Faktor Risiko Perdarahan Gastrointestinal pada Pasien dengan Sindrom Koroner Akut: Sebuah Tinjauan Sistematis

Authors

• Assyadilla Kirana setyobudi, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaFollow
• Amie Vidyani, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaFollow
• Jonathan Christianto Sutadji, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaFollow
• Lady Aqnes Kurniawati, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaFollow
• Kevin Fernando Suhardi, Faculty of Medicine, University of Indonesia, Jakarta, IndonesiaFollow

Abstract

Introduction. Gastrointestinal bleeding (GIB) is a serious but potentially preventable condition. Its symptoms include hematemesis, hematochezia, and melena. Risk factors for GIB include medications such as antiplatelets and anticoagulants, which are standard treatments for acute coronary syndrome (ACS). GIB is strongly associated with ACS and represents the most common bleeding complication in these patients. This study aimed to systematically review the factors contributing to GIB in patients with ACS.

Methods. Relevant articles were retrieved from PubMed, ScienceDirect, Springer, and EBSCO databases, covering studies on GIB risk factors in ACS patients published between March 31, 2003, and March 31, 2025. The search was conducted using specific keywords and Boolean operators. Data were then extracted and comprehensively evaluated.

Results. A total of 17 studies were included, with varied patient populations, including general ACS patients, as well as those specifically diagnosed with acute myocardial infarction (AMI), ST-elevation myocardial infarction (STEMI), or non-ST-elevation myocardial infarction (NSTEMI). The follow-up periods ranged widely, from 15 days to 4 years. Based on the initial evaluation, 23 potential risk factors were identified. GIB was more likely to occur in older individuals, females, and those with a history of smoking and alcohol consumption. Comorbidities, including anemia, diabetes, peptic ulcer disease, cirrhosis, and chronic kidney disease, were also more frequently observed among ACS patients with GIB events. The use of proton pump inhibitors (PPIs) was identified as the only protective factor.

Conclusion. This systematic review identified several risk factors associated with GIB in ACS patients. Careful monitoring and appropriate management should be implemented in patients with these risk factors to prevent bleeding events, which may be fatal.

Bahasa Abstract

Pendahuluan. Perdarahan gastrointestinal merupakan kondisi yang serius, namun dapat dicegah. Gejalanya meliputi hematemesis, hematoskezia, dan melena. Perdarahan gastrointestinal sangat terkait dengan sindrom koroner akut (SKA) dan merupakan masalah perdarahan paling umum pada pasien SKA. Tujuan penelitian ini adalah untuk meninjau secara sistematis faktor-faktor yang berkontribusi terhadap perdarahan gastrointestinal pada pasien SKA.

Metode. Artikel yang relevan diambil dari database PubMed, ScienceDirect, Springer, dan EBSCO untuk studi tentang faktor risiko perdarahan gastrointestinal pada pasien SKA, dari tanggal 31 Maret 2003 hingga 31 Maret 2025, menggunakan kata kunci tertentu dan operator Boolean. Data diekstraksi dan dievaluasi secara komprehensif.

Hasil. Terdapat 17 penelitian yang dilibatkan dengan populasi pasien bervariasi, mulai dari pasien SKA secara umum, pasien acute myocardial infarction (AMI), ST-segment elevation acute myocardial infarction (STEMI), atau non-ST-segment elevation acute myocardial infarction (NSTEMI). Periode follow-up berkisar antara 15 hari hingga 4 tahun. Terdapat 23 faktor risiko potensial diidentifikasi untuk tinjauan sistematis. Perdarahan gastrointestinal lebih mungkin terjadi pada individu berusia lanjut, berjenis kelamin perempuan, riwayat merokok, dan konsumsi alkohol. Penyakit penyerta, termasuk anemia, diabetes, penyakit ulkus peptikum, sirosis, dan penyakit ginjal kronis juga dikaitkan dengan kejadiaan perdarahan gastrointestinal pada pasien SKA. Penggunaan proton pump inhibitor (PPI) ditemukan sebagai satu-satunya faktor protektif.

Kesimpulan. Tinjauan sistematis ini menemukan beberapa faktor risiko yang berhubungan dengan kejadian perdarahan gastrointestinal pada pasien SKA, yaitu terutama lanjut usia, perempuan, riwayat merokok, dan konsumsi alkohol. Pemantauan dan pengobatan secara cermat perlu dilakukan pada pasien dengan faktor risiko untuk menghindari kejadian perdarahan gastrointestinal. 

Kata Kunci: Perdarahan gastrointestinal, sindroma koroner akut, tinjauan sistematis

Recommended Citation

setyobudi, Assyadilla Kirana; Vidyani, Amie; Sutadji, Jonathan Christianto; Kurniawati, Lady Aqnes; and Suhardi, Kevin Fernando (2026) "Faktor Risiko Perdarahan Gastrointestinal pada Pasien dengan Sindrom Koroner Akut: Sebuah Tinjauan Sistematis," Jurnal Penyakit Dalam Indonesia: Vol. 13: Iss. 1, Article 1.
DOI: 10.7454/jpdi.v13i1.1735
Available at: https://scholarhub.ui.ac.id/jpdi/vol13/iss1/1