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cover JIF 18(1) 2022
Submitted
July 16, 2021
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July 30, 2022
Published
July 31, 2022
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Abstract

Background: Contrast-induced nephropathy (CIN) is a common complication in patients undergoing percutaneous coronary intervention (PCI). The Elderly is one of the risk factors for CIN and increase mortality. N-acetylcysteine is recommended as preventive therapy for CIN post PCI due to its antioxidant activity. However, previous studies have shown that the effectiveness of n-acetylcysteine as preventive therapy for CIN is still inconsistent.
Objective: The aim of this study was to determine the effect of N-acetylcysteine as preventive therapy for CIN post PCI in the elderly.
Method: This study used a retrospective study design. Data collection was carried out at one General Hospital in Jakarta from January until March 2020. The medical records in the 2019 period were used for the population. We included an elderly patient who underwent PCI by purposive sampling technique and obtained 78 samples. Data were analyzed by paired t-test to determine the effect of N-acetylcysteine as preventive therapy for CIN post PCI in the elderly.
Results: The characteristic of elderly patients who underwent PCI were dominated by males (66.67%) with a GFR <60 mL/min/1.73m2 (74.36%). About 92.31% of patients did not have CIN and only 7.69% of patients showed a significant acute renal impairment (LFG decreased > 20%). Overall, there was an increase in average GFR value (2.33±7.90) in elderly who underwent PCI after n-acetylcysteine administration (p=0.011).
Conclusion: N-acetylcysteine was effective in preventing the incidence of CIN post PCI in the elderly.
Keywords: N-acetylcysteine, preventive therapy, contrast-induced nephropathy (CIN), percutaneous coronary intervention (PCI), elderly


Intisari
Latar belakang: Contrast Induced Nephropathy (CIN) diketahui sebagai komplikasi yang banyak terjadi pada pasien yang menjalani intervensi koroner perkutan (IKP). Usia lanjut merupakan salah satu faktor resiko terjadinya CIN dan dapat meningkatkan mortalitas. N-asetilsistein direkomendasikan sebagai terapi pencegahan CIN pasca IKP karena dihubungkan dengan aktivitas antioksidannya. Namun dari berbagai penelitian terkait efektivitas N-asetilsistein untuk mencegah CIN masih beragam dan tidak konsisten.
Tujuan: Tujuan penelitian ini untuk mengetahui efek N-asetilsistein sebagai terapi pencegahan CIN paska IKP pada lansia.
Metode: Penelitian menggunakan rancangan studi retrospektif. Pengambilan data dilakukan di salah satu rumah sakit umum di Jakarta pada bulan Januari – Maret 2020. Sampel yang digunakan adalah data rekam medik pasien periode tahun 2019 yang menjalani IKP dan berusia lanjut. Pengambilan sampel menggunakan teknik purposive sampling, diperoleh 78 sampel yang memenuhi kriteria inklusi dan eksklusi. Data diolah dan dianalisis dengan uji-t berpasangan untuk mengetahui efek N-asestilsistein sebagai terapi pencegahan CIN paska IKP pada lansia.
Hasil: Karakteristik pasien lansia yang menjalani IKP didominasi oleh laki-laki (66,67%) dengan nilai LFG <60 mL/min/1,73m2 sebanyak 74,36%. Dari 78 pasien yang diberi terapi N-Asetilsistein, 92,31% diantaranya tidak mengalami CIN dan hanya 7,69% yang mengalami penurunan nilai LFG >20%. Secara keseluruhan, terjadi peningkatan rata-rata nilai LFG pada lansia yang menjalani IKP setelah pemberian N-asetilsistein sebesar 2,33±7,90 (p=0,011).
Kesimpulan: N-asetilsistein efektif dalam mencegah kejadian CIN paska IKP pada lansia.
Kata kunci: N-asetilsistein, contrast induced nephropathy (CIN), intervensi koroner perkutan (IKP), lansia

Keywords

N-acetylcysteine preventive therapy contrast-induced nephropathy (CIN) percutaneous coronary intervention (PCI) elderly

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References

  1. Anwar, M. R., Hai, A. N. M. A., Debnath, D. K., Faraji, M. A. H., & Hasan, K. M. (2018). Incidence and Risk Factors of Contrast Induced Nephropathy in Patients Following Coronary Angiography. Journal of Science Foundation, 15(1), 20-25. doi:10.3329/jsf.v15i1.34779
  2. Ashley, C., & Dunleavy, A. (2018). The Renal Drug Handbook: The Ultimate Prescribing Guide for Renal Practitioners 5 ed., Boca Raton, London: CRC Press
  3. Dewi, V. A., Musthafa, Z., & Bustamam, N. (2019). Analisis Komparatif Akses Vaskular terhadap Kejadian Hematoma Pasca Percutaneous Coronary Intervention dengan Pemasangan Stent pada Pasien Acute Coronary Syndrome di RSPAD Gatot Subroto. Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan, 9(1). doi:10.33533/jpm.v9i1.821
  4. Eskandarian, R., Yarmohamadi, M., Zaker-Tavalae, M., Mirmohammadkhani, M., Biglari, M., Tamadon, M., & Jalali, T. (2018). The Standard Dose versus Double Dose of N-acetylcysteine to Prevent Contrast-Induced Nephropathy; A Randomized Controlled Clinical Trial. Journal of Nephropathology, 7(3), 145-150. doi:10.15171/jnp.2018.33
  5. Evola, S., Lunetta, M., Macaione, F., Fonte, G., Milana, G., Corrado, E., Bonura, F., Novo, G., Hoffmann, E., & Novo, S. (2012). Risk Factors for Contrast Induced Nephropathy: A Study among Italian Patients. Indian Heart J, 64(5), 484-491. doi:10.1016/j.ihj.2012.07.007
  6. Hartanto, E., Saleh, K., Alkatiri, A. H., & Kabo, P. (2018). Outcome Jangka Pendek Pasien Penyakit Jantung Koroner Multivessel Stabil Kandidat untuk Operasi Coronary Artery Bypass Grafting dengan Gambaran EKG Normal. Indonesian Journal of Cardiology, 39(2). doi:10.30701/ijc.v39i2.634
  7. Hossain, M. A., Costanzo, E., Cosentino, J., Patel, C., Qaisar, H., Singh, V., Khan, T., Cheng, J. S., Asif, A., & Vachharajani, T. J. (2018). Contrast-induced Nephropathy: Pathophysiology, Risk Factors, and Prevention. Saudi J Kidney Dis Transpl, 29(1), 1-9. doi:10.4103/1319-2442.225199
  8. Habib, M., Alla, H., Amen, H. (2016). N-Acetylcysteine and/or Ascorbic Acid versus Placebo to Prevent Contrast-Induced Nephropathy in Patients Undergoing Elective Cardiac Catheterization: The NAPCIN Trial; A Single-Center, Prospective, Randomized Trial. Saudi J Kidney Dis Transpl, 27(1), 55-61.
  9. Kemenkes_RI. (2019). Laporan Nasional Riskesdas 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI
  10. Kovar, F., Knazeje, M., & Mokan, M. C. (2013). What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease. In Contrast-Induced Nephropathy: Risk Factors, Clinical Implication, Diagnostics Approach, Prevention. IntechOpen. doi:10.5772/54036
  11. Parlindungan, H., Hasan, R., Andra, C., Akbar, N., Nasution, A., Hasan, H., Safri, Z., Lubis, A., & Napitupulu, B. (2019). CHA2DS2-VAS-HSF Score as a Predictor for Contrast- Induced Nephropathy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention. Indonesian Journal of Cardiology, 39(2). doi:10.30701/ijc.v39i2.766
  12. PERKI. (2018). Pedoman Tata Laksana Sindrom Koroner Akut (4 ed.) https://inaheart.org/wp-content/uploads/2021/07/Buku-ACS-2018.pdf
  13. Pintaningrum, Y. (2016). Komplikasi Intervensi Koroner Perkutan. Jurnal Kedokteran, 5(4). doi:10.29303/jku.v5i4.9
  14. Ruhimat, U., Kuntara, A., & Togatorop, M. R. (2017). Pengaruh Puasa terhadap Kejadian Contrast-Media Induced Nephropathy (CIN) pada Pemeriksaan CT-Scan Setelah Pemberian Kontras Intravena. Majalah Kedokteran Bandung, 49(1), 55–60. doi:10.15395/mkb.v49n1.988
  15. Simatupang, L., Susalit, E., & Wijaya, I. (2017). Peran Kombinasi Hidrasi dan N-Acetyl Cysteine terhadap Nefropati akibat Kontras 48 Jam Pasca Percutaneous Coronary Intervention pada Pasien Penyakit Ginjal Kronik Stadium 3. Jurnal Penyakit Dalam Indonesia, 3(3), 125. doi:10.7454/jpdi.v3i3.22
  16. Sun, Z., Fu, Q., Cao, L., Jin, W., Cheng, L., & Li, Z. (2013). Intravenous N-acetylcysteine for Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of Randomized, Controlled Trials. PLoS One, 8(1), e55124. doi:10.1371/journal.pone.0055124
  17. Wijaya, A., & Atmadja, B. (2016). Identifikasi Risiko dan Pencegahan Terhadap Nefropati Akibat Kontras. Jurnal Radiologi Indonesia, 2, 52-58. doi:10.33748/jradidn.v2i1.50
  18. Xie, W., Liang, X., Lin, Z., Liu, M., & Ling, Z. (2021). Latest Clinical Evidence About Effect of Acetylcysteine on Preventing Contrast-Induced Nephropathy in Patients Undergoing Angiography: A Meta-Analysis. Angiology, 72(2), 105-121. doi:10.1177/0003319720950162
  19. Xu, R., Tao, A., Bai, Y., Deng, Y., & Chen, G. (2016). Effectiveness of N-Acetylcysteine for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc, 5(9). doi:10.1161/jaha.116.003968