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Abstrak :
STEMI masih menjadi penyebab kasus kematian utama di Indonesia. Di Jakarta, angka kejadian STEMI meningkat setiap tahunnya. IKP primer merupakan tindakan utama untuk penanganan STEMI, namun tidak mengatasi penyebab terjadinya oklusi. Pengetahuan pencegahan sekunder diperlukan untuk mencegah terjadinya restenosis sehingga mampu meningkatkan kualitas hidup setelah IKP primer. Penelitian ini memiliki tujuan untuk mengetahui hubungan antara tingkat pengetahuan pencegahan sekunder dengan kualitas hidup pada pasien STEMI Pasca IKP Primer. Desain penelitian ini bersifat analitik dengan pendekatan potong lintang cross sectional. Responden terdiri dari 60 pasien STEMI pasca IKP Primer yang dipilih melalui teknik consequtive sampling. Instrumen yang digunakan Maugerl Cardiac Prevention Questionnare MICRO-Q dan Seattle Angina Questionaire-7 SAQ 7. Hasil penelitian menunjukkan hasil tidak ada hubungan yang bermakna antara tingkat pengetahuan pencegahan sekunder dengan kualitas hidup pada STEMI pasca IKP primer p=0,662; =0,05. Namun, pengetahuan pencegahan sekunder penting untuk tetap diperlukan sabagai salah satu komponen yang dapat meningkatkan kualitas hidup pada pasien STEMI pasca IKP primer. ...... STEMI is one a leading cause of death cases in Indonesia. In Jakarta, the incidence of STEMI increases anually. Primary PCI is the main treatment eventhough it is not the causes of occlusion. Secondary prevention knowledge is needed to prevent the occurrence of restenosis so it can improve quality of life after primary PCI. This research has purpose to know the relationship between knowledge level about secondary prevention and quality of life in STEMI patient after Primary PCI. This is analytic with cross sectional approach. Respondents consisted of 60 STEMI patients post Primary PCI selected through concequtive sampling technique. The instrument is the Maugerl Cardiac Prevention Questionnare MICRO Q and Seattle Angina Questionaire 7 SAQ 7. The results showed no correlation between knowledge level and quality of life in STEMI after primary IKP p 0,662 0,05. However, secondary prevention knowledge is important to remain as one of the components that can improve quality of life in STEMI post primary IKP.

Abstrak :
Latar belakang: COVID-19 menyebabkan respon inflamasi sistemik yang dapat disertai dengan pembentukan trombus koroner dan berhubungan dengan morbiditas serta mortalitas yang tinggi. Pasien IMA-EST yang menjalani IKPP dengan beban trombus intrakorener yang tinggi berhubungan dengan luaran klinis yang lebih buruk. Tujuan: Mengetahui hubungan antara COVID-19 dengan beban trombus intrakoroner pada pasien IMA-EST yang menjalani IKPP. Metode: Terdapat 181 pasien IMA-EST yang menjalani intervensi koroner perkutan primer (IKPP) pada periode April 2020 hingga November 2021 dianalisis secara retrospektif. Beban trombus intrakoroner menurut TIMI saat IKPP dibagi menjadi beban trombus tinggi (BTT) dan beban trombus rendah (BTR). COVID-19 dibagi menjadi positif dan negatif berdasarkan pemeriksaan laboratorium, kemudian dinilai hubungannya dengan BTT. Hasil: Beban trombus intrakoroner tinggi berdasarkan TIMI didapatkan pada 70,2% pasien. Subjek COVID-19 positif cenderung mempunyai resiko 3,03 kali (95% IK: 1,11 – 8,31; p=0,025) untuk mengalami BTT. Namun, dari analisis multivariat tidak didapatkan hubungan antara status positif COVID-19 dengan BTT. Pada model akhir analisis multivariat, faktor risiko yang berhubungan dengan kejadian beban trombus tinggi adalah nilai CRP > 5 mg/L dengan odds ratio 3,29 (95% IK: 1,09 – 9,88; p=0,034) dan merokok (OR 2,92; 95% IK: 1,12 – 7,58; p=0,027). Kesimpulan: Status COVID-19 positif tidak berhubungan dengan kondisi beban trombus intrakoroner tinggi pada pasien IMA-EST yang menjalani IKPP. Kata Kunci: IKP primer; IMA-EST; COVID-19; C-reactive protein; trombus; beban trombus ......Introduction: COVID-19 infection causes a systemic inflammatory response that increases the activation of coagulation system prone to hypercoagulable conditions that can trigger thrombus formation. Erosion of susceptible atherosclerotic plaques can lead to intracoronary thrombus which is the main cause of ST segment elevation acute myocardial infarction (STEMI). STEMI patients undergoing primary percutaneous coronary intervention (PPCI) with a high intracoronary thrombus burden were associated with a worse clinical outcome. Objective: Aimed to determine association between COVID-19 positivity and other factors related to intracoronary thrombus burden in STEMI. Methode: A total of 181 patients with STEMI who underwent PPCI between April 2020 and November 2021 were retrospectively analized. Intracoronary thrombus burden based on TIMI criteria was reclassified into high thrombus burden (HTB) and low thrombus burden (LTB). HTB was analyzed with COVID-19 which divided into positive and negative based on laboratory results. Results: HTB was found in 70,2% patients. Positive COVID-19 patients tend to showed HTB during PPCI (OR 3,03; 95% IK: 1,11–8,31; p=0,025). From multivariate analysis, there is no association between COVID-19 positivity and HTB. In the last model of multivariate analysis, CRP > 5 mg/L (OR 3,29; 95% IK: 1,09 – 9,88; p=0,034) and smoking status (OR 2,92; 95% IK: 1,12 – 7,58; p=0,027) were associated with HTB. Conclusion: There is no association between COVID-19 positivity and HTB in STEMI patients underwent PPCI. Keywords: Primary PCI; STEMI; COVID-19; intracoronary thrombus; thrombus burden.

Abstrak :
Latar Belakang: Angka defisiensi besi di negara berkembang sangat tinggi dibandingkan negara maju dan hubungan antara defisiensi besi dengan myocardial blush kuantitatif pada pasien infark miokard akut disertai elevasi segmen ST (IMA-EST) yang menjalani intervensi koroner perkutan primer (IKPP) belum pernah dilakukan. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara defisiensi besi dengan myocardial blush kuantitatif pada pasien IMA-EST yang menjalani IKPP. Metode: Kami mengevaluasi 64 pasien IMA-EST yang menjalani IKPP dan memenuhi kriteria untuk dilakuakan penilaian myocardial blush kuantitatif menggunakan program Quantitative Blush Evaluator (QuBE). Penilaian defisiensi besi diukur menggunakan feritin, serum besi, dan total iron binding capacity (TIBC). Hasil: Pasien dengan defisiensi besi memiliki nilai QuBE yang 7,48 kali lebih buruk dibandingkan dengan pasien tanpa defisiensi besi. Analisis multivariat menunjukan bahwa defisiensi besi merupakan prediktor terhadap nilai QuBE yang rendah (OR 7,48, 95% interval kepercayaan 1,78-31,49, p 0,006). Kesimpulan: Terdapat hubungan antara defisiensi besi dengan nilai QuBE yang lebih buruk pada pasien IMA-EST yang menjalani IKPP ......Background: Prevalence of iron deficiency in developing countries is higher than developed country, and association between iron deficiency and quantitative myocardial blush in acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been investigated. Objective: This study sought to evaluate the association between iron deficiency and quantitative myocardial blush of patient with acute STEMI undergoing primary PCI. Methods: We enrolled 64 patients with acute STEMI underwent primary PCI who fulfilled the standard criteria for quantitative myocardial blush evaluation using quantitative blush evaluator (QuBE). Iron deficiency were measure by ferritin, serum iron, and total iron binding capacity (TIBC). Results: Patients with Iron deficiency 7,48 times risk of poor QuBE index than group without iron deficiency. Multivariate logistic analysis showed that iron deficiency was an predictor of a poor QuBE index (OR 7,48, 95% confidence interval 1,78-31,49, p 0,006). Conclusion: There is association between iron deficiency with poor QuBE index in patients STEMI undergoing primary PCI.

Abstrak :
Much has been written about reperfusion injury in the past decade but unfortunately the information has been generally presented in the form of original specialist papers and little if any integral publication exists on the topic, summarising and analysing the clinical impact of the condition and its management. The pathophysiology and molecular mechanisms of reperfusion injury are complex and, regarding diagnosis, individual diagnostic techniques have been proposed but without a proper assessment of the relative values of these methods. A publication dealing with integral diagnostic strategies would be welcome by the managing physician. Management of the condition is also problematic, as strategies that appear to work in the experimental models do not translate into beneficial interventions in patients. There is a need for these issues to be addressed and discussed in a monographic fashion. Management of myocardial reperfusion injury will tackle these issues in a modern and systematic way and the information will be delivered in a fashion that will be appealing to the reader.