Tesis

Perbandingan Nilai Diagnostik High Sensitive Troponin T jam ke-1 dan jam ke-3 pada Terduga Sindrom Koroner Akut Non Elevasi Segmen ST = Comparison of High Sensitive Troponin T Diagnostic Value at One Hour and 3 hour of Suspect Acute Coronary Syndrome Non ST Elevation.

Sindrom koroner akut (SKA) merupakan salah satu kegawatan kardiovaskular di Instalasi Gawat Darurat (IGD). Tatalaksana SKA yang ada saat ini membutuhkan waktu minimal 3 jam untuk menentukan apakah pasien dirawat atau dipulangkan, hal ini akan berdampak pada kepadatan IGD dan pemborosan biaya perawatan. European Society of Cardiology merekomendasikan algoritma 0/1 jam pada pasien dengan gambaran EKG non elevasi segmen ST (NEST) dengan menggunakan high sensitive troponin T (hscTnT) dalam menegakkan atau penapisan infark miokard akut non elevasi segmen ST (IMA-NEST). Penelitian ini bertujuan untuk membandingkan nilai diagnostik hs-cTnT jam ke-1 dan jam ke-3 pada terduga SKA non elevasi segmen ST dengan awitan nyeri dada kurang dari 6 jam. Desain penelitian potong lintang. Sebanyak 100 subjek penelitian yang diambil secara konsekutif sampling. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif kadar hs-cTnT 0/1 jam secara berurutan adalah 93,75%, 98,81%, 93,75%, 98,81%, sementara sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif kadar hs-cTnT 0/3 jam secara berurutan adalah 87,50%, 96,81%, 93,33% 97,65%. Pemeriksaan hs-cTnT 0/1 jam dapat dipergunakan dalam rule in dan rule out terduga IMA-NEST dengan awitan nyeri dada kurang dari 6 jam.
Kata kunci: Nyeri dada, algoritma 0/1 jam, infark miokard


Acute coronary syndrome (ACS) is one of the cardiovascular events in an Emergency Installation (ED). The patients management of ACS required at least 3 hours to determined whether the patient hospitalized or outpatient, these would increased ED’s crowded and high cost treatment. The European Society of Cardiology recommended a 0/1 hour algorithm in patients with ECG showed non ST segment elevationusing high sensitive troponin T (hs-cTnT) parameter to rule in or rule out non ST segment elevation myocard infarct (NSTEMI).We aimed to compare diagnostic values of hscTnT at the 1st and 3rd hour in NSTEMI with chest pain onset less than 6 hours. Study design was cross sectional. A total of 100 subjects enrolled by consecutive sampling method. Sensitivity, specificity, positive predictive value, and negative predictive value of hs-cTnT 0/1 hours were 93.75%, 98.81%, 93.75%, 98.81%, while sensitivity, specificity, positive predictive value, and the negative predictive value of hs-cTnT 0/3 hours were 87.50%, 96.81%, 93.33%, 97.65%. Hs-cTnT 0/1 hour test can be used in rule in and rule out suspect NSTEMI with the chest pain onset less than 6 hours.
Keywords: Chest pain, 0/1 hour algorithm, myocard infarct.