Evacuation of cost effectiveness of checking both CTNI & CKMB in acute coronary syndromes patients admitted in Shahid Madani hospital

Abstract

The increase in the daily number of heart diseases and the wide range of treatment services provided to heart patients has caused that in the daily treatment business, the methods of measuring and evaluating heart patients are numerous, costly and time-consuming, and perhaps time is the gold standard for treatment evaluation The increase in the number of heart patients who come to the hospital with symptoms of chest pain, shortness of breath, nausea, vomiting, sweating, etc. and are admitted to the wards as acute coronary syndrome (ACS) has increased the variety and number of requested tests. Meanwhile, cardiac troponin I (CTNI) is used as a protein biomarker in the protein structure of the heart that prevents the connection of actin and myosin (other structural proteins in the heart and contractile components) in the resting state, as the most specific structural component of the heart. But many years before this structural component was known, the measurement of Creatine Kinase (CK) enzyme and its cardiac isoenzyme CK-MB (Creatine kinaseMB) have been used. Currently, two markers, CTNI and CK-MB, are often checked together to measure the status of ACS patients. The evaluation of these two cardiac determinants has been discussed in various articles and magazines to reject or confirm the performance of only one of the two in about two decades, and the necessity of performing CTNI and CKMB at the same time has been rejected. In this study, the aim is that the result of simultaneous examination CTNI and CKMB should be measured in ACS patients admitted to Shahid Madani Hospital in Tabriz in order to determine the cost-effectiveness of simultaneous CKMB and CTNI examination. materials and methods: In this retrospective analytical study, taking into account the limitations of resources and time, the file information of 500 patients admitted during the year 1400 in Shahid Madani Avari Hospital is fully counted. Inclusion criteria for patients hospitalized due to acute coronary syndrome. The exclusion criterion is not checking troponin and CK-MB at the same time. Results: Demographic information and the results of Na, K, CTNI, CK, CK-MB, Triglyceride, Cholesterol, Blood glucose parameters and the final diagnosis are collected. The data are entered in IBM SPSS STATISTIC 21 software and the false positive and false negative values for CKMB are checked. and CTNI is placed as the most sensitive test and the most specific reference standard test to measure CKMB values based on it, the cost of the laboratory kit for the tests is measured and the values obtained if only one test is used are checked together, so that Economic efficiency has been evaluated