PERBANDINGAN HASIL INR (International Normalized Ratio) SEBELUM DAN SESUDAH TERAPI HEPARIN WARFARIN PADA PASIEN PENYAKIT JANTUNG KORONER DI RUMAH SAKIT ATMA JAYA JAKARTA UTARA

  • Heru Setiawan
  • Venna Venna
  • Lowisa Debora Turnip
Keywords: : CHD, warfarin, INR

Abstract

Coronary Heart Disease (CHD) is a disorder of heart function due to a lack of blood in the heart muscle due to narrowing or blockage of the coronary arteries caused by atherosclerosis. This occurs when the heart muscle's supply of oxygen-rich blood is blocked by plaque in the blood vessels leading to the heart blood or coronary arteries. Warfarin is an anticoagulant that is strongly associated with bleeding in CHD. The laboratory examination that is often used to measure prothrombin time and as anticoagulant therapy to detect bleeding disorders is INR (International Normalized Ratio). This study aims to determine the comparison of INR results before and after heparin warfarin therapy in coronary heart disease patients at Atma Jaya Hospital. The method of this research is cross sectional descriptive analysis using 39 RM data from CHD patients who have met the inclusion and exclusion criteria using the Wilcoxon test. These results showed that the average INR value before therapy was 1.849 per second, the average INR value after therapy was 1.316 per second. The Wilcoxon test results showed a difference between INR values ​​before and after therapy (p=0.000) with significance (α=<0.05) in patients on heparin warfarin therapy at Atma Jaya Hospital. From this research, it is hoped that CHD patients will continue to undergo therapy to prevent hemostasis disorders and to avoid the risk of bleeding which can cause death.

Keywords: CHD, warfarin, INR.

References

1. Harahap GA, Nurcahyo WI, Ismail A. Widya Istanto Nurcahyo. Akhmad Ismail JKD [Internet]. 2016;5(2):160–6. Available from: https://ayosehat.kemkes.go.id/peringatan-hari-jantung-sedunia-2021-jaga-jantungmu-untuk-hidup-lebih-sehat
2. Kemkes. kemkes.go.id. 2021 [cited 2024 Mar 14]. Peringatan Hari Jantung Sedunia 2021: Jaga Jantungmu untuk Hidup Lebih Sehat. Available from: https://ayosehat.kemkes.go.id/peringatan-hari-jantung-sedunia-2021-jaga-jantungmu-untuk-hidup-lebih-sehat
3. Roveny. Antikoagulan untuk Stroke Iskemik Kardioemboli, IAI Continuing Professional Development. 2015;42(5):345–9.
4. Agustini TT, Arifin H, Hanif AM. Comparison between Warfarin Dose with Duration Achieving Target INR in Patient with CHF and Atrial Fibrillation. J Sains Farm Klin [Internet]. 2016;2(2):162–70. Available from: http://jsfkonline.org/index.php/jsfk/article/view/67
5. Octasari PM, Silvianingsih N, Mangunwijaya PK. Kesesuaian Nilai INR ( International Normalized Ratio ) Pasien Kardiovaskuler Dengan Terapi Warfarin Di Poli Spesialis Jantung RS Roemani Muhammaddiyah This study aims to determine the suitability of the INR value in cardiovascular patients with warfarin . 2022;6(1):46–54.
6. Setiabudy RD. Hemostasis dan Trombisis Edisi Kelima, Fakultas Kedokteran Universitas Indonesia. Prosedur Penelit. 2012;
7. Andini R, Astuti YP. Klasifikasi Kelompok Umur Manusia Bedasarkan Analisis Dimensi Fraktal Box Counting Dari Citra Wajah Dengan Deteksi Tepi Canny. J Ilm Mat [Internet]. 2021;9(2):437–46. Available from: https://media.neliti.com/media/publications/249234-model-infeksi-hiv-dengan-pengaruh-percob-b7e3cd43.pdf
8. Aisyah, Ranggauni Hardy F, Pristya TY, Qoulan Karima U. Kejadian Penyakit Jantung Koroner Pada Pasien Di RSUD Pasar rebo. Higeia J Public Heal Res Dev [Internet]. 2022;6(4):250–60. Available from: http://journal.unnes.ac.id/sju/index.php/higeia
9. Vercayie D. Jurnal_Florence (Laki-laki dan Riwayat Keluarga PJK).pdf.
10. Melyani M, Tambunan LN, Baringbing EP. Hubungan Usia dengan Kejadian Penyakit Jantung Koroner pada Pasien Rawat Jalan di RSUD dr. Doris Sylvanus Provinsi Kalimantan Tengah. J Surya Med. 2023;9(1):119–25.
11. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Zachary D, Hahn EJ, et al. Erratum: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (Circulation. (2019) 140 (e596-e646) DOI: 10.1161/CIR. Vol. 141, Circulation. 2020. E774 p.
12. Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Vol. 45, Stroke. 2014. 2160–2236 p.
13. Bjective O. WARFARIN : MANAGEMENT OF OUT-OF-RANGE INRS. :2–7.
14. NCBI. National Center for Biotechnology Information (NCBI). PubChem Compound Warfarin. Dilihat 09 Maret 2024. [Internet]. 2011. p. ncbi.nlm.nih.gov. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Warfarin
15. Medscape. Drug Interaction [Internet]. 2020. Available from: http://reference.medscape.com/druginteractionchecker
Published
2025-06-05
How to Cite
Setiawan, H., Venna, V., & Debora Turnip, L. (2025). PERBANDINGAN HASIL INR (International Normalized Ratio) SEBELUM DAN SESUDAH TERAPI HEPARIN WARFARIN PADA PASIEN PENYAKIT JANTUNG KORONER DI RUMAH SAKIT ATMA JAYA JAKARTA UTARA. Jurnal Fisioterapi Dan Kesehatan Indonesia, 5(01), 66-72. https://doi.org/10.59946/jfki.2025.399