Perdarahan saluran cerna setelah dilakukan intervensi koroner perkutan: suatu keputusan terapi yang sulit

Meidianaser Putra✉, Muhammad Fadil, Yose Ramda Ilhami
DOI: https://doi.org/10.25077/mka.v41.i3.p120-133.2018

Abstract

Intervensi koroner perkutan merupakan prosedur invasif jantung yang sering dilakukan untuk mengobati pasien dengan penyakit arteri koroner. Komplikasi yang menakutkan seperti diseksi koroner atau penyumbatan koroner akut pada era balon angioplasti telah banyak berkurang dengan ditemukannya stent arteri koroner dan penggunaan rutin terapi antiplatelet dan antitrombotik. Peningkatan penggunaan DAPT tersebut meningkatkan risiko pasien untuk terjadinya cedera saluran cerna dan perdarahan. Mengobati pasien yang mengalami perdarahan setelah IKP merupakan suatu hal yang rumit, karena kita harus  mempertimbangkan intervensi yang tepat untuk mengelola perdarahan aktif, untuk menimbang manfaat potensial untuk meneruskan atau menghentikan terapi antiplatelet dan untuk mengevaluasi apakah diperlukan transfusi sel darah merah yang bisa menimbulkan efek samping yang merugikan. Pemberian PPI direkomendasikan oleh panduan Amerika dan Eropa untuk terapi yang bisa diberikan pada perdarahan saluran cerna akibat pemberian antiplatelet dan hemostasis endoskopi merupakan pilihan yang direkomendasikan untuk mengurangi angka morbiditas dan mortalitas.

Keywords

Intervensi koroner perkutan; perdarahan saluran cerna; antiplatelet; penghambat pompa proton

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