Eksplorasi Faktor-Faktor Determinan Time In Therapeutic Range Pada Pasien Lanjut Usia Dengan Fibrilasi Atrium

Agata Christi Febriani Wanggol; Chairun Wiedyaningsih; I Dewa Putu Pramantara Setiabudi

doi:10.22146/farmaseutik.v21i1.103532

Eksplorasi Faktor-Faktor Determinan Time In Therapeutic Range Pada Pasien Lanjut Usia Dengan Fibrilasi Atrium

https://doi.org/10.22146/farmaseutik.v21i1.103532

Agata Christi Febriani Wanggol^(1*), Chairun Wiedyaningsih⁽²⁾, I Dewa Putu Pramantara Setiabudi⁽³⁾

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Departememn Farmasetika, Fakultas Farmasi, Universitas Gadjah Mada
(3) Departemen Ilmu Penyakit Dalam, Divisi Geriatri FKKMK, Universitas Gadjah Mada
(*) Corresponding Author

Abstract

Warfarin telah lama digunakan sebagai antikoagulan utama untuk fibrilasi atrium. Dengan indeks terapi sempit, penggunaannya membutuhkan pemantauan ketat, terutama pada lansia yang mengalami perubahan fisiologis yang memengaruhi farmakokinetik dan farmakodinamiknya. Time in therapeutic range (TTR) menjadi parameter utama untuk menilai kualitas kontrol antikoagulasi Warfarin. Penelitian ini bertujuan untuk mengeksplorasi faktor-faktor determinan TTR pada pasien lanjut usia dengan fibrilasi atrium kronik. Penelitian ini adalah penelitian observasional dengan desain cross sectional. Data diperoleh dari rekam medis pasien fibrilasi atrium yang menjalani rawat jalan di Poli Jantung RSUP Dr. Sardjito Yogyakarta. Pengambilan sampel dilakukan dengan metode consecutive sampling. Sebanyak 40 pasien yang memenuhi kriteria inklusi dan eksklusi diikutsertakan dalam penelitian ini. Hasil penelitian menunjukkan bahwa indeks massa tubuh dan risiko perdarahan (HAS-BLED) berpengaruh terhadap kualitas kontrol antikoagulasi Warfarin. Pasien non-obesitas berpotensi kecil untuk mencapai kontrol antikoagulasi yang baik (TTR ≥65%) dibandingkan pasien obesitas (OR = 0,14, CI 95% = 0,02 – 0,91, p = 0,039), pasien dengan risiko perdarahan rendah-sedang (skor HAS-BLELD 1-2) 9,1 kali lebih berpotensi mencapai TTR ≥65% dibandingkan pasien berisiko tinggi mengalami perdarahan (skor HAS-BLED ≥3) (OR = 9,1 , 95% CI = 1,29 – 64,11, p = 0,027).

Keywords

fibrilasi atrium; Warfarin; lanjut usia; time in therapeutic range

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DOI: https://doi.org/10.22146/farmaseutik.v21i1.103532