Tesis

Hubungan Vulnerable Plaquedengan Sindrom Koroner Akut Pasien risiko atau suspek PJK di RS Jantung Pembuluh Darah Harapan Kita = The Correlation between Vulnerable Plaque with Acute Coronary Syndrome in patient with risk or suspect Coronary Heart Dsease at Harapan Kita Heart and Vascular Hospital.

Latar belakang dan Tujuan : Kejadian sindrom koroner akut (SKA) pada pasien risiko atau suspek penyakit jantung koroner (PJK) terkait dengan tipe plaque-nya. Coronary Computed Tomography Angiography (CCTA) merupakan modalitas pilihan untuk melihat adanya soft plaque, mixed plaque dan calcified plaque pada arteri koronaria. Mengetahui hubungan antara vulnerable plaque dengan kejadian SKA pada pasien yang telah diperiksa CCTA menjadi informasi tambahan dalam evaluasi dan penatalaksanaan pasien. Metode.: Penelitian dilakukan retrospektif dengan comparative cross sectional pada 165 pasien risiko atau suspek PJK yang menjalani pemeriksaan CCTA dan kontrol rutin berobat di RS JPDHK dalam rentang waktu Juli 2014 – Juli 2015. Subjek dibagi menjadi soft plaque dan mixed plaque yang termasuk vulnerable plaque serta calcified plaque. Dilakukan penilaian rerata Hounsfield Unit dan perhitungan remodeling indeks (RI) untuk melihat komponen positif remodeling(PR). Hasil : Dari total 165 subjek penelitian dengan perhitungan Chi square didapatkan hubungan yang bermakna pada 81 subjek vulnerable plaque yang mengalami SKA dengan nilai p < 0,001 dan OR : 6.55. Selain itu didapatkan juga hubungan yang bemakna antara soft plaque dan mixed plaque dengan positif remodeling dibandingkan tanpa positif remodeling terkait kejadian SKA dengan nilai p : 0,039 dan OR : 2,92. Kesimpulan : Terdapat hubungan yang bermakna antara vulnerable plaque pada pasien risiko atau suspek PJK dengan kejadian SKA,sehingga perlu dilakukan penilaian rerata Hounsfield Unit dan perhitungan remodeling indeks sebagai kriteria yang perlu dicantumkan pada setiap keadaan vulnerable plaque.
Kata kunci : Penyakit jantung koroner, vulnerable plaque, sindrom koroner akut



Background and Objective : Acute coronary syndrome (ACS) event in risk or suspect of coronary artery disesase depent on their plaque type. Coronary Computed Tomography Angiography (CCTA) is modality of choice to recognise soft plaque, mixed plaque and calcified plaque in coronary artery disease (CAD). Correlation between vulnerable plaque with ACS event in risk or suspek CAD that already examined by CCTA have additional information for evaluation and treatment patient. Methods : Comparative cross sectional retrospective study in 165 patient with risk or CAD that already examined by CCTA and routine control at RS JPDHK in July 2014 to July 2015. Subject divided to soft plaque and mixed plaque that categorized as vulnerable plaque and calcified plaque, also assessment average value of Hounsfield Unit and quantification of remodeling index to see the positive remodeling. Results : From total 165 subject study with Chi squre test there is correlation in 81 subject of vulnerable plaque related to ACS with p < 0,001 and OR : 6,55. Besides that there also correlation between soft plaque and mixed plaque with posistif remodeling compare without positive remodeling with value p 0,039 and OR : 2,92 Conclusions : There is correlation between ACS event and vulnerable plaque in patient with risk or suspect CAD with the result that need to estimated average value Hounsfield Unit and quantification remodeling index as criteria that must be assign in every vulnerable plaque condition
Keys words : Coronary artery disease, vulnerable plaque,acute coronary syndrome