Clinical Factors Associated with Stroke Recurrence in Atrial Fibrillation Patients

Lailla Affianti Fauzi; Erna Kristin; Rizaldy Taslim Pinzon

doi:10.30872/

Penulis

Lailla Affianti Fauzi Universitas Negeri Yogyakarta Penulis
Erna Kristin Universitas Gadjah Mada Penulis
Rizaldy Taslim Pinzon Universitas Kristen Duta Wacana Penulis

DOI:

https://doi.org/10.30872/

Kata Kunci:

Warfarin, fibrilasi atrium, stroke berulang, switching dosis, indeks massa tubuh

Abstrak

Stroke berulang pada pasien fibrilasi atrium (AF) masih menjadi masalah klinis yang signifikan meskipun telah diberikan terapi warfarin. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor klinis yang berhubungan dengan kejadian stroke berulang pada pasien AF yang menerima warfarin. Penelitian kohort retrospektif dilakukan pada 50 pasien dengan diagnosis stroke iskemik dan fibrilasi atrium yang menerima warfarin selama minimal satu tahun di RSUP Dr. Sardjito Yogyakarta dan RSUD Dr. Moewardi Surakarta periode 2015–2019. Analisis bivariat dan multivariat regresi logistik dilakukan untuk menilai hubungan berbagai faktor klinis dengan stroke berulang. Sebanyak 11 pasien (22%) mengalami stroke berulang. Pada analisis bivariat, switching dosis warfarin, variasi dosis warfarin, dan indeks massa tubuh berhubungan dengan kejadian stroke berulang. Namun, analisis multivariat (regresi logistik konvensional maupun Firth’s penalized logistic regression) tidak mengonfirmasi ketiga variabel tersebut sebagai prediktor independen yang signifikan secara statistik. Interval kepercayaan yang lebar dan mencakup nilai 1 pada kedua model mencerminkan keterbatasan jumlah sampel dan kejadian. Nilai INR (p=0,06) dan frekuensi pemeriksaan INR (p=0,27) juga tidak berhubungan signifikan dengan stroke berulang. Temuan ini bersifat eksploratif dan menunjukkan bahwa pemantauan INR saja tidak cukup sebagai prediktor utama. Diperlukan pendekatan manajemen terapi yang lebih komprehensif, termasuk upaya menjaga stabilitas dosis warfarin dan mempertimbangkan karakteristik pasien seperti indeks massa tubuh, serta penelitian prospektif dengan ukuran sampel yang lebih besar.

Biografi Penulis

Lailla Affianti Fauzi, Universitas Negeri Yogyakarta

Department of Indonesian Traditional Medicine, Faculty of Vocational Studies, Yogyakarta State University, Yogyakarta, Indonesia
Erna Kristin, Universitas Gadjah Mada

Department of Pharmacology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Rizaldy Taslim Pinzon, Universitas Kristen Duta Wacana

Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia

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