STATUS PENGGUMPALAN (AGREGASI) TROMBOSIT SEBAGAI FAKTOR PROGNOSTIK TEJADINYA KELUARAN KLINIS STROK INFARK MENDADAK (STROK INFARK AKUT)

Abstract

The propriate management of acute infarction stroke will be able to reduce the morbidity and mortality of the disease. In diagnosing
and managing the diseases, for the detection of the risk or prognostic factors information's such as the history physical findings,
confirmation and other supporting tests are needed. One of the supporting test is the laboratory examination i.e. platelet aggregation
test. Platelet aggregation is suggested having an important role in haemostasis especially to prevent excessive bleeding by forming platelet
plug. Finally, further hyperactivity of platelet in terms of platelet hyper aggregation can create a thrombus and moreover lead to obstruct
the vessels. The occlusion will give a negative outcome of an acute infarction stroke. The aim of this study is to know whether platelet
hyper aggregation has a contribution in the outcome of the disease or not by certain testing. A prospective cohort study was carried out,
to compare between two groups of exposed and non-exposed group in Sardjito hospital Yogyakarta during the period of March up to
early July 2007. Eighty four subjects who met the inclusion and exclusion criteria were involved in this study. The exposed group was a
group of acute infarction stroke patient who were exposed to platelet hyper aggregation 48 (57%), on the other hand, patients who did
not have platelet hyper aggregation was separated as non-exposed group is 36 (43%). Inception of cohort was applied when the patient
was admitted to the emergency unit during 72 hours of the onset, before receiving antithrombotic drugs and had no previous history of
stroke. The patients were followed after 7 days hospitalization in the stroke unit and neurology unit and the outcome was measured by
evaluating the score using Gadjah Mada stroke scale. The characteristics of the subjects were grouped by baseline data X2 test. Unvaried
analysis and multivariate analysis were taken to get the relative risk of having acute infarction stroke. In this case logistic regression
analysis was used to know the relative risk (RR) measurement. Prognostic factors had influenced the outcome of acute infarction stroke
in patients who had a history of cardiovascular disease and aggregation status. The outcome of the platelet hyper aggregation group
had a RR=2.15 (95% CI: 2.01–4.07) and the history of cardiovascular disease had a RR=1.78 (95% CI: 1.18–13.28).