Efektivitas Beta Blocker Terhadap Mortalitas Semua Penyebab dan Luaran Kardiovaskular Mayor Pasca AMI/STEMI : Scoping Review
DOI:
https://doi.org/10.54082/jupin.2077Kata Kunci:
beta-blockers, infark miokard, kardiovaskular, mortalitasAbstrak
Beta-blocker (BB) merupakan terapi standar dalam pencegahan sekunder pasca infark miokard (MI), namun efektivitasnya di era terapi kardiovaskular modern masih diperdebatkan, terutama pada pasien dengan fraksi ejeksi ventrikel kiri (LVEF) terpelihara. Scoping review ini bertujuan memetakan dan mengevaluasi bukti ilmiah terkini mengenai efektivitas BB dalam menurunkan mortalitas dan kejadian kardiovaskular berulang pada pasien pasca MI. Pencarian literatur menggunakan kerangka Population, Concept, and Context (PCC) melalui basis data PubMed, Google Scholar, dan Crossref untuk artikel periode 2020-2025, mencakup uji klinis acak, studi kohort, dan meta-analisis. Hasil menunjukkan BB memberikan penurunan mortalitas sekitar 11% pada pasien dengan LVEF <50%. Pada pasien dengan LVEF ≥50% yang menerima terapi modern (PCI primer, DAPT, statin, ACE inhibitor), manfaat terhadap mortalitas dan reinfark terbatas, meskipun BB tetap berkontribusi pada stabilisasi hemodinamik dan kontrol aritmia. Studi ABYSS (2025) menunjukkan penghentian BB meningkatkan tekanan darah dan denyut jantung secara signifikan. Di Indonesia, tingkat penggunaan BB mencapai 70-89% pada pasien penyakit jantung koroner, namun bukti efektivitas jangka panjang masih terbatas. BB tetap esensial pada pasien dengan disfungsi ventrikel kiri pasca MI, sedangkan pada pasien dengan LVEF terpelihara, personalisasi terapi berdasarkan profil risiko individual diperlukan. Review ini mengidentifikasi gap penelitian prospektif mengenai efektivitas jangka panjang, keamanan deprescribing, dan pedoman berbasis bukti untuk populasi Indonesia, yang krusial bagi optimalisasi praktik klinis pencegahan sekunder pasca MI..
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Hak Cipta (c) 2026 Regy Abiana Saputra, Al Salvana Dwie Aunnie, Farrel Maulana Gunawan, Giacinta Caningtyas Nareswari , Sabrina Aulia Maulida, Salsabila Francisca Putri, Heri Ridwan
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