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Simple Clinical Predictors of Successful Fibrinolysis in Combined Assessment of ST-Segment Resolution, Myocardial Infraction Flow Grade, and Myocardial Perfusion Grade: Importance of Admission Blood Glucose and Ischemic Time

Heart Science Journal · Vol. 2 No. 3 (2021) · hlm. 12–19

DOI
10.21776/ub.hsj.2021.002.03.3
ISSN
2721-9984, 2721-9976
Terbit
2021-07-30
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

BackgroundÂ: Fibrinolytic therapy (FT) is the alternative recommendation in patients with ST-segment elevation myocardial infarction (STEMI) if primary percutaneous coronary intervention (PCI) could not be perfomed timely at initial presentation. Successful revascularization of occluded infarct-related coronary arteries depends on complex mechanisms of hemodynamic, clinical, biochemical, and mechanical parameters. The aim of study was to find outpredictors of patient characteristics to achieve complete reperfusion based on Thrombolysis in Myocardial Infarction(TIMI) 3 flow, Myocardial Blush Grade (MBG) 3, and ST-segment resolution.   Method: This retrospective study was held in Saiful Anwar, Malang Hospital during 2017-2021, including total of 142 patients. All patients received FT and coronary angiographic evaluation post-FT. Those were divided into 3 groups, which included R0,1 (0/1 highest measure of reperfusion), R2 (2 highest measures of reperfusion), and R3 (3 highest measures of reperfusion).  Results: Ischemic time (OR 0,82 [95%CI -0,39;-0,01]; p=0,04] and admission blood glucose (ABG) (OR 0,99 [95%CI -0,01;0]; p=0,046] were negatively correlated to the complete restoration of reperfusion (R3). This study revealed that ischemic time <5 hours (AUC 0,742 [95%CI 0,645-0,839]; p=0,000)  and ABG <140 mg/dL (AUC 0,701 [95%CI 0,612-0,790]; p=0,000) were significant predictor for R≥2. Coronary characteristic was not related to measure of reperfusion (p=0,25). Conclusion: Ischemic time <5 hours and ABG <140 mg/dL are important predictors of successful reperfusion post FT (R≥2). Early assessment of patients who are likely to have low parameter reperfusion (R<2) would help promptly preparing for primary PCI.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
  • Afiliasi tidak diketahui
  • Organisasi berbeda
  • Organisasi sama
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Rekan penulisOrganisasiArtikel bersama
Anna Fuji RahimahUniversity of Brawijaya49
Setyasih AnjarwaniUniversity of Brawijaya47
Cholid Tri TjahjonoUniversity of Brawijaya40
Budi SatrijoUniversity of Brawijaya34
Sasmojo WiditoUniversity of Brawijaya32
Heny MartiniUniversity of Brawijaya31
Djanggan SargowoUniversity of Brawijaya26
Yoga WaranugrahaUniversity of Brawijaya12
Wella KarolinaUniversity of Brawijaya12
Adhika Prastya WikanandaUniversity of Brawijaya11
Tri AstiawatiUniversity of Brawijaya8
Putri Annisa KamilaUniversity of Brawijaya8
Seprian WidasmaraUniversity of Brawijaya8
Valerinna YogibuanaAfiliasi tidak diketahui7
Nikhen NoverikeUniversity of Brawijaya7
Hayla Iqda MillisaniUniversity of Brawijaya6
Icmi Dian RochmawatiUniversity of Brawijaya6
Tria Yudha NugrahaUniversity of Brawijaya5
Muhammad Rizki FadlanUniversity of Brawijaya5
Danti Utami SetyowatiRSUD Prof. Dr. Saiful Anwar Malang5
Oktafin Srywati PamunaUniversity of Brawijaya5
Anna Fuji RahimahAfiliasi tidak diketahui5
Ratna PancasariUniversity of Brawijaya5
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya5
Mokhamad Aswin BaharUniversity of Brawijaya5
Dea Arie KurniawanUniversity of Brawijaya5
Fandy HazzyUniversity of Brawijaya4
Sawitri SatwikajatiUniversity of Brawijaya4
Olivia HandayaniUniversity of Brawijaya4
Ayu Asri Devi AdityawatiUniversity of Brawijaya4
Ira Vori NugrohoUniversity of Brawijaya4
Lutfi Hafiz ZunardiUniversity of Brawijaya4
Imam Mi'raj SuprayogaUniversity of Brawijaya4
Dadang HendrawanUniversity of Brawijaya3
Arif Ranu WicaksonoUniversity of Brawijaya3

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Simple Clinical Predictors of Successful Fibrinolysis in Combined Assessment of ST-Segment Resolution, Myocardial Infraction Flow Grade, and Myocardial Perfusion Grade: Importance of Admission Blood Glucose and Ischemic Time</dc:title>
	<dc:creator xml:lang="en">Rusnanta, Fahmy</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:creator xml:lang="en">Prasetya, Indra</dc:creator>
	<dc:creator xml:lang="en">Rizal, Ardian</dc:creator>
	<dc:creator xml:lang="en">Kurnianingsih, Novi</dc:creator>
	<dc:subject xml:lang="en">STEMI</dc:subject>
	<dc:subject xml:lang="en">fibrinolytic therapy</dc:subject>
	<dc:subject xml:lang="en">coronary angiography</dc:subject>
	<dc:subject xml:lang="en">ischemic time</dc:subject>
	<dc:subject xml:lang="en">blood glucose</dc:subject>
	<dc:description xml:lang="en">Background : Fibrinolytic therapy (FT) is the alternative recommendation in patients with ST-segment elevation myocardial infarction (STEMI) if primary percutaneous coronary intervention (PCI) could not be perfomed timely at initial presentation. Successful revascularization of occluded infarct-related coronary arteries depends on complex mechanisms of hemodynamic, clinical, biochemical, and mechanical parameters. The aim of study was to find outpredictors of patient characteristics to achieve complete reperfusion based on Thrombolysis in Myocardial Infarction(TIMI) 3 flow, Myocardial Blush Grade (MBG) 3, and ST-segment resolution.   Method : This retrospective study was held in Saiful Anwar, Malang Hospital during 2017-2021, including total of 142 patients. All patients received FT and coronary angiographic evaluation post-FT. Those were divided into 3 groups, which included R0,1 (0/1 highest measure of reperfusion), R2 (2 highest measures of reperfusion), and R3 (3 highest measures of reperfusion).  Results : Ischemic time (OR 0,82 [95%CI -0,39;-0,01]; p=0,04] and admission blood glucose (ABG) (OR 0,99 [95%CI -0,01;0]; p=0,046] were negatively correlated to the complete restoration of reperfusion (R3). This study revealed that ischemic time &amp;lt;5 hours (AUC 0,742 [95%CI 0,645-0,839]; p=0,000)  and ABG &amp;lt;140 mg/dL (AUC 0,701 [95%CI 0,612-0,790]; p=0,000) were significant predictor for R≥2. Coronary characteristic was not related to measure of reperfusion (p=0,25). Conclusion : Ischemic time &amp;lt;5 hours and ABG &amp;lt;140 mg/dL are important predictors of successful reperfusion post FT (R≥2). Early assessment of patients who are likely to have low parameter reperfusion (R&amp;lt;2) would help promptly preparing for primary PCI.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2021-07-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/203</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2021.002.03.3</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 2 No. 3 (2021): The Science and Art of Myocardial Revascularization; 12-19</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2021.002.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/203/283</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2021 Fahmy Rusnanta, Mohammad Saifur Rohman, Indra Prasetya, Ardian Rizal, Novi Kurnianingsih</dc:rights>
</oai_dc:dc>