Background: Recent studies showed that CHA 2 DS 2-VASc-HS score can effectively predict longterm outcome, hospitalization and severity in CAD. However,the role of this score in predicting failed reperfusion after fibrinolytic in STEMI patients has not been studied extensively. The main objective of this study was to determine whether CHA 2 DS 2-VASc-HS score can predict failed reperfusion after fibrinolytic in STEMI patients. Methods: A total of 62 patients with STEMI who undergo fibrinolytic at Haji Adam Malik Hospital since October 2017 until November 2018 were recruited in this cross sectional study. We also performed complete blood count and chest x-ray. CHA 2 DS 2-VASc-HS score was counted before the fibrinolytic started. After the fibrinolytic was done, we assessed the succesfullness with the decrease of chest pain, resolution of ST segments > 50% and aritmia reperfusion criterias. Results: The cutoff value of CHA 2 DS 2-VASc-HS score was 4 (AUC 0.928, 95% CI 0.861-0.995, p<0.05). The CHA 2 DS 2-VASc-HS score ≥ 4 group had higher incidence of failed reperfusion. CHA 2 DS 2-VASc-HS score ≥ 4 is considered to predict the incidence of failed reperfusion with a sensitivity of 91.7%, a specificity of 69.2%, NPV of 85.7% and PPV of 80.4%. Multivariate analysis also showed that CHA 2 DS 2-VASc-HS score ≥ 4 was an independent factor that could predict the occurrence of failed reperfusion (OR 23.769, p<0.001). Conclusion: CHA 2 DS 2-VASc-HS score is a simple, very useful and easy-to remember bedside score and an inexpensive indicator which can be used as a prognostic marker for failed reperfusion after fibrinolytic in STEMI. Keyword : CHA 2 DS 2-VASc-HS, fibrinolytic, STEMI.
Background: Acute heart failure is a global health problem with high morbidity and mortality. Short term and long term prognosis of these patients is poor. Therefore, early identification of patients at high risk for major adverse cardiovascular events (MACEs) during hospitalization was needed to improve outcome. Creatinine levels at admission could be used as predictors of major adverse cardiovascular events in acute heart failure patients because creatinine is a simple and routine biomarker of renal function examined in patients with acute heart failure. This study aimed to determine whether creatinine can be used as a predictor of major adverse adverse cardiovascular events in patients with acute heart failure.Methods: This study is a prospective cohort study of 108 acute heart failure patients treated at H. Adam Malik Hospital from July 2018 to January 2019. Creatinine cut-off points were determined using the ROC curve, then bivariate and multivariate analyzes were performed to determine predictors of major adverse cardiovascular events during hospitalization.Results: From 108 study subjects, 24 (22.2%) subjects experienced major adverse cardiovascular events during hospitalization. The subjects who died were 20 people (83.4%), subjects with arrhythmia were 2 people (8.3%), and those who had stroke were 2 people (8.3 %). Through the ROC curve analysis, we found creatinine cut-off values of ≥1.7 mg / dl (AUC 0.899, 95% CI 0.840- 0.957, p <0.05). Creatinine ≥1.7 mg/dl could predict major adverse cardiovascular events with a sensitivity of 87.5% and specificity of 79.5%. Multivariate analysis showed that creatinine ≥1.7 mg / dl was an independent factor to predict MACEs during hospitalization in this study (OR 18,310, p 0.001) as well as creatinine clearance and heart rate.Conclusion: Creatinine levels at admission is an independent predictor for major adverse cardiovascular events during hospitalization in acute heart failure patients.
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