Tesis

Modifikasi Skor TIMI untuk Prediksi Mortalitas 30 hari Pasca Intervensi Koroner Perkutan Primer pada Pasien STEMI di RSCM = TIMI Score Modification in Predicting 30-Day Mortality Following Primary Percutaneous Coronary Intervention among STEMI Patients at RSCM.

Latar Belakang Skor TIMI sudah digunakan luas dalam praktek, tapi belum ada studi yang menambahkan variabel-variabel temuan hasil tindakan IKPP ke skoring TIMI. Studi ini melihat pengaruh 3 variabel tambahan hasil temuan IKPP yaitu fraksi ejeksi berdasarkan ekokardiografi pasca Intervensi Koroner Perkutan Primer, TIMI flow dan jumlah lesi pada populasi STEMI yang menjalani IKPP di RSCM menilai mortalitas 30 hari Tujuan Mendapatkan modifikasi skor TIMI yang memiliki kemampuan lebih baik untuk memprediksi mortalitas 30 hari pasien STEMI di RSCM pasca Intervensi Koroner Perkutan Primer Metode Studi kohort retrospektif dari data rekam medis RSCM pasien STEMI menjalani IKPP dari Januari 2018 sampai November 2024. Dilakukan analisis univariat untuk proporsi mortalitas 30 hari pasien STEMI pasca IKPP. Dilakukan analisis bivariat untuk melihat hubungan fraksi ejeksi berdasarkan ekokardiografi pasca Intervensi Koroner Perkutan Primer, TIMI flow dan jumlah lesi dengan mortalitas 30 hari. Dilakukan uji validasi skor TIMI, dan analisis multivariat untuk mendapatkan model prediksi baru Hasil Dari 230 subjek penelitian, didapatkan proporsi mortalitas 30 hari pasien STEMI pasca IKPP sebesar 10%. Tidak terdapat hubungan bermakna antara fraksi ejeksi berdasarkan ekokardiografi pasca IKPP, TIMI flow serta jumlah lesi dengan mortalitas 30 hari pasca IKPP pada pasien STEMI. Performa diskriminasi skor TIMI dalam memprediksi mortalitas 30 hari pasca Intervensi Koroner Perkutan Primer pada pasien STEMI di RSCM sangat baik (AUC 0,901), dengan kalibrasi baik. Kesimpulan Performa diskriminasi skor TIMI dalam memprediksi mortalitas 30 hari pasca Intervensi Koroner Perkutan Primer pada pasien STEMI di RSCM sangat baik (AUC 0,901 IK 95% 0,849 – 0,952), dengan kalibrasi baik.
Kata Kunci STEMI, IKPP, mortalitas


Background This study aims to validate the TIMI score and also assess the validity of a modified TIMI score that includes three additional variables from PPCI findings: left ventricular ejection fraction based on echocardiography post-Primary Percutaneous Coronary Intervention, TIMI flow, and the number of lesions, in a population of STEMI patients undergoing PPCI at RSCM, with a focus on predicting 30-day mortality. Objective To develop a modified TIMI score with enhanced ability to predict 30- day mortality among STEMI patients at RSCM following Primary Percutaneous Coronary Intervention (PPCI). Methods This is a retrospective cohort study utilizing medical record data from STEMI patients who underwent PPCI at RSCM from January 2018 to November 2024. Univariate analysis was performed to determine the 30-day mortality rate of STEMI patients post-PPCI. Bivariate analysis was conducted to examine the relationship between left ventricular ejection fraction based on echocardiography post-PPCI, TIMI flow, the number of lesions, and 30-day mortality. Validation testing of the TIMI score was conducted, followed by multivariable analysis to derive a new predictive model Results Among 230 study subjects, the 30-day mortality rate for STEMI patients post-PPCI was 10%. There was no significant association between ejection fraction based on echocardiography after PPCI, TIMI flow or the number of lesions and 30- day mortality post-PPCI in STEMI patients. The discrimination performance of the TIMI score in predicting 30-day mortality post-PPCI in STEMI patients at RSCM was very good (AUC 0,901), with good calibration Conclusion In conclusion, the performance of the TIMI score in predicting 30-day mortality after Primary Percutaneous Coronary Intervention in STEMI patients at RSCM is excellent (AUC 0.901, 95% CI 0.849 – 0.952), with good calibration.
Keywords STEMI, PPCI, Primary PCI, mortality