ASESMEN RISIKO PERDARAHAN SEKELOMPOK PASIEN FIBRILASI ATRIUM PENERIMA WARFARIN BERDASARKAN NILAI HAS-BLED DI RS ABC GIANYAR

Authors

  • Putu Dian Marani Kurnianta Sekolah Tinggi Farmasi Mahaganesha
  • Ni Komang Putri Pradnyani Sekolah Tinggi Farmasi Mahaganesha
  • Kadek Dwi Oktariadi Sekolah Tinggi Farmasi Mahaganesha
  • Anak Agung Ngurah Putra Riana Prasetya Sekolah Tinggi Farmasi Mahaganesha

DOI:

https://doi.org/10.36387/jiis.v9i1.1590

Keywords:

Atrial Fibrillation, Warfarin, Risk of Bleeding, HAS-BLED

Abstract

In the management of atrial fibrillation (AF) preventing risk of stroke, warfarin may be prescribed. Warfarin’s narrow therapeutic index encourages the importance of regular monitoring during therapy to avoid the risk of bleeding. This study aimed to describe the risk of bleeding in a group of patients with AF receiving warfarin based on HAS-BLED score assessment at ABC Hospital Gianyar, Bali. A descriptive-observational study was conducted under retrospective case study approach involving outpatient’s data at mentioned hospital. This study included all patients with AF receiving warfarin based on visit history during January 2022-May 2023. Risk of bleeding documentation addressed the HAS-BLED assessment which then were illustrated into tables and diagram according to patients’ profile. From a total of eight eligible patients, five patients (62.5%) had moderate-risk of bleeding (score 1-2) and the rest were in the low-risk category (score 0). Advanced age >65 y.o. (50.00%), use of specified drugs (25.00%), and high INR values had contributed to the findings of moderate-risk based on stratification category. Despite the absence of high-risk category, therapeutic monitoring is necessary focusing on modifiable risk factors. The limited number of samples and several laboratory parameters may suggest for the advancement of clinical practice and further research.

Author Biographies

  • Putu Dian Marani Kurnianta, Sekolah Tinggi Farmasi Mahaganesha

    Program Studi Farmasi Program Diploma Tiga

  • Ni Komang Putri Pradnyani, Sekolah Tinggi Farmasi Mahaganesha

    Program Studi Farmasi Program Diploma Tiga

  • Kadek Dwi Oktariadi, Sekolah Tinggi Farmasi Mahaganesha

    Program Studi Farmasi Program Diploma Tiga

  • Anak Agung Ngurah Putra Riana Prasetya, Sekolah Tinggi Farmasi Mahaganesha

    Program Studi Farmasi Program Sarjana

References

Amaraneni, A., Chippa, V., dan Rettew, A.C. 2023. Anticoagulation Safety. Treasure Island (FL): StatPearls Publishing.

Andika, G.A., Sukohar, A., dan Yonata, A., 2021. Tatalaksana aritmia: Fibrilasi atrial. Medula, 11, 247-252.

APhA, 2014. Drug Information Handbook: A Comprehensive Resource for All Clinicians and Healthcare Professionals, Ohio, Lexi-Comp, American Pharmacists Association.

Aulia, I.A., Rahmawati, F., Pramantara, I.D.P., et al., 2022. Profil klinis pasien pengguna warfarin pada poli jantung RSUD dr. Soeselo Kabupaten Tegal. Majalah Farmaseutik, 18, 201-210.

Azmi, A.B., Yanni, M., dan Efrida, 2020. Profil klinis pasien fibrilasi atrium di RSUP Dr. M. Djamil Padang periode 1 Januari-31 Desember 2017. JKA, 9, 1-7.

Dewilde, W.J., Oirbans, T., Verheugt, F.W., et al., 2013. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet, 381, 1107-15.

Dinkes Kabupaten Gianyar, 2017. Profil Kesehatan Kabupaten Gianyar Tahun 2017, Gianyar, Dinas Kesehatan Kabupaten Gianyar.

Eikelboom, J.W., Hirsh, J., Spencer, F.A., et al., 2012. Antiplatelet drugs: Antithrombotic therapy and prevention of thrombosis, 9th ed: American ... clinical practice guidelines. Chest, 141, e89S-e119S.

Ghlichloo, I., dan Gerriets, V. 2023. Nonsteroidal Anti-inflammatory Drugs (NSAIDs). Treasure Island (FL): StatPearls Publishing.

Gubernur Bali, 2017. Peraturan Gubernur Bali Nomor 69 Tahun 2017 tentang Standardisasi Harga Barang/Jasa Pemerintah Provinsi Bali, Denpasar, Sekretaris Daerah Provinsi Bali.

Hindricks, G., Potpara, T., Dagres, N., et al., 2021. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association ... Eur Heart J, 42, 373-498.

Idacahyati, K., Nofianti, T., Aswa, G.A., et al., 2019. Hubungan tingkat kejadian efek samping antiinflamasi non steroid dengan usia dan jenis kelamin. JFIKI, 6, 56-61.

Jun, M., James, M.T., Manns, B.J., et al., 2015. The association between kidney function and major bleeding in older adults with atrial fibrillation starting warfarin ... BMJ, 350, h246.

Karapedi, E., Papadopoulos, N., Trifylli, E.M., et al., 2022. Anticoagulation in patients with atrial fibrillation and liver cirrhosis. Ann Gastroenterol, 35, 557-567.

Katzung, B.G., 2018. Basic & Clinical Pharmacology, New York, McGraw-Hill Education.

Kemenkes RI, 2018. Data Riset Kesehan Dasar Tahun 2018, Jakarta, Kementerian Kesehatan Republik Indonesia.

Kornej, J., Borschel, C.S., Benjamin, E.J., et al., 2020. Epidemiology of atrial fibrillation in the 21st century: Novel Circ Res, 127, 4-20.

LKPP, 2023. E-Catalogue Etalase Produk ‘Warfarin’. LKPP, diakses pada 15 April 2023, <https://e-katalog.lkpp.go.id/id/search-produk?q=warfarin>.

Nesheiwat, Z., Goyal, A., dan Jagtap, M. 2023. Atrial Fibrillation. Treasure Island (FL): StatPearls Publishing.

Patrono, C., 2016. Cardiovascular effects of cyclooxygenase-2 inhibitors: a mechanistic ... Br J Clin Pharmacol, 82, 957-64.

PERKI, 2019. Pedoman Tata Laksana Fibrilasi Atrium Nonvalvular, Jakarta, PT. Trans Medical International.

Pinzon, R.T., Astyari, G.A.P.I.B.S., dan Tarigan, L., 2017. Pola pengobatan antitrombotik pada pasien stroke iskemik dengan fibrilasi atrium ... HAS BLED. Pharmaciana, 7, 63-70.

Pisters, R., Lane, D.A., Nieuwlaat, R., et al., 2010. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest, 138, 1093-100.

Putri, N.A., Lestari, K., Diantini, A., et al., 2012. Monitoring terapi warfarin pada pasien pelayanan jantung pada rumah sakit di Bandung. IJCP, 1, 110-116.

Qureshi, O., dan Dua, A. 2023. COX Inhibitors. Treasure Island (FL): StatPearls Publishing.

Rubboli, A., Saia, F., Sciahbasi, A., et al., 2017. Twelve-month outcome of patients with an established indication for oral anticoagulation ... Cardiovasc Revasc Med, 18, 425-430.

Shendre, A., Parmar, G.M., Dillon, C., et al., 2018. Influence of age on warfarin dose, anticoagulation control, and ... Pharmacotherapy, 38, 588-596.

Zhu, W., He, W., Guo, L., et al., 2015. The HAS-BLED score for predicting major bleeding risk in anticoagulated patients with atrial fibrillation: A systematic ... Clin Cardiol, 38, 555-61.

Published

2024-03-31

Issue

Section

Article

How to Cite

ASESMEN RISIKO PERDARAHAN SEKELOMPOK PASIEN FIBRILASI ATRIUM PENERIMA WARFARIN BERDASARKAN NILAI HAS-BLED DI RS ABC GIANYAR. (2024). JIIS (Jurnal Ilmiah Ibnu Sina): Ilmu Farmasi Dan Kesehatan, 9(1), 48-57. https://doi.org/10.36387/jiis.v9i1.1590