TEKANAN DARAH DENGAN KEJADIAN INFARK PASIEN ACUTE CORONARY SYNDROME

ABSTRAKAcute coronary syndrome (ACS) merupakan rangkaian gangguan klinis yang disebabkan oleh penyakit akut iskemik jantung. Spektrum klinis ACS adalah Unstable Angina Pectoris(UAP), non-ST elevasi myocardial infarction (NSTEMI), dan ST-elevasi myocardial infarction (STEMI). Proses ACS dapat berlanjut dengan infark transmural atau kematian. Infark transmural terjadi ditandai dengan gambaran Q patologis menetap pada Elektrokardiogram. Tekanan darah tinggi merupakan salah satu faktor risiko ACS. Tekanan darah menjadi menifestasi klinis penting klien Acute coronary syndrome 24 jam pertama rawat inap. Penelitian ini bertujuan untuk mengetahui hubungan tekanan darah dengan kejadian infark transmural pada klien acute coronary syndrome rawat inap. Penelitian ini merupakan penelitian diskriptif kuantitatif dengan desain perspektif studi (cohort). Jumlah sampel adalah 33 orang klien acute coronary syndrome. Teknik pengambilan sampel adalah proporsive sampling dengankriteriainklusi: diagnosa STEMI, NSTEMI, UAP, onset 24 jam, gagal jantung killip I dan II, tidak ada disritmia mengancam, mendapatkan terapi pengobatan standar (satu atau dua anti platelet, nitrat, trombolitik, oksigen). Tempat penelitian Rumah sakit dr Zainoel Abidin Banda Aceh. Variabel independen pada penelitian ini adalah tekanan darah sistole dan diastole, alat ukurnya Sphygmomanometer-manometer air raksa, sedangkan yang menjadi variabel dependennya adalah infark dan tidak infark, alat ukurnya elektrokardiogram. Metode analisa data menggunakan uji statistik regresi logistik. Hasil penelitian bahwa pasien dengan tekanan darah sistole rata-rata tinggi memiliki kejadian infark 7.5 kali lebih besar dari sistole normal. Sementara pasien dengan tekanan diastole rata-rata tinggi memiliki kejadian infark 6.5 kali lebih besar dari tekanan diastole normal. Tekanan darah sistole dan diastole tinggi pada pasien ACS harus dimonitor dan dikontrol oleh perawat secara intensif selama 24 jam pertama untuk mencegah atau mengurangi risiko kejadianinfark. Kata kunci: acute coronary syndrome, infark, tekanan darah sistole dan tekanan darah diastole. ABSTRACTAcute coronary syndrome (ACS) is a set of clinical disturbance caused by heart ischaemic acute disease. clinical spectrum of acute coronary syndrome is unstable angina pectoris, non ST elevation myocardial infarction and ST elevation myocardial infarction. The process of acute coronary syndrome can develop with transmural infarction or death. Transmural infarction is characterized with remain patological Q description on electrocardiogram. High blood pressure is on of risk factors of acute coronary syndrome. Blood pressure is as important clinical manifestation on patient with acute coronary syndrome during the first 24 hours. The research was to identify relationship between blood pressure and transmural infarction occurence on patient with acure coronary syndrome. The research was descriptive quantitative with perspective study (cohort) design. The number of sample was 33 patients with acute coronary syndrome. Sampling technique was proporsive sampling with inclusion criteria i.e. diagnosed with ST elevation myocardial infarction, non ST elevation myocardial infarction, unstable angina pectoris, onset 24 hours, Killip I and II heart failure, non threatening dysrhythmias, obtaining standard treatment therapy (one or two antiplatelets, trombolitik, nitrat, oksigen). The location of the research was in dr. Zainoel Abidin general hospital Banda Aceh. Independent variable in this research were sistole and diastole blood pressure. Meanwhile the dependent variable were infaction and non infarction. Data analyzed method was use a logisticregression test of statistic. The result of the research showed that patients with high average sistole blood pressure had infarct occurence 7,5 times greater than normal sistole. Whilst patients with high average diastole blood pressure had infarct occurence 6,5 times greater than normal sistole. High sistole and diastole blood pressureon patients with acute coronary syndrome must be monitored and controlled intensively by nurses during the first 24 hours to prevent or alleviate infarction risks.Keywords: acute coronary syndrome, infarction, sistole and diastole blood pressur