Manajemen Pemberian Dual Antiplatelet Therapy (DAPT) Pada Pasien Sindrom Koroner Akut Dengan Trombositopenia
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Keywords

Dual Antiplatelet Therapy
Sindrom Koroner Akut,
Trombositopenia

How to Cite

Yusa, Z. H., & Muyasir, M. (2023). Manajemen Pemberian Dual Antiplatelet Therapy (DAPT) Pada Pasien Sindrom Koroner Akut Dengan Trombositopenia. Journal of Medical Science, 4(2), 82–96. https://doi.org/10.55572/jms.v4i2.108

Abstract

Berdasarkan data Riset Kesehatan Dasar (Riskesdas) 2018, prevalensi penyakit jantung koroner sebagai etiologi utama sindrom koroner akut (SKA) di Indonesia sebesar 1,5%. Sekitar 5,4% pasien dengan penyakit arteri koroner (PAD) dan 0,9% pasien dengan SKA didiagnosis dengan trombositopenia. Menurut American Heart Association (AHA)/American College of Cardiology Foundation (ACCF) dan European Society of Cardiology (ESC), pemberian dual antiplatelet therapy (DAPT) yang terdiri dari aspirin dan antagonis reseptor P2Y12 adalah komponen mendasar dari manajemen SKA. Selain itu, terapi definitif berupa intervensi koroner perkutan (IKP), harus disertai dengan kombinasi obat antiplatelet dan antikoagulan untuk mencegah pembentukan trombus di lokasi intervensi koroner. Studi melaporkan bahwa trombositopenia yang diinduksi agen antiplatelet berkorelasi dengan mortalitas dan komorbiditas jangka pendek dan jangka panjang yang lebih tinggi pada pasien dengan SKA. Pada pasien dengan SKA dan trombositopenia, manajemen terapi pemberian antiplatelet masih sulit untuk dipertimbangkan dan saat ini tidak ada pedoman rekomendasi atau laporan konsensus untuk memandu dokter tentang manajemen pada kelompok ini. Oleh karena itu, kami berusaha untuk menjelaskan dari berbagai macam studi literatur tentang penggunaan DAPT pada pasien SKA dengan trombositopenia.

https://doi.org/10.55572/jms.v4i2.108
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References

Bates, E. R. (2013). Effect of platelet inhibition with cangrelor during PCI on ischemic events, Cardiology Review. 29(3), 1303-1313. doi: 10.1056/nejmoa1300815.

Biino, G. et al. (2013). Age- And Sex-Related Variations in Platelet Count in Italy: A Proposal of Reference Ranges Based on 40987 Subjects Data, PLoS ONE, 8(1), 1-7. doi: 10.1371/journal.pone.0054289.

Campo, G. et al. (2012). Medical and interventional management of patients with severe thrombocytopenia undergoing percutaneous coronary intervention, Journal of Thrombosis and Haemostasis, 10(1), 153-156. doi: 10.1111/j.1538-7836.2011.04563.x.

Chao, C. J. et al. (2021). Baseline thrombocytopenia in acute coronary syndrome: The lower, the worse, International Journal of Cardiology, 332, 1-7. doi: 10.1016/j.ijcard.2021.03.059.

Claassens, D. M. F. et al. (2019). A Genotype-Guided Strategy for Oral P2Y 12 Inhibitors in Primary PCI, New England Journal of Medicine, 381(17), 1621-1631. doi: 10.1056/nejmoa1907096.

Dasanu, C. A., Lamana, S. and Trikudanathan, G. (2010). Thrombocytopenia in NAFLD: Is thrombopoietin involved?, Southern Medical Journal, 103(2), 1278-1279. doi: 10.1097/SMJ.0b013e3181fa61ef.

Hakim, D. A. et al. (2011). Impact of baseline thrombocytopenia on the early and late outcomes after ST-elevation myocardial infarction treated with primary angioplasty: Analysis from the Harmonizing Outcomes with revascularization and stents in acute myocardial infarction (HORIZONS-AMI), American Heart Journal, 161(2), 391-396. doi: 10.1016/j.ahj.2010.11.001.

Levine, G. N. et al. (2011). 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, Journal of the American College of Cardiology, 124(23), 574-651. doi: 10.1016/j.jacc.2011.08.007.

Levine, G. N. et al. (2016). 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease, The Journal of Thoracic and Cardiovascular Surgery, 134(10), e123-e155. doi: 10.1016/j.jtcvs.2016.07.044.

Liu, R. et al. (2022). Long-term effects of baseline on-treatment platelet reactivity in patients with acute coronary syndrome and thrombocytopenia undergoing percutaneous coronary intervention, Journal of International Medical Research, 50(4), 1-15. doi: 10.1177/03000605221081725.

Makris, M. et al. (2013). Guideline on the management of bleeding in patients on antithrombotic agents, British Journal of Haematology, 160, 35-46. doi: 10.1111/bjh.12107.

McCarthy, C. P. et al. (2017). The management of antiplatelet therapy in acute coronary syndrome patients with thrombocytopenia: A clinical conundrum, European Heart Journal, 38, 3488-3492. doi: 10.1093/eurheartj/ehx531.

McClure, M. W. et al. (1999). Clinical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome: The platelet glycoprotein IIb/IIIa in unstable angina: Receptor suppression using integrilin therapy (pursuit) trial experience, Circulation, 99(22), 2892-2900. doi: 10.1161/01.CIR.99.22.2892.

Napolitano, G. et al. (2017). Bleeding after invasive procedures is rare and unpredicted by platelet counts in cirrhotic patients with thrombocytopenia, European Journal of Internal Medicine, 38, 79-82. doi: 10.1016/j.ejim.2016.11.007.

Oktaviono, Y. H. and Meuthia, F. (2021). Thrombocytopenia in a Patient Undergoing Primary Percutaneous Coronary Intervention, Folia Medica Indonesiana, 55(1), 68-73. doi: 10.20473/fmi.v55i1.24434.

Overgaard, C. B. et al. (2008). Thrombocytopenia at baseline is a predictor of inhospital mortality in patients undergoing percutaneous coronary intervention, American Heart Journal, 156(1), 0-124. doi: 10.1016/j.ahj.2008.02.003.

Rocco, E. et al. (2020). Thrombosis & Haemostasis : Research Acute Coronary Syndromes in Patients with Thrombocytopenia, 4(1), 1037.

Roizen, M. F. (2008). Impact of Aspirin Therapy in Cancer Patients With Thrombocytopenia and Acute Coronary Syndromes, Yearbook of Anesthesiology and Pain Management, 2008, 14-15. doi: 10.1016/s1073-5437(08)70783-6.

Sinkovič, A. and Majal, M. (2015). The Impact of Thrombocytopenia on Outcome in Patients with Acute Coronary Syndromes: A Single Center Retrospective Study, BioMed Research International, 2015(5), 1-7. doi: 10.1155/2015/907304.

Spoon, D. B. et al. (2013). Outcomes After PCI In Patients With Thrombocytopenia, Journal of the American College of Cardiology, 61(10), e1718. doi: 10.1016/s0735-1097(13)61718-0.

Steg, P. G. et al. (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation, European Heart Journal, 33(20), 2569-2619. doi: 10.1093/eurheartj/ehs215.

Tosetto, A. et al. (2009). Management of bleeding and of invasive procedures in patients with platelet disorders and/or thrombocytopenia: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET), Thrombosis Research, 124(5), e13-8. doi: 10.1016/j.thromres.2009.06.009.

Urban, P. et al. (2015). Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk, New England Journal of Medicine, 373(21), 2038-47. doi: 10.1056/nejmoa1503943.

Valgimigli, M. et al. (2015). Zotarolimus-eluting versus bare-metal stents in uncertain drug-eluting stent candidates, Journal of the American College of Cardiology, 65(8), 805-815. doi: 10.1016/j.jacc.2014.11.053.

Wang, T. Y. et al. (2009). Incidence and prognostic significance of thrombocytopenia developed during acute coronary syndrome in contemporary clinical practice, Circulation, 119(18), 2454-62. doi: 10.1161/CIRCULATIONAHA.108.827162.

Warkentin, T. E. and Crowther, M. A. (2009). Adverse prognostic significance of thrombocytopenia in acute coronary syndrome: Can anything be done about it?, Circulation, 119(18), 2420-2422. doi: 10.1161/CIRCULATIONAHA.109.858316.

Yadav, M. et al. (2016). Effect of Baseline Thrombocytopenia on Ischemic Outcomes in Patients With Acute Coronary Syndromes Who Undergo Percutaneous Coronary Intervention, Canadian Journal of Cardiology, 32(2), 226-33. doi: 10.1016/j.cjca.2015.05.020.

Yusuf, S. W. et al. (2010). Antiplatelet therapy and percutaneous coronary intervention: In patients with acute coronary syndrome and thrombocytopenia, Texas Heart Institute Journal, 37(3), 336-40.

PERKI. Pedoman Tatalaksana Sindrom Koroner Akut. 4th ed.; 2018. www.inaheart.org.

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Copyright (c) 2023 Zainur Hafiz Yusa; Muyasir

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