Perbandingan Efek Samping Antiplatelet Tunggal dan Ganda terhadap Gastrointestinal pada Pasien Strok Iskemik
Abstract
Antiplatelet merupakan terapi yang digunakan secara tunggal maupun ganda untuk strok iskemik. Namun, pengobatan antiplatelet dapat memberikan risiko efek samping terhadap gastrointestinal. Penelitian ini dilakukan bertujuan untuk membandingkan efek samping penggunaan antiplatelet tunggal (aspirin 80 mg) dan antiplatelet ganda (aspirin 80 mg + clopidogrel 75 mg) terhadap gejala klinis efek samping terhadap gastrointestinal pada pasien stroke iskemik. Desain dan subyek penelitian ini menggunakan uji klinik kohort observasional prospektik dilakukan di RSUP Dr. Wahidin Sudirohusodo, sebanyak 78 pasien rawat inap dipilih secara consecutive sampling dan dibagi 2 kelompok masing-masing berjumlah 39 subjek. Pengobatan Aspirin 80 mg adalah kelompok 1 dan pengobatan Aspirin 80 mg + clopidogrel 75 mg adalah kelompok 2. Data risiko efek samping diambil berdasarkan gejala klinis, data objektif pada saat pre dan post pengobatan hingga timbulnya keluhan gejala klinis. Penelitian dihentikan jika pasien memiliki gejala klinis efek samping terus memburuk. Uji Mann-Whitney digunakan untuk melihat perbandingan data laboratorium antara kedua kelompok dan Uji Chi Square digunakan untuk melihat perbandingan risiko efek samping. Hasil uji menunjukkan penggunaan antiplatelet ganda memberikan risiko pada kejadian mual (p=0,007 ; OR=3,918, 95% Cl=1,396-10,998), muntah (p=0,008 ; OR=3,681, 95% Cl=1,365-9,998) dan nyeri ulu hati (p=0,007; OR=3,918 95% Cl=1,396-10,998) dibanding pada kelompok antiplatelet tunggal. Dapat disimpulkan bahwa terapi antiplatelet ganda memberikan risiko gejala klinis efek samping terhadap gastrointestinal lebih besar dibandingkan antiplatelet tunggal, sehingga penting dilakukan pemantauan terapi obat serta edukasi terhadap pasien jika gejala perdarahan timbul agar segera menghubungi tim medis.
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