Influence of Secondary Prevention and Risk Factors to Recurrent Miocard Infark on Acute Coronary Syndrome Patients in General Hospital Surakarta Indonesia

Abstract

The patient who had myocardial infraction has a risk of recurrent myocardial infraction. Secondary prevention including antiplatelet, beta-blocker, statin, ACE inhibitor/ARB aims to prevent recurrent myocardial infarction. This study aimed to find the influence of secondary prevention and risk factors on the occurrence of recurrent myocardial infraction. This research was conducted with quantitative and case-control retrospectively. The subjects were 80 respondents consisting of 40 respondents in the case group and 40 respondents in control group patients. Data were analyzed using bivariate analysis of chi-square test followed by multivariate analysis of logistic regression. Rate of recurrent myocardial infarction (MI) with antiplatelet therapy decreased from 64.3% to 34.2%, with beta-blocker therapy decreased from 57.7% to 35.7%, with statin therapy decreased from 65.9% to 30.5%, with ACE inhibitor/ARB therapy decreased from 65.9% to 30.5%, with a combination of fourth therapy reduced from 57.4% to 34.6%. Chi-square test showed that there was a statistically significant relationship between antiplatelet therapy (p = 0.007), statin therapy (p = 0.002), ACE inhibitor / ARB therapy (p = 0.002), family history (p = 0.011) and adherence (p = 0.007) to recurrent MI. While multivariate analysis of logistic regression showed that the variables influencing the incidence of recurrent myocardial infarction were did not use antiplatelet therapy (P = 0,005; OR= 4.006) and statin therapy (P = 0,029; OR= 3.111). The secondary prevention reduced the incident of recurrent myocardial infarction.