worse in CKD patients. Modified ACEF (mACEF) score is well established in determining cardiovascular mortality of patients undergoing revascularization therapy and has never been used to evaluate the complexity of coronary lesions before. mACEF score?s potential as a diagnostic tool needs to be evaluated to help stratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as a predictor of coronary lesion complexity in patients with CKD stages 3 and 4 with ACS. Methods: This study is a diagnostic test conducted retrospectively involving 179 subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012 to 2014. Cut-off analysis was performed using ROC curve with confidence intervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed to generate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of 90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainly due to delayed revascularization or complex coronary lesions which are usually worse in CKD patients. Modified ACEF (mACEF) score is well established in determining cardiovascular mortality of patients undergoing revascularization therapy and has never been used to evaluate the complexity of coronary lesions before. mACEF score?s potential as a diagnostic tool needs to be evaluated to help stratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as a predictor of coronary lesion complexity in patients with CKD stages 3 and 4 with ACS. Methods: This study is a diagnostic test conducted retrospectively involving 179 subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012 to 2014. Cut-off analysis was performed using ROC curve with confidence intervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed to generate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of 90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.

Abstrak :
ABSTRAK
Latar Belakang: Aritmia selama perawatan merupakan komplikasi yang sering terjadi pada pasien sindrom koroner akut (SKA) sehingga dibutuhkan identifikasi risiko secara dini. Tujuan: Mengetahui insidens pasien SKA yang mengalami aritmia selama perawatan dan mengetahui pengaruh hiperglikemia admisi terhadap kejadian aritmia selama perawatan pasien SKA. Metode: Studi kohort retrospektif ini menggunakan rekam medik pasien SKA yang dirawat di ICCU RSPUN dr. Cipto Mangunkusumo dalam periode 1 Januari-31 Desember 2014. Hiperglikemia admisi didefinisikan sebagai kadar gula darah admisi >140 mg/dL. Kejadian aritmia selama perawatan meliputi aritmia atrium, takikardia supraventrikular, blok AV derajat tinggi, dan aritmia ventrikel, yang diidentifikasi dalam tujuh hari pertama perawatan. Hasil: Terdapat 232 subjek pada penelitian ini. Prevalensi hiperglikemia admisi adalah 50,43%. Insidens pasien SKA yang mengalami aritmia selama perawatan adalah 21,55% (IK 95% 16,26-26,84). Analisis bivariat menunjukkan hiperglikemia admisi terkait dengan peningkatan risiko aritmia selama perawatan (RR 1,747; IK 95% 1,042-2,930). Tidak terdapat hubungan yang bermakna antara jenis SKA, diabetes melitus (DM), obesitas, dan hipertensi dengan kejadian aritmia selama perawatan. Analisis multivariat menunjukkan OR hiperglikemia admisi setelah penyesuaian adalah 2,852 (IK 95% 1,351-6,024), dengan variabel perancu DM. Simpulan: Insidens pasien SKA yang mengalami aritmia selama perawatan adalah 21,55%. Hiperglikemia admisi dapat meningkatkan risiko kejadian aritmia selama perawatan pasien SKA.ABSTRACT Background: The in-hospital arrhythmias complicating acute coronary syndrome (ACS) is a common complication, and its ealy risk identification is urgently needed. Aim: to determine the incidence of in-hospital arrhythmia complicating ACS and to determine the influence of HA on in-hospital arrhythmia complicating ACS. Methods: a retrospective cohort study was conducted using secondary data from medical records of patients with ACS who were admitted to ICCU RSCM between January 1st-Desember 31st, 2014. Hyperglycemia at admission was defined when the blood glucose level at admission was >140 mg/dL. The in-hospital arrhythmias were observed during the first seven days of hospitalization. Result: there were 232 subjects. The prevalence of HA WAS 50.43%. The incidence of in-hospital arrhythmias was 21.55% (95% CI 16.26-26.84). In bivariate analysis, there was significant association between HA and in-hospital arrhythmia (RR 1.747; 95% CI 1.042-2.930). There were no significant relationship among the type of ACS, diabetes mellitus (DM), obesity, and hypertension, with the influence of HA on in-hospital arrhythmia. In multivariate analysis, the adjusted OR of HA was 2.852 (95% CI 1.351-6.024), and DM was the confounding variable. Conclusion: In-hospital arrhythmias is a common complication in patients with ACS. Hyperglycemia at admission may increase the risk of in-hospital arrhythmia complicating ACS. ;Background: The in-hospital arrhythmias complicating acute coronary syndrome (ACS) is a common complication, and its ealy risk identification is urgently needed. Aim: to determine the incidence of in-hospital arrhythmia complicating ACS and to determine the influence of HA on in-hospital arrhythmia complicating ACS. Methods: a retrospective cohort study was conducted using secondary data from medical records of patients with ACS who were admitted to ICCU RSCM between January 1st-Desember 31st, 2014. Hyperglycemia at admission was defined when the blood glucose level at admission was >140 mg/dL. The in-hospital arrhythmias were observed during the first seven days of hospitalization. Result: there were 232 subjects. The prevalence of HA WAS 50.43%. The incidence of in-hospital arrhythmias was 21.55% (95% CI 16.26-26.84). In bivariate analysis, there was significant association between HA and in-hospital arrhythmia (RR 1.747; 95% CI 1.042-2.930). There were no significant relationship among the type of ACS, diabetes mellitus (DM), obesity, and hypertension, with the influence of HA on in-hospital arrhythmia. In multivariate analysis, the adjusted OR of HA was 2.852 (95% CI 1.351-6.024), and DM was the confounding variable. Conclusion: In-hospital arrhythmias is a common complication in patients with ACS. Hyperglycemia at admission may increase the risk of in-hospital arrhythmia complicating ACS.