Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, Maryland.
Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA Intern Med. 2017 Oct 1;177(10):1508-1512. doi: 10.1001/jamainternmed.2017.3597.
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments. Eliminating a simple laboratory test that provides no incremental value to patient care can lead to millions of health care dollars saved without adversely affecting patient care quality, and in this case potentially improving patient care.
在美国，每年有近 3000 万次急诊就诊需要进行心脏生物标志物检测。美国心脏病学院/欧洲心脏病学会指出，由于心肌肌钙蛋白具有近乎绝对的心肌组织特异性和对心肌损伤的高临床灵敏度，因此是首选的生物标志物。多个学术医疗中心已经实施了干预措施，以消除常规开具肌酸激酶-MB 测试的做法，并公布了患者安全结果数据；然而，在许多医院和急诊部门仍在开具肌酸激酶-MB 测试。消除一项对患者护理没有增加价值的简单实验室测试，可以节省数百万美元的医疗保健费用，而不会对患者护理质量产生不利影响，在这种情况下还可能改善患者护理。
