Acs

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SINDROM KORONER AKUT

Manifestasi klinis manifestasi klinis sebagai akibat iskemia miokardium

UAP NSTEMI STEMI

1

WHO → 60% penyebab kematian → PJK

AHA → > 1 juta orang PJK → MI

Indonesia → 26,4% PJK

40% kematian → PJK

ETIOLOGI

3

Pathophysiology of Atherosclerosis

Endothelial Dysfunction
•Foam •Cells
•oxidized LDL •homocysteine •smoking •aging •hyperglycemia •hypertension

•Fatty •Streak

•Intermediate •Fibrous •Complicated •Lesion •Atheroma •Plaque •Lesion/Rupture

35-45 yrs Endothelial injury
•nitric oxide •endothelin-1 •vasodilation

45-55 yrs Lipid accumulation
•adhesion molecules (ICAM, VCAM) •monocyte adhesion •macrophage LDL uptake

Inflammation

55-65 yrs

>65 yrs

•continued macrophage/lipid accumulation •leukocyte accumulation •cytokines (IL-6, TNFa, IFNg )
4

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