Creatine Kinase–MB

Singh, Gurmukh; Baweja, Paramdeep

doi:10.1309/ajcpbik3g4bwejko

Cited by 20 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It also highlighted the importance of early involvement of the ED and medical leadership, which was consistent with our experience as well (7). Our study, which was conducted in a community hospital setting, re-emphasizes the paramount importance of joint efforts among different specialties and departments.…”

Section: Discussionsupporting

confidence: 88%

“…The only potential indication for the CK-MB assay is in the case of re-infarction or an extension of recent infarction in a patient with ACS. However, according to a recent study, even in this scenario, CK-MB could be safely substituted by serial troponin testing (7). …”

Section: Discussionmentioning

confidence: 99%

“…University of Missouri-Kansas City reported an exciting study at their institution involving removal of these older biomarkers, facilitated by close collaboration between Cardiology and Pathology Departments (7). It also highlighted the importance of early involvement of the ED and medical leadership, which was consistent with our experience as well (7).…”

Section: Discussionmentioning

confidence: 99%

“…In the era of nearly ubiquitous electronic medical records and CPOE, the process of changing physician practice with clinical decision support or by developing order sets is a rapidly evolving area of health care (7). Given the presumed variability in resources and practice between community hospitals and university hospitals, one may argue that what can be done in a university program may not be applicable at a community hospital.…”

Section: Discussionmentioning

confidence: 99%

“…This is due to their significantly higher sensitivity and specificity compared to other cardiac markers (3). Multiple studies have illustrated the fading role of creatinine kinase (CK)-MB and myoglobin, in the diagnosis of ACS (4–7). In 2012, the American College of Cardiology Foundation Task Force recommended against checking cardiac biomarkers other than troponins for diagnostic use for ACS risk assessment.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Financial impact of a targeted reduction in cardiac enzyme testing at a community hospital

Zhang

Sill

Young

et al. 2016

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

ObjectivesNearly one-third of healthcare costs are potentially avoidable and would not compromise medical care if eliminated. Therefore, we sought to evaluate the financial impact of reduction in use of creatinine kinase (CK)-MB and myoglobin tests after removing them from the cardiac enzyme order set at a community hospital.MethodsGrand rounds were held, and an email notification was sent to de-emphasize the use of CK, CK-MB, myoglobin, SGOT (glutamic-oxaloacetic transaminase), and SGPT (serum glutamic-pyruvic transaminase) in acute coronary syndrome (ACS) work up. The above tests were removed from the pre-checked cardiac enzyme order set in the computerized physician order entry on February 13, 2014. The tests continued to be available, but needed to be ordered individually. The mean monthly volume of cardiac enzyme tests for 12 months after this intervention was compared with the mean monthly volume of 12 months before the change. Total cost savings were calculated.ResultsAfter the intervention, the number of CK, CK-MB, myoglobin, SGOT, and SGPT tests utilized for ACS workup decreased dramatically (p<0.001). The volume of troponin testing remained the same (p=0.283). The total annual savings of billable charges to healthcare payers was $463,744.7.ConclusionsRemoval of CK-MB, myoglobin, CK, SGOT, and SGPT tests from cardiac enzyme order sets can successfully reduce unnecessary laboratory testing for ACS workup, leading to significant cost savings to the healthcare system.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%