Health Technology Assessment Practice in Indonesia: A comprehensive study of Fibrinolytic Therapy among ST-Segment Elevation Myocardial Infarction Patients
Keywords:
Alteplase, cost-effectiveness, ICER, STEMI, streptokinase
Abstract
Acute coronary syndrome disease is responsible for half of all cardiovascular disease-related deaths and encompasses all ischemic symptoms, including ST segment elevation myocardial infarction. Streptokinase and alteplase each have advantages and disadvantages, both in terms of the economic, safety, and efficacy aspects that need to be considered in their use for STEMI patients. The aim of this study was to compare the effectiveness of using alteplase and streptokinase among STEMI patients in Indonesia. This study uses a retrospective cohort method and a systematic review to evaluate clinical effectiveness, makes a decision tree analysis model for economic evaluation, analyzes the cost impact, and uses qualitative analysis to determine clinical preferences. The proportion of patients with stable CAD in the Alteplase group was greater than in the Streptokinase group (87.37% vs. 62.50%). Based on this proportion, Alteplase is considered to be able to significantly reduce the incidence of MACE in STEMI patients compared to patients receiving Streptokinase therapy (RR 1.398; 95% CI 1.058–1.848). The decision tree model showed that the incremental cost-effectiveness ratio (ICER) value of the use of Alteplase when compared with Streptokinase produced in this study was 24.27 million rupiahs per stable CAD patient. The qualitative data revealed there was no significant difference in the use of Alteplase or Streptokinase except for the time required for monitoring. The clinical effectiveness of Alteplase is consistently better than Streptokinase for the management of STEMI patients. The cost-effectiveness analysis shows that although Alteplase costs more than Streptokinase, its use provides greater clinical benefits. The budget requirement for the provision of Alteplase as the main therapy for STEMI patients in Indonesia is IDR 272.15 billion in 2025. In the context of selecting a fibrinolytic agent, cardiologists and vascular specialists are more likely to use Alteplase.
References
Adisasmito, W., Amir, V., Atin, A., Megraini, A., & Kusuma, D. (2020). Geographic and socioeconomic disparity in cardiovascular risk factors in Indonesia: Analysis of the basic health research 2018. BMC Public Health, 20. https://doi.org/10.1186/s12889-020-09099-1
Alipour, V., Zandian, H., Yazdi-Feyzabadi, V., Avesta, L., & Moghadam, T. Z. (2021). Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran. Cost Effectiveness and Resource Allocation, 19(1), 1–10. https://doi.org/10.1186/s12962-020-00250-8
Anindya, K., Ng, N., Atun, R., Marthias, T., Zhao, Y., McPake, B., van Heusden, A., Pan, T., & Lee, J. T. (2021). Effect of multimorbidity on utilisation and out-of-pocket expenditure in Indonesia: quantile regression analysis. BMC Health Services Research, 21(1), 1–12. https://doi.org/10.1186/s12913-021-06446-9
Artime, E., Romera, I., Díaz-Cerezo, S., & Delgado, E. (2021). Epidemiology and Economic Burden of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in Spain: A Systematic Review. Diabetes Therapy, 12(6), 1631–1659. https://doi.org/10.1007/s13300-021-01060-8
BARRON, H. V., RUNDLE, A., GURWITZ, J., & TIEFENBRUNN, A. (1999). Reperfusion Therapy for Acute Myocardial Infarction. Cardiology in Review, 7(3), 156–160. https://doi.org/10.1097/00045415-199905000-00013
Bates, E. R. (2010). Streptokinase, alteplase, reteplase, or tenecteplase. Pharmacology in the Catheterization Laboratory, 133–139. https://doi.org/https://doi.org/10.1002/9781444306347.ch16
Blakely, T., Kvizhinadze, G., Atkinson, J., Dieleman, J., & Clarke, P. (2019). Health system costs for individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New Zealand. PLoS Medicine, 16(1), 1–21. https://doi.org/10.1371/journal.pmed.1002716
Boland, A., Dundar, Y., Bagust, A., Haycox, A., Hill, R., Mujica Mota, R., Walley, T., & Dickson, R. (2003). Early thrombolysis for the treatment of acute myocardial infarction: a systematic review and economic evaluation. Health Technology Assessment (Winchester, England), 7(15), 1–136. https://doi.org/10.3310/hta7150
Butcher, K., Shuaib, A., Saver, J., Donnan, G., Davis, S. M., Norrving, B., Wong, K. S. L., Abd-Allah, F., Bhatia, R., & Khan, A. (2013). Thrombolysis in the developing world: Is there a role for streptokinase? International Journal of Stroke, 8(7), 560–565. https://doi.org/10.1111/j.1747-4949.2012.00923.x
Chang, K., Ahn, Y., Lim, S., Yang, J. H., Lee, K. Y., Choo, E. H., Kim, H. K., Nam, C. W., Kim, W., Hwang, J. Y., Rha, S. W., Kim, H. S., Cho, M. C., Jang, Y., Jeong, M. H., Kim, J. H., Kang, H. J., Bae, J. W., Kim, B. K., … Byeon, J. (2021). 2021 Korean society of myocardial infarction expert consensus document on revascularization for acute myocardial infarction. Korean Circulation Journal, 51(4), 289–307. https://doi.org/10.4070/KCJ.2021.0043
Dundar, Y., Hill, R., Dickson, R., & Walley, T. (2003). Comparative efficacy of thrombolytics in acute myocardial infarction: A systematic review. QJM - Monthly Journal of the Association of Physicians, 96(2), 103–113. https://doi.org/10.1093/qjmed/hcg016
Ehlers, L., Müskens, W. M., Jensen, L. G., Kjølby, M., & Andersen, G. (2008). National Use of Thrombolysis with Alteplase for Acute Ischaemic Stroke via Telemedicine in Denmark. CNS Drugs, 22(1), 73–81. https://doi.org/10.2165/00023210-200822010-00006
Faour, A., Collins, N., Williams, T., Khan, A., Juergens, C. P., Lo, S., Walters, D. L., Chew, D. P., & French, J. K. (2021). Reperfusion after Fibrinolytic Therapy (RAFT): An open-label, multi-centre, randomised controlled trial of bivalirudin versus heparin in rescue percutaneous coronary intervention. PLoS ONE, 16(10 October), 1–18. https://doi.org/10.1371/journal.pone.0259148
Fayet-Moore, F., George, A., Cassettari, T., Yulin, L., Tuck, K., & Pezzullo, L. (2018). Healthcare expenditure and productivity cost savings from reductions in cardiovascular disease and type 2 diabetes associated with increased intake of cereal fibre among Australian adults: A cost of illness analysis. Nutrients, 10(1), 1–22. https://doi.org/10.3390/nu10010034
Firman, D., Mangkuanom, A. S., Iryuza, N., Fahri, I., Artha, I. M. J. R., Mulia, E., Syukri, M., Yonas, E., Pranata, R., & Alkatiri, A. A. (2021). Decrease in the Number of Patients Presenting With ST-Segment Elevation Myocardial Infarction Across Catheterization Centers in Indonesia During the Coronavirus Disease 2019 Pandemic. Frontiers in Cardiovascular Medicine, 8(August). https://doi.org/10.3389/fcvm.2021.676592
Grijseels, E. W. M., Bouten, M. J. M., Lenderink, T., Deckers, J. W., Hoes, A. W., Hartman, J. A. M., Van Der Does, E., & Simoons, M. L. (1995). Pre-hospital thrombolytic therapy with either alteplase or streptokinase: Practical applications, complications and long-term results in 529 patients. European Heart Journal, 16(12), 1833–1838. https://doi.org/10.1093/oxfordjournals.eurheartj.a060836
Han, X., Bai, L., Jeong, M. H., Ahn, J. H., Hyun, D. Y., Cho, K. H., Kim, M. C., Sim, D. S., Hong, Y. J., Kim, J. H., & Ahn, Y. K. (2021). Higher long-term mortality in patients with non-st-elevation myocardial infarction than st-elevation myocardial infarction after discharge. Yonsei Medical Journal, 62(5), 400–408. https://doi.org/10.3349/ymj.2021.62.5.400
Huang, D., Qian, J., Liu, Z., Xu, Y., Zhao, X., Qiao, Z., Fang, W., Jiang, L., Hu, W., Shen, C., Liang, C., Zhang, Q., & Ge, J. (2021). Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial. Frontiers in Cardiovascular Medicine, 8(August), 1–10. https://doi.org/10.3389/fcvm.2021.710994
Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., Caforio, A. L. P., Crea, F., Goudevenos, J. A., Halvorsen, S., Hindricks, G., Kastrati, A., Lenzen, M. J., Prescott, E., Roffi, M., Valgimigli, M., Varenhorst, C., Vranckx, P., Widimský, P., … Gale, C. P. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 39(2), 119–177. https://doi.org/10.1093/eurheartj/ehx393
Intan, R. E., Hasibuan, F. S., Gandi, P., & Alkaff, F. F. (2021). Gastric perforation mimicking ST-segment elevation myocardial infarction. BMJ Case Reports, 14(3), 2020–2022. https://doi.org/10.1136/bcr-2020-237470
Kamarullah, W., Sabrina, A. P., Rocky, M. A., & Gozali, D. R. (2021). Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis. Indian Heart Journal, 73(4), 404–412. https://doi.org/10.1016/j.ihj.2021.06.009
Karmali, K. N., Lloyd-Jones, D. M., van der Leeuw, J., Goff, D. C., Yusuf, S., Zanchetti, A., Glasziou, P., Jackson, R., Woodward, M., Rodgers, A., Neal, B. C., Berge, E., Teo, K., Davis, B. R., Chalmers, J., Pepine, C., Rahimi, K., & Sundström, J. (2018). Blood pressure-lowering treatment strategies based on cardiovascular risk versus blood pressure: A meta-analysis of individual participant data. PLoS Medicine, 15(3), 1–20. https://doi.org/10.1371/journal.pmed.1002538
Kazibwe, J., Tran, P. B., & Annerstedt, K. S. (2021). The household financial burden of non-communicable diseases in low- and middle-income countries: a systematic review. Health Research Policy and Systems, 19(1), 1–15. https://doi.org/10.1186/s12961-021-00732-y
Kostic, T., Perisic, Z., Milic, D., Apostolovic, S., Salinger-Martinovic, S., Bozinovic, N., Mitov, V., & Vidanovic, M. (2009). Coronary flow and hemorrhagic complications after alteplase and streptokinase administration in patients with acute myocardial infarction. Vojnosanitetski Pregled, 66(3), 218–222. https://doi.org/10.2298/vsp0903218k
Liu, Y., & Dalal, K. (2011). Review of cost-effectiveness analysis of medical treatment for myocardial infarction. International Journal of Preventive Medicine, 2(2), 64–72.
Lorenzoni, R., Pagano, D., Mazzotta, G., Rosen, S. D., Fattore, G., De Caterina, R., & Gensini, G. (1998). Pitfalls in the economic evaluation of thrombolysis in myocardial infarction. European Heart Journal, 19(10), 1518–1524. https://doi.org/10.1053/euhj.1998.1092
Maharani, A., Sujarwoto, Praveen, D., Oceandy, D., Tampubolon, G., & Patel, A. (2019). Cardiovascular disease risk factor prevalence and estimated 10-year cardiovascular risk scores in Indonesia: The SMARThealth Extend study. PLoS ONE, 14(4), 1–13. https://doi.org/10.1371/journal.pone.0215219
Martha, J. W., Sihite, T. A., & Listina, D. (2021). The Difference in Accuracy Between Global Registry of Acute Coronary Events Score and Thrombolysis in Myocardial Infarction Score in Predicting In-Hospital Mortality of Acute ST-Elevation Myocardial Infarction Patients. Cardiology Research, 12(3), 177–185. https://doi.org/10.14740/cr1247
Mounsey, J. P., Skinner, J. S., Hawkins, T., McDermott, A. F. N., Furniss, S. S., Adams, P. C., Kesteven, P. J. L., & Reid, D. S. (1995). Rescue thrombolysis: Alteplase as adjuvant treatment after streptokinase in acute myocardial infarctione. British Heart Journal, 74(4), 348–353. https://doi.org/10.1136/hrt.74.4.348
Mrad, I. Ben, Mrad, M. Ben, Oumaya, Z., Zairi, I., Besbes, B., Ouaghlani, K., Kamoun, S., Mleyhi, S., Miri, R., Mzoughi, K., & Kraiem, S. (2021). Alveolar hemorrhage following thrombolytic therapy for acute myocardial infarction: Two case reports and literature review. Open Access Emergency Medicine, 13(August), 399–405. https://doi.org/10.2147/OAEM.S324366
Mughal, L. H., & Sastry, S. (2022). Advances in the treatment of ST Elevation Myocardial Infarction in the UK. JRSM Cardiovascular Disease, 11, 1–10. https://doi.org/10.1177/20480040221075519
Nepal, G., Yadav, J. K., Bhandari, S., Gautam, J., & Gajurel, B. P. (2021). Low-cost alternatives for the management of acute ischemic stroke in low and middle-income countries. Annals of Medicine and Surgery, 72(October), 16–19. https://doi.org/10.1016/j.amsu.2021.102969
Noma, S., Miyachi, H., Fukuizumi, I., Matsuda, J., Sangen, H., Kubota, Y., Imori, Y., Saiki, Y., Hosokawa, Y., Tara, S., Tokita, Y., Akutsu, K., Shimizu, W., Yamamoto, T., & Takano, H. (2022). Adjunctive Catheter-Directed Thrombolysis during Primary PCI for ST-Segment Elevation Myocardial Infarction with High Thrombus Burden. Journal of Clinical Medicine, 11(1), 262. https://doi.org/10.3390/jcm11010262
Peiris, D., Ghosh, A., Manne-Goehler, J., Jaacks, L. M., Theilmann, M., Marcus, M. E., Zhumadilov, Z., Tsabedze, L., Supiyev, A., Silver, B. K., Sibai, A. M., Norov, B., Mayige, M. T., Martins, J. S., Lunet, N., Labadarios, D., Jorgensen, J. M. A., Houehanou, C., Guwatudde, D., … Geldsetzer, P. (2021). Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data. PLoS Medicine, 18(3), 1–19. https://doi.org/10.1371/JOURNAL.PMED.1003485
Reindl, M., Eitel, I., & Reinstadler, S. J. (2020). Role of cardiac magnetic resonance to improve risk prediction following acute ST-elevation myocardial infarction. Journal of Clinical Medicine, 9(4). https://doi.org/10.3390/jcm9041041
Resic, N., Durak-Nalbantic, A., Dzubur, A., Hodzic, E., Kulic, M., Sabanovic-Bajramovic, N., & Jahic, E. (2013). Streptokinase versus alteplase: comparison of echocardiographic parameters and post-coronarography treatment - our experience. Medicinski Arhiv, 67(5), 322–325. https://doi.org/10.5455/medarh.2013.67.322-325
Rochmah, T. N., Rahmawati, I. T., Dahlui, M., Budiarto, W., & Bilqis, N. (2021). Economic burden of stroke disease: A systematic review. International Journal of Environmental Research and Public Health, 18(14). https://doi.org/10.3390/ijerph18147552
Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7
Alipour, V., Zandian, H., Yazdi-Feyzabadi, V., Avesta, L., & Moghadam, T. Z. (2021). Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran. Cost Effectiveness and Resource Allocation, 19(1), 1–10. https://doi.org/10.1186/s12962-020-00250-8
Anindya, K., Ng, N., Atun, R., Marthias, T., Zhao, Y., McPake, B., van Heusden, A., Pan, T., & Lee, J. T. (2021). Effect of multimorbidity on utilisation and out-of-pocket expenditure in Indonesia: quantile regression analysis. BMC Health Services Research, 21(1), 1–12. https://doi.org/10.1186/s12913-021-06446-9
Artime, E., Romera, I., Díaz-Cerezo, S., & Delgado, E. (2021). Epidemiology and Economic Burden of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in Spain: A Systematic Review. Diabetes Therapy, 12(6), 1631–1659. https://doi.org/10.1007/s13300-021-01060-8
BARRON, H. V., RUNDLE, A., GURWITZ, J., & TIEFENBRUNN, A. (1999). Reperfusion Therapy for Acute Myocardial Infarction. Cardiology in Review, 7(3), 156–160. https://doi.org/10.1097/00045415-199905000-00013
Bates, E. R. (2010). Streptokinase, alteplase, reteplase, or tenecteplase. Pharmacology in the Catheterization Laboratory, 133–139. https://doi.org/https://doi.org/10.1002/9781444306347.ch16
Blakely, T., Kvizhinadze, G., Atkinson, J., Dieleman, J., & Clarke, P. (2019). Health system costs for individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New Zealand. PLoS Medicine, 16(1), 1–21. https://doi.org/10.1371/journal.pmed.1002716
Boland, A., Dundar, Y., Bagust, A., Haycox, A., Hill, R., Mujica Mota, R., Walley, T., & Dickson, R. (2003). Early thrombolysis for the treatment of acute myocardial infarction: a systematic review and economic evaluation. Health Technology Assessment (Winchester, England), 7(15), 1–136. https://doi.org/10.3310/hta7150
Butcher, K., Shuaib, A., Saver, J., Donnan, G., Davis, S. M., Norrving, B., Wong, K. S. L., Abd-Allah, F., Bhatia, R., & Khan, A. (2013). Thrombolysis in the developing world: Is there a role for streptokinase? International Journal of Stroke, 8(7), 560–565. https://doi.org/10.1111/j.1747-4949.2012.00923.x
Chang, K., Ahn, Y., Lim, S., Yang, J. H., Lee, K. Y., Choo, E. H., Kim, H. K., Nam, C. W., Kim, W., Hwang, J. Y., Rha, S. W., Kim, H. S., Cho, M. C., Jang, Y., Jeong, M. H., Kim, J. H., Kang, H. J., Bae, J. W., Kim, B. K., … Byeon, J. (2021). 2021 Korean society of myocardial infarction expert consensus document on revascularization for acute myocardial infarction. Korean Circulation Journal, 51(4), 289–307. https://doi.org/10.4070/KCJ.2021.0043
Dundar, Y., Hill, R., Dickson, R., & Walley, T. (2003). Comparative efficacy of thrombolytics in acute myocardial infarction: A systematic review. QJM - Monthly Journal of the Association of Physicians, 96(2), 103–113. https://doi.org/10.1093/qjmed/hcg016
Ehlers, L., Müskens, W. M., Jensen, L. G., Kjølby, M., & Andersen, G. (2008). National Use of Thrombolysis with Alteplase for Acute Ischaemic Stroke via Telemedicine in Denmark. CNS Drugs, 22(1), 73–81. https://doi.org/10.2165/00023210-200822010-00006
Faour, A., Collins, N., Williams, T., Khan, A., Juergens, C. P., Lo, S., Walters, D. L., Chew, D. P., & French, J. K. (2021). Reperfusion after Fibrinolytic Therapy (RAFT): An open-label, multi-centre, randomised controlled trial of bivalirudin versus heparin in rescue percutaneous coronary intervention. PLoS ONE, 16(10 October), 1–18. https://doi.org/10.1371/journal.pone.0259148
Fayet-Moore, F., George, A., Cassettari, T., Yulin, L., Tuck, K., & Pezzullo, L. (2018). Healthcare expenditure and productivity cost savings from reductions in cardiovascular disease and type 2 diabetes associated with increased intake of cereal fibre among Australian adults: A cost of illness analysis. Nutrients, 10(1), 1–22. https://doi.org/10.3390/nu10010034
Firman, D., Mangkuanom, A. S., Iryuza, N., Fahri, I., Artha, I. M. J. R., Mulia, E., Syukri, M., Yonas, E., Pranata, R., & Alkatiri, A. A. (2021). Decrease in the Number of Patients Presenting With ST-Segment Elevation Myocardial Infarction Across Catheterization Centers in Indonesia During the Coronavirus Disease 2019 Pandemic. Frontiers in Cardiovascular Medicine, 8(August). https://doi.org/10.3389/fcvm.2021.676592
Grijseels, E. W. M., Bouten, M. J. M., Lenderink, T., Deckers, J. W., Hoes, A. W., Hartman, J. A. M., Van Der Does, E., & Simoons, M. L. (1995). Pre-hospital thrombolytic therapy with either alteplase or streptokinase: Practical applications, complications and long-term results in 529 patients. European Heart Journal, 16(12), 1833–1838. https://doi.org/10.1093/oxfordjournals.eurheartj.a060836
Han, X., Bai, L., Jeong, M. H., Ahn, J. H., Hyun, D. Y., Cho, K. H., Kim, M. C., Sim, D. S., Hong, Y. J., Kim, J. H., & Ahn, Y. K. (2021). Higher long-term mortality in patients with non-st-elevation myocardial infarction than st-elevation myocardial infarction after discharge. Yonsei Medical Journal, 62(5), 400–408. https://doi.org/10.3349/ymj.2021.62.5.400
Huang, D., Qian, J., Liu, Z., Xu, Y., Zhao, X., Qiao, Z., Fang, W., Jiang, L., Hu, W., Shen, C., Liang, C., Zhang, Q., & Ge, J. (2021). Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial. Frontiers in Cardiovascular Medicine, 8(August), 1–10. https://doi.org/10.3389/fcvm.2021.710994
Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., Caforio, A. L. P., Crea, F., Goudevenos, J. A., Halvorsen, S., Hindricks, G., Kastrati, A., Lenzen, M. J., Prescott, E., Roffi, M., Valgimigli, M., Varenhorst, C., Vranckx, P., Widimský, P., … Gale, C. P. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 39(2), 119–177. https://doi.org/10.1093/eurheartj/ehx393
Intan, R. E., Hasibuan, F. S., Gandi, P., & Alkaff, F. F. (2021). Gastric perforation mimicking ST-segment elevation myocardial infarction. BMJ Case Reports, 14(3), 2020–2022. https://doi.org/10.1136/bcr-2020-237470
Kamarullah, W., Sabrina, A. P., Rocky, M. A., & Gozali, D. R. (2021). Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis. Indian Heart Journal, 73(4), 404–412. https://doi.org/10.1016/j.ihj.2021.06.009
Karmali, K. N., Lloyd-Jones, D. M., van der Leeuw, J., Goff, D. C., Yusuf, S., Zanchetti, A., Glasziou, P., Jackson, R., Woodward, M., Rodgers, A., Neal, B. C., Berge, E., Teo, K., Davis, B. R., Chalmers, J., Pepine, C., Rahimi, K., & Sundström, J. (2018). Blood pressure-lowering treatment strategies based on cardiovascular risk versus blood pressure: A meta-analysis of individual participant data. PLoS Medicine, 15(3), 1–20. https://doi.org/10.1371/journal.pmed.1002538
Kazibwe, J., Tran, P. B., & Annerstedt, K. S. (2021). The household financial burden of non-communicable diseases in low- and middle-income countries: a systematic review. Health Research Policy and Systems, 19(1), 1–15. https://doi.org/10.1186/s12961-021-00732-y
Kostic, T., Perisic, Z., Milic, D., Apostolovic, S., Salinger-Martinovic, S., Bozinovic, N., Mitov, V., & Vidanovic, M. (2009). Coronary flow and hemorrhagic complications after alteplase and streptokinase administration in patients with acute myocardial infarction. Vojnosanitetski Pregled, 66(3), 218–222. https://doi.org/10.2298/vsp0903218k
Liu, Y., & Dalal, K. (2011). Review of cost-effectiveness analysis of medical treatment for myocardial infarction. International Journal of Preventive Medicine, 2(2), 64–72.
Lorenzoni, R., Pagano, D., Mazzotta, G., Rosen, S. D., Fattore, G., De Caterina, R., & Gensini, G. (1998). Pitfalls in the economic evaluation of thrombolysis in myocardial infarction. European Heart Journal, 19(10), 1518–1524. https://doi.org/10.1053/euhj.1998.1092
Maharani, A., Sujarwoto, Praveen, D., Oceandy, D., Tampubolon, G., & Patel, A. (2019). Cardiovascular disease risk factor prevalence and estimated 10-year cardiovascular risk scores in Indonesia: The SMARThealth Extend study. PLoS ONE, 14(4), 1–13. https://doi.org/10.1371/journal.pone.0215219
Martha, J. W., Sihite, T. A., & Listina, D. (2021). The Difference in Accuracy Between Global Registry of Acute Coronary Events Score and Thrombolysis in Myocardial Infarction Score in Predicting In-Hospital Mortality of Acute ST-Elevation Myocardial Infarction Patients. Cardiology Research, 12(3), 177–185. https://doi.org/10.14740/cr1247
Mounsey, J. P., Skinner, J. S., Hawkins, T., McDermott, A. F. N., Furniss, S. S., Adams, P. C., Kesteven, P. J. L., & Reid, D. S. (1995). Rescue thrombolysis: Alteplase as adjuvant treatment after streptokinase in acute myocardial infarctione. British Heart Journal, 74(4), 348–353. https://doi.org/10.1136/hrt.74.4.348
Mrad, I. Ben, Mrad, M. Ben, Oumaya, Z., Zairi, I., Besbes, B., Ouaghlani, K., Kamoun, S., Mleyhi, S., Miri, R., Mzoughi, K., & Kraiem, S. (2021). Alveolar hemorrhage following thrombolytic therapy for acute myocardial infarction: Two case reports and literature review. Open Access Emergency Medicine, 13(August), 399–405. https://doi.org/10.2147/OAEM.S324366
Mughal, L. H., & Sastry, S. (2022). Advances in the treatment of ST Elevation Myocardial Infarction in the UK. JRSM Cardiovascular Disease, 11, 1–10. https://doi.org/10.1177/20480040221075519
Nepal, G., Yadav, J. K., Bhandari, S., Gautam, J., & Gajurel, B. P. (2021). Low-cost alternatives for the management of acute ischemic stroke in low and middle-income countries. Annals of Medicine and Surgery, 72(October), 16–19. https://doi.org/10.1016/j.amsu.2021.102969
Noma, S., Miyachi, H., Fukuizumi, I., Matsuda, J., Sangen, H., Kubota, Y., Imori, Y., Saiki, Y., Hosokawa, Y., Tara, S., Tokita, Y., Akutsu, K., Shimizu, W., Yamamoto, T., & Takano, H. (2022). Adjunctive Catheter-Directed Thrombolysis during Primary PCI for ST-Segment Elevation Myocardial Infarction with High Thrombus Burden. Journal of Clinical Medicine, 11(1), 262. https://doi.org/10.3390/jcm11010262
Peiris, D., Ghosh, A., Manne-Goehler, J., Jaacks, L. M., Theilmann, M., Marcus, M. E., Zhumadilov, Z., Tsabedze, L., Supiyev, A., Silver, B. K., Sibai, A. M., Norov, B., Mayige, M. T., Martins, J. S., Lunet, N., Labadarios, D., Jorgensen, J. M. A., Houehanou, C., Guwatudde, D., … Geldsetzer, P. (2021). Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data. PLoS Medicine, 18(3), 1–19. https://doi.org/10.1371/JOURNAL.PMED.1003485
Reindl, M., Eitel, I., & Reinstadler, S. J. (2020). Role of cardiac magnetic resonance to improve risk prediction following acute ST-elevation myocardial infarction. Journal of Clinical Medicine, 9(4). https://doi.org/10.3390/jcm9041041
Resic, N., Durak-Nalbantic, A., Dzubur, A., Hodzic, E., Kulic, M., Sabanovic-Bajramovic, N., & Jahic, E. (2013). Streptokinase versus alteplase: comparison of echocardiographic parameters and post-coronarography treatment - our experience. Medicinski Arhiv, 67(5), 322–325. https://doi.org/10.5455/medarh.2013.67.322-325
Rochmah, T. N., Rahmawati, I. T., Dahlui, M., Budiarto, W., & Bilqis, N. (2021). Economic burden of stroke disease: A systematic review. International Journal of Environmental Research and Public Health, 18(14). https://doi.org/10.3390/ijerph18147552
Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7
Published
2025-03-27
How to Cite
Setiawan, D., Herlinawaty, E., Prasuma, G. S., Zulyadaini, E., Juzar, D. A., Idaiani, S., Susanty, A. L., Annisa, A. N., Nadjib, M., Atthobari, J., Kristin, E., & Lianawati, L. (2025). Health Technology Assessment Practice in Indonesia: A comprehensive study of Fibrinolytic Therapy among ST-Segment Elevation Myocardial Infarction Patients. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.13015
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Section
Research Article
