INFERIOR STEMI FOLLOWING INTRAVENOUS TRANEXAMIC ACID IN AN ELDERLY PATIENT : A CASE REPORT
DOI:
https://doi.org/10.31004/jkt.v7i1.52861Keywords:
asam traneksamat, infark miokard dengan elevasi segmen ST, lansia, reaksi obat yang merugikan, syok kardiogenikAbstract
Asam traneksamat (TXA) merupakan agen antifibrinolitik yang banyak digunakan untuk mengurangi perdarahan pada kasus trauma, pembedahan, dan obstetri. Meskipun secara umum dianggap aman, terdapat laporan langka mengenai terjadinya sindrom koroner akut yang muncul segera setelah pemberian TXA, terutama pada pasien lanjut usia dengan faktor risiko kardiovaskular. Studi ini melaporkan kasus seorang wanita berusia 80 tahun dengan hipertensi tidak terkontrol yang mengalami infark miokard inferior akut (STEMI) segera setelah menerima TXA intravena untuk mengatasi perdarahan kulit kepala yang persisten akibat jatuh. Setelah dilakukan penutupan luka dan perawatan suportif, pasien mengalami hipotensi, penurunan kesadaran, dan tanda-tanda syok kardiogenik. Hasil elektrokardiogram menunjukkan elevasi segmen ST pada sadapan inferior, dan pasien kemudian mendapat terapi antiplatelet ganda, cairan intravena, norepinefrin, serta dirujuk untuk intervensi koroner perkutan primer. Meskipun uji klinis acak berskala besar tidak menunjukkan peningkatan risiko trombosis arteri akibat TXA, laporan kasus yang terisolasi—termasuk kasus ini—mengindikasikan potensi risiko trombotik pada individu yang rentan. TXA tetap dianggap aman dan efektif berdasarkan bukti berkualitas tinggi; namun, dokter perlu mempertimbangkan manfaat hemostatik dibandingkan potensi risiko trombotik pada pasien lanjut usia atau berisiko tinggi, tetap waspada terhadap kejadian koroner akut, serta melaporkan efek samping untuk meningkatkan pemahaman kolektif.References
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