Terapi Antiplatelet Ganda Durasi Pendek terhadap Durasi Standar pada Pasien Resiko Perdarahan Tinggi setelah Intervensi Koroner Perkutan: Litteratur Review

Kurnia Eryani, Bambang Subakti Z

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ABSTRACT

 

Percutaneous coronary intervention (PCI) is a procedure involving stent placement that is commonly performed in patients with acute coronary syndrome (ACS) to increase oxygen perfusion to the myocardium. Dual antiplatelet therapy (DAPT) after PCI is important to prevent stent thrombosis. The duration of DAPT therapy along with the development of new generation drug eluting stents (DES) can be shortened by 1-3 months but it is necessary to consider the risk of bleeding and ischemia in patients. The purpose of this literature review is to update the ischemic and bleeding outcomes in the use of DAPT therapy for 1 and 3 months compared to the standard therapy duration of 6 and 12 months in patients with high bleeding risk after PCI. This research method is qualitative by conducting a search using the PubMed and Science direct databases with a publication year limit of 2019-2024. The articles obtained were selected based on inclusion and exclusion criteria. The results obtained were 5 research articles with a total population of 16,654 participants and 1 article with a randomized clinical trial (RCT) design. The results of using short-term DAPT therapy with standard duration by looking at the results of myocardial ischemia and bleeding through NACE, MACCE, death/myocardial infarction, stent thrombosis, and bleeding measurements. All articles provide results of short-term DAPT therapy (1-3 months) that are not inferior to the results of standard therapy duration.

 

Keywords: Acute coronary syndrome (ACS); Percutaneous coronary intervention (PCI); Dual antiplatelet therapy (DAPT); High bleeding risk (HBR)

 

ABSTRAK

 

Intervensi koroner perkutan (IKP) merupakan tindakan dengan pemasangan stent yang biasa dilakukan pada pasien sindrom koroner akut (SKA) untuk meningkatkan perfusi oksigen ke miokard jantung. Terapi antiplatelet ganda setelah tindakan IKP penting untuk mencegah trombosis stent. Durasi terapi antiplatelet ganda seiring perkembangan drug eluting stent (DES) generasi baru penggunaanya dapat diperpendek 1- 3 bulan, namun perlu mempertimbangkan risiko perdarahan dan iskemia pada pasien. Tujuan litteratur review ini untuk mengupdate hasil iskemia dan perdarahan pada penggunaan terapi DAPT durasi 1 dan 3 bulan dibandingkan dengan durasi terapi standar 6 dan 12 bulan pada pasien resiko perdarahan tinggi setelah IKP. Penelitian ini menggunakan metode kualitatif dengan desain litteratur review. Data dikumpulkan dari berbagai referensi yang diperoleh melalui pencarian di database PubMed dan ScienceDirect, dengan pembatasan pada artikel yang diterbitkan antara tahun 2019 dan 2024. Proses seleksi artikel dilakukan melalui screening cepat, menghasilkan 5 artikel penelitian dengan total populasi 16.654 peserta, serta 1 artikel yang menggunakan desain uji klinis acak (randomized clinical trial, RCT). Hasil penggunaan terapi DAPT durasi pendek dengan durasi standar dengan melihat hasil iskemia miokard dan perdarahan melalui pengukuran NACE, MACCE, kematian/ infark miokard, trombosis stent, dan perdarahan. Semua artikel memberikan hasil terapi DAPT durasi pendek (1-3 bulan) tidak kalah dibandingkan hasil durasi terapi standar.

 

Kata Kunci: Sindrom koroner akut (SKA); Intervensi koroner perkutan (IKP); Terapi antiplatelet ganda; Risiko perdarahan tinggi


Kata Kunci


Acute coronary syndrome (ACS); Percutaneous coronary intervention (PCI); Dual antiplatelet therapy (DAPT); High bleeding risk (HBR)

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Referensi


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DOI: https://doi.org/10.33024/mnj.v6i10.17121

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