Evaluasi Penggunaan Obat Golongan Statin Pada Pasien Stroke Terhadap Kejadian Stroke Berulang Di Rsud Dungus Madiun

Abstract

Stroke menurut World Health Organization (WHO) adalah gangguan fungsional otak yang terjadi secara mendadak dengan gejala klinik baik fokal maupun global yang berlangsung 24 jam atau lebih. Di Kabupaten Madiun penyakit stroke diperkirakan sebanyak 115.258 orang berdasarkan Riskesdas tahun 2018. Penderita stroke memiliki risiko kekambuhan tinggi. Statin dengan efek pleiotropiknya dapat menjadi neuroprotektan sehingga dapat memperbaiki kondisi klinis dan mencegah terjadinya stroke berulang. Tujuan secara umum dilakukannya penelitian ini yaitu untuk mengevaluasi penggunaan obat golongan statin melalui pemeriksaan profil lipid terhadap kejadian stroke berulang pada pasien stroke di RSUD Dungus Madiun. Desain penelitian ini adalah studi kasus prospektif dengan teknik pengambilan sampel purposive sampling berdasarkan pertimbangan kriteria inklusi dan eksklusi sehingga didapatkan total sampel 25 pasien dengan 5 pasien dilakukan evaluasi kejadian stroke berulang.

Karakteristik pasien stroke di RSUD Dungus Madiun berdasarkan jenis kelamin adalah laki-laki (54%) dan perempuan (46%). Berdasarkan karakteristik usia, persentase terbanyak pada kelompok usia 55-64 tahun (52%), usia 65-74 tahun (28%), usia 45-54 tahun (16%), 35-44 tahun (4%). Hasil evaluasi penggunaan obat golongan statin melalui pemeriksaan profil lipid adalah obat simvastatin dan atorvastatin kadar LDL dalam kategori optimal (100%). Kadar HDL obat simvastatin dalam kategori rendah (67%) dan tinggi (33%) sedangkan obat atorvastatin dalam kategori tinggi (100%). Kadar TG obat simvastatin dalam kategori normal (67%) dan tinggi (33%) sedangkan obat atorvastatin dalam kategori normal (100%). Penggunaan obat simvastatin ataupun atorvastatin pada pasien stroke terhadap kejadian stroke berulang tidak terdapat kejadian stroke berulang dengan total persentase 100% selama 3 bulan evaluasi namun memiliki risiko terjadinya stroke berulang sebesar 40% setelah evaluasi.

Kata kunci : Statin, Profil Lipid, Stroke Berulang

EVALUATION OF THE USE OF STATIN GROUP DRUGS IN STROKE PATIENTS AGAINST RECURRENT STROKE AT DUNGUS MADIUN HOSPITAL

ABSTRACT

Stroke according World Health Organization (WHO) is a functional brain disorder that occurs suddenly with clinical symptoms both focal and global lasting 24 hours or more. In Madiun Regency, it is estimated that there are 115,258 stroke patients based on the 2018 Riskesdas. Stroke sufferers have a high risk of recurrence. Statins with their pleiotropic effects can be neuroprotectants so that they can improve clinical conditions and prevent recurrent strokes. The general objective of this study was to evaluate the use of statin drugs by examining lipid profiles for recurrent strokes in stroke patients at Dungus Madiun General Hospital. The research design is a case study prospective by sampling technique purposive sampling based on consideration of inclusion and exclusion criteria so that a total sample of 25 patients was obtained with 5 patients being evaluated for the incidence of recurrent stroke.

Characteristics of stroke patients at Dungus Madiun General Hospital based on gender were male (54%) and female (46%). Based on age characteristics, the highest percentage was in the age group 55-64 years (52%), age 65-74 years (28%), age 45-54 years (16%), 35-44 years (4%). The results of evaluating the use of statin drugs through lipid profile examination were simvastatin and atorvastatin LDL levels in the optimal category (100%). The HDL levels of the simvastatin drugs were in the low (67%) and high (33%) categories, while the atorvastatin drugs were in the high category (100%). TG levels of the simvastatin drugs were in the normal (67%) and high (33%) categories, while the atorvastatin drugs were in the normal category (100%). The use of simvastatin or atorvastatin drugs in stroke patients for the incidence of recurrent stroke did not occur with a total percentage of 100% during the 3 month evaluation but had a risk of recurrent stroke of 40% after the evaluation.

Keywords : Statins, Lipid Profile, Recurrent Stroke