Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014;6(1):29-33.
doi: 10.5681/jcvtr.2014.006. Epub 2014 Mar 21.

Cost-effectiveness of cardiac biomarkers as screening test in acute chest pain

Samad Shams-Vahdati  1 , Zahra Vand-Rajavpour  2 , Seyed-Pouya Paknezhad  2 , Reza Piri  2 , Elnaz Moghaddasi-Ghezeljeh  2 , Saba Mirabolfathi  2 , Mohammad Naghavi-Behzad  3
Affiliations

Cost-effectiveness of cardiac biomarkers as screening test in acute chest pain

Samad Shams-Vahdati et al. J Cardiovasc Thorac Res. 2014.

Abstract

Introduction: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Associated findings of electrocardiograph (ECG) are rather heterogeneous, and traditional cardiac biomarkers such as Creatine Kinase-MB (CK-MB) suffer from low cardiac specificity and sensitivity. In this study cost effectiveness of cardiac biomarkers single quantitative measurement was examined.

Methods: The present descriptive-analytic study conducted on patients who were asked for troponin I and CK-MB. All patients who referred to Emergency unit of Tabriz Imam Reza educational-medical center during January 2012 to July the 2013 were included in study. All patients included in the study were documented in terms of age, sex, working shift of referring, main complaint of patient, symptoms in referring, ECG findings, and results of troponin I and CK-MB tests.

Results: In this study, 2900 patients were studied including 1440 (49.7%) males and 1460 (50.3%) females. Mean age of patients was 62.91 (SD=14.36). Of all patients 1880 (64.8%) of patients referred during 8 a.m. to 8 p.m. and 1020 (35.2%) patients were referred during 8 p.m. to 8 a.m. The sensitivity of cardiac biomarkers' test in diagnosing Acute Coronary Syndrome (ACS) disease was calculated as 44.8% and its specificity was 86.6%. For diagnosing Acute Myocardial Infarction (AMI), sensitivity of cardiac biomarkers' test was 72.2% and its specificity was 86%. None of patients who were finally underwent unstable angina diagnosis showed increase in cardiac enzymes.

Conclusion: In conclusion, cardiac biomarkers can be used for screening acute chest pains, also cost effectiveness of cardiac biomarkers, appropriate specificity and sensitivity can guarantee their usefulness in emergency room.

Keywords: Acute Chest Pain; Cardiac Biomarkers; Creatine Kinase-MB; Myocardial Infarction.

PubMed Disclaimer

References

    1. Zalenski RJ, McCarren M, Roberts R, Rydman RJ, Jovanovic B, Das K. et al. An evaluation of a chest pain diagnostic protocol to exclude acute cardiac ischemia in the emergency department. Arch Intern Med. 1997;157:1085–91. - PubMed
    1. Yaghoubi A, Tabrizi JS, Mirinazhad MM, Azami S, Naghavi-Behzad M, Ghojazadeh M. Quality of Life in Cardiovascular Patients in Iran and Factors Affecting It: A Systematic Review. J Cardiovascand Thorac Res. 2012;4:95–101. - PMC - PubMed
    1. Laudon DA, Vukov LF, Breen JF, Rumberger JA, Wollan PC, Sheedy PF 2nd. Use of electron-beam computed tomography in the evaluation of chest pain patients in the emergency department. Ann Emerg Med. 1999;33:15–21. - PubMed
    1. McCaig LF, Nawar EW. National Hospital Ambulatory Medical Care Survey: 2004 emergency department summary. Adv Data. 2006;372:1–29. - PubMed
    1. Gibler WB, Cannon CP, Blomkalns AL, Char DM, Drew BJ, Hollander JE. et al. Practical implementation of the Guidelines for Unstable Angina/Non-ST-Segment Elevation Myocardial Infarction in the emergency department. Ann Emerg Med. 2005;46:185–97. - PubMed

LinkOut - more resources