Evaluasi Elektrokardiogram Interval QTc dan JTc pada Penderita Malaria Vivaks yang Diberikan Dihidroartemisinin-Piperakuin dan Primakuin
<!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG /> </o:OfficeDocumentSettings> </xml><![endif]--> <p class="MsoNormal" style="text-align: justify;"><a name="OLE_LINK9"></a><a name="OLE_L...
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| Format: | Article |
| Language: | English |
| Published: |
Universitas Indonesia
2015-12-01
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| Series: | Journal Kedokteran Indonesia |
| Online Access: | http://journal.ui.ac.id/index.php/eJKI/article/view/5646 |
| Summary: | <!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG /> </o:OfficeDocumentSettings> </xml><![endif]--> <p class="MsoNormal" style="text-align: justify;"><a name="OLE_LINK9"></a><a name="OLE_LINK8"><span style="mso-bookmark: OLE_LINK9;"><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">Dihidroartemisinin-piperakuin (DHA-PPQ) telah digunakan secara global sebagai terapi malaria vivaks. Salah satu efek samping DHA-PPQ adalah pemanjangan repolarisasi ventrikel yang dapat menimbulkanaritmia ventrikuler yaitu Torsade de Pointes (TdP). Studi before-after ini bertujuan untuk mengetahuiperbedaan rerata interval QTc dan JTc penderita malaria vivaks sebelum dan sesudah pemberian DHA-PPQdan primakuin (PQ). Penelitian dilakukan di Lembaga Biologi Molekuler Eijkman, Jakarta pada bulan Mei-Juli2015. Sumber data adalah data sekunder hasil rekaman EKG pada penelitian utama “Safety, tolerability, andefficacy of artesunat-pyonaridine or dihydroartemisinin-piperaquine in combination with primaquine as radicalcure for P.vivax in Indonesian soldiers” tahun 2010.<strong> </strong>Subyek yang masuk kriteria seleksi pada pemberianDHA-PPQ dan PQ, masing-masing berjumlah 24 subyek dan 14 subyek. Interval QT dan JT dalam penelitianini menggunakan dua formula yang sudah dikoreksi terhadap frekuensi denyut jantung yaitu formula Bazett(QTcB, JTcB) dan Fridericia (QTcF, JTcF). Pemberian DHA-PPQ menunjukkan pemanjangan rerata intervalQTcF secara bermakna dibandingkan baseline yaitu sebesar 14,42 milidetik terjadi di D3 predose dan 20,53milidetik di D3 postdose. Rerata pemanjangan interval JTcF setelah pemberian DHA-PPQ adalah 13,43milidetik di D3 postdose. Pada pemberian PQ terdapat perbedaan nilai rerata interval QTcB dibandingkanbaseline sebesar 19,42 milidetik. Rerata pemanjangan interval JTcF dibandingkan baseline 16,50 milidetik diD42 postdose dan secara statistik bermakna.</span></span></a></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><strong><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">Kata kunci</span></strong></span></span><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">: dihidroartemisinin-piperakuin, primakuin, malaria vivaks, Torsade de Pointes, interval QTc,<strong> </strong>interval JTc.</span></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;"> </span></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><strong><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20;">Electrocardiogram Evaluation of QTc and JTc Interval of DihydroartemisininPiperaquine and Primaquine Therapies Given to The Vivax Malaria Patients </span></strong></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><strong><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">Abstract</span></strong></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">Dihydroartemisinin-piperaquin (DHA-PPQ) has been used globally as standard combination therapies for vivax malaria treatment. One of the side effects that must be put into caution is the prolongation ofventricular repolarization, which can lead to the development of ventricular arrhythmia known as Torsadede Pointes (TdP).<strong> </strong>This study used<span style="mso-spacerun: yes;"> </span>‘before and after’ design and was aimed to find out whether there was asignificant difference of QTc and JTc interval of vivax malaria patients pre and post DHA-PPQ and Primaquin(PQ) dose. The ECG record of DHA-PPQ and PQ, respectively, 24 and 14 subjects. QT and JT intervalsare affected by heart rate, thus, both of them have to be corrected according to the heart rate using twoformulas, i.e.: Bazett (QTcB, JTcB) and Fridericia (QTcF, JTcF) formulas.<strong> </strong>The results showed significant QTcFprolongations of 14.42 ms predose and 20.53 ms postdose on D3 DHA-PPQ treatment compared to thebaseline value, whereas prolongations of JT interval were 13.43 ms found on D3 postdose. The results aftergiven PQ showed mean difference of QTcB compared to the baseline value was 19.42 ms. The result for JTcFinterval after given PQ, showed mean difference of prolongations compared to the baseline value was 16.50ms, which was statistically significant.</span></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><strong><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">Key words</span></strong></span></span><span style="mso-bookmark: OLE_LINK8;"><span style="mso-bookmark: OLE_LINK9;"><span style="font-size: 9.0pt; line-height: 107%; font-family: "Arial",sans-serif; color: #231f20; mso-bidi-font-style: italic;">: dihydroartemisinin-piperaquine, primaquine vivax malaria, Torsade de Pointes, QTcinterval,JTc interval</span></span></span></p> |
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| ISSN: | 2338-1426 2338-6037 |