Routine Serum Enzyme Tests in the Diagnosis of Acute Myocardial Infarction: Cost-Effectiveness

Michael L. Fisher, Michael H. Kelemen, David Collins, Frank Morris, George W. Moran, Nathan H. Carliner, Gary D. Plotnick

Research output: Contribution to journalArticlepeer-review

Abstract

To determine the cost-effectiveness of routine use of serial SGOT, lactic dehydrogenase (LDH), and LDH isoenzyme determinations in patients with suspected acute myocardial infarction (AMI), 166 consecutive patients admitted to a coronary care unit were prospectively identified and clinical findings analyzed independently using predetermined criteria. Based on chest pain characteristics, ECG, and creatine kinase—MB (CK-MB) results, patients were placed in categories of definite AMI (31%), possible AMI (34%), or AMI excluded (36%). The SGOT and/or LDH patterns were considered positive (ie, suggestive of AMI) in 82% of the patients with definite AMI but only confirmed CK-MB results. Positive SGOT/LDH results yielded new clinically relevant information in only 14 patients (8%). Total charges for SGOT/LDH determinations in these 166 patients totaled $10,938 or approximately $780 for each additional clinically important positive result. When serial ECG and CK-MB results are available, routine serial SGOT/LDH determinations are not justified.

Original languageEnglish (US)
Pages (from-to)1541-1543
Number of pages3
JournalArchives of internal medicine
Volume143
Issue number8
DOIs
StatePublished - Aug 1983
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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