Penilaian Risiko Beban Iskemik Pasca Intervensi Koroner Perkutan

Abstract

Pendahuluan: Penyakit jantung koroner tetap menjadi penyebab utama kematian global, meskipun kemajuan terapi, khususnya intervensi koroner perkutan (IKP), telah menurunkan angka mortalitas. Namun, risiko kejadian iskemik residual pasca-IKP masih tinggi, sehingga diperlukan stratifikasi risiko yang optimal. Metode: Tinjauan kepustakaan ini bertujuan mengevaluasi berbagai strategi penilaian risiko iskemik yang digunakan pada pasien pasca-IKP. Metode yang digunakan adalah telaah literatur terkait penilaian risiko iskemik menggunakan skor, pencitraan non-invasif, dan pencitraan intravascular. Hasil: setiap sistem penilaian memiliki keunggulan dan keterbatasan dalam memprediksi kejadian iskemik dan perdarahan, serta dalam menentukan durasi terapi antiplatelet. Pencitraan intravaskular merupakan sistem penilaian terperinci. Namun, sistem skor efektif untuk prediksi jangka pendek dan membantu menentukan durasi terapi, meskipun implementasi skor dalam praktik klinis masih terbatas. Kesimpulan: pemilihan sistem penilaian risiko yang tepat dan penyesuaian terapi individual sangat penting untuk meminimalkan risiko iskemik dan perdarahan pada pasien pasca-IKP.

Introduction: Coronary artery disease remains the leading cause of global mortality, despite therapeutic advancements, particularly percutaneous coronary intervention (PCI), which have reduced mortality rates. However, the risk of residual ischemic events post-PCI remains high, necessitating optimal risk stratification. Method: This literature review aims to evaluate various ischemic risk assessment strategies used in post-PCI patients. The methods employed include a literature review related to ischemic risk assessment using scores, non-invasive imaging, and intravascular imaging. Results: each assessment system has advantages and limitations in predicting ischemic and bleeding events, as well as in determining the duration of antiplatelet therapy. Intravascular imaging is a detailed assessment system. However, the scoring system is effective for short-term prediction and helps determine the duration of therapy, although the implementation of the score in clinical practice is still limited. Conclusion: The selection of the appropriate risk assessment system and individual therapy adjustments are crucial to minimize the risk of ischemic and bleeding events in post-PCI patients.