Skripsi

Relationship between multivessel revascularization, type of stent and the occurrence of stent thrombosis. = Hubungan antara revaskularisasi pada multivessel, tipe stent, dan timbulnya stent thrombosis.

Background: A potential link between multivessel revascularization with DES and increased risk of stent thrombosis has caused great concerns for both health providers and patients as it is associated with serious consequences. Aim: To determine the relationship between multivessel revascularization and the occurrence of stent thrombosis and to study the association between the stent types (BMS and DES) usage in multivessel revascularized patients and the occurrence of stent thrombosis Methods: A nested case-control study was conducted in 2008 to 2011 in Harapan Kita Hospital, Jakarta. Patients with definite stent thrombosis (n = 12) were compared with those without stent thrombosis (n = 36) with a ratio of one to three. The multivessel revascularization as the risk factors of stent thrombosis was evaluated within both groups. Then, the association with the usage of bare metal stent and drug-eluting stent was also compared. Results: Patients with multivessel stenting were three times more likely to have stent thrombosis compared to those with single vessel stenting (75% vs. 25%; p = 0.094). The percentages of multivessel stenting with BMS and DES were slightly higher in case group compared to control group [50% vs. 31.8% (p = 0.591); 87.5% vs. 71.4% (p = 0.613); respectively]. Conclusion and recommendation: The increased trend of stent thrombosis occurrence in patients underwent multivessel stenting with DES warrants future studies to be conducted. Keywords: stent thrombosis; multivessel revascularization; single vessel revascularization; drug-eluting stents; bare metal stents. ///// Latar belakang:Potensi hubungan antara revaskularisasi pada multivessel dengan stent berlapis obat dan peningkatan resiko stent thrombosis telah menimbulkan kekhawatiran hebat, mengingat kaitannya dengan konsekuensi yang serius,. Tujuan: Menyelidiki asosiasi antara revaskularisasi pada multivessel dan kejadian stent thrombosis serta mempelajari hubungan antara jenis stent pada pasien dengan revaskularisasi di multivessel dan kejadian stent thrombosis. Methods: Sebuah studi kasus-kontrol bersarang dilaksanakan pada tahun 2008 sampai 2011 di Rumah Sakit Harapan Kita, Jakarta. Pasien dengan definite stent thrombosis (n = 12) dibandingkan dengan pasien tanpa stent thrombosis (n = 36). Rasio kontrol dan kasus adalah tiga banding satu. Perbandingan kemudian dilakukan pada kedua kelompok tersebut berdasarkan status revaskularisasi pada multivessel dan penggunaan stent berlapis obat. Results: Pasien yang direvaskularisasi pada multivessel memiliki resiko tiga kali lebih besar dalam hal terjadinya stent thrombosis dibandingkan pasien yang divaskularisasi pada satu pembuluh darah saja (75% vs. 25%; p = 0.094). Grup kasus memiliki persentase revaskularisasi pada multivessel dengan stent berlapis obat dan stent berlapis besi yang lebih tinggi daripada grup kontrol. [masing- masing, 50% vs. 31.8% (p = 0.591); 87.5% vs. 71.4% (p = 0.613)]. Kesimpulan dan rekomendasi: Kecenderungan peningkatan kejadian stent thrombosis pada pasien yang direvaskularisasi pada multivessel, terutama dengan stent berlapis obat, masih harus dipastikan dengan penelitian lebih lanjut.
Keywords: stent thrombosis; stent berlapis obat; stent berlapis besi; revaskularisasi pada multivessel; revaskularisasi pada single vessel.