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Serum Enzyme Determination in Patients With Suspected Myocardial Infarction

Joseph S. Alpert, MD
Arch Intern Med. 1983;143(8):1522-1523. doi:10.1001/archinte.1983.00350080028006.
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Accurate, rapid diagnosis of myocardial infarction is an important goal from a therapeutic as well as cost-effective point of view. The more rapidly the clinician can diagnose acute myocardial infarction, the sooner appropriate therapy can be initiated. However, daily charges for hospitalization in a coronary care unit in the United States frequently exceed $500. Thus, admission to the hospital for suspected myocardial infarction is often expensive, particularly if the patient remains in intensive care for two to three days while infarction is "ruled out." What laboratory test should be obtained to confirm the clinical diagnosis of myocardial infarction in these cost-conscious times? In this issue of the Archives (p 1541), Fisher et al offer one rational answer to the question aimed at decreasing the cost of hospitalization for patients with suspected myocardial infarction. Their observations support earlier recommendations for serial sampling of only the enzymes creatine kinase (CK)/CK-MB in this


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