CK-MB test should no longer be used for diagnosing heart attacks

A report from researchers at the Johns Hopkins University School of Medicine and the Mayo Clinic recently published in JAMA Internal Medicine, recommends eliminating the CK-MB blood test from use in diagnosing heart attacks. 

The report cites a previous statement from the American College of Cardiology and five peer-reviewed studies concluding that creatine kinase-myocardial band (CK-MB) testing can no longer be considered an effective biomarker for detecting damaged heart muscle and can be safely eliminated from practice in this clinical setting.

The CK-MB test has largely been phased out for this purpose in Australia but continues to be widely used in the US. The report also recommends a strategy based on the US Health Resources & Services Administration's strategies for implementing any quality improvement initiative.

The four steps listed include:

  1. Design and implement a hospital-wide education campaign
  2. Partner with clinical stakeholders (in cardiology, emergency medicine, internal medicine laboratory/pathology) to remove CK-MB from standardized heart disease routine order sets
  3. Enlist information technology/laboratory medicine staff to create and integrate a best practice "alert" that appears on any computerized provider order entry system when clinicians order CK-MB
  4. Measure use of the test and patient care quality and safety outcomes before and after the intervention

The authors point out that eliminating this single 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.

Further Reading
Johns Hopkins Hospital News Release
JAMA article abstract

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