APPROPRIATENESS OF TROPONIN TEST REQUESTS FROM COST EFFICACY AND SAFETY PROSPECTIVE, CARDIOLOGY DEPARTMENT LOUGHLINSTOWN HOSPITAL DUBLIN

Abstract

Cardiac troponin I and T are contractile proteins found only in cardiac myocytes and are preferred selective biomarkers for the presence of myocardial necrosis. According to the recommendations of the ESC/ACC Committee for the Redefinition of Myocardial Infarction, troponin tests can be ordered for patients with acute chest pain at admission, 6 to 9 hours later, and again at 12 to 24 hours if results are negative and the clinical index of suspicion is high. The purpose of this study was to ascertain whether troponin tests are requested appropriately for acute admissions via ED (Emergency Department) at St. Columcille's Hospital, Dublin and how adherent are we to the ESC/ACC.A prospective random review of troponin performance for acute admissions via ED at two cycles level, first cycle during the period 15/01 -15/02/2013 and re cycle period 15/05/ -15/06/2013. (N=55) for each cycle separately. Of the 55 troponins in first cycle we found 32 troponin were appropriate and 23 (41.8%) were inappropriate, the later decreased to 21.8 % in the second cycle. In terms of time frame for requesting troponins remains more or less complying with the recommendations at average of 9.3 hours between 2 cycles. Observing these recommendations will contribute hugely in reducing the burden of the budget