Cardiac biomarker testing in the emergency department (ED) is common even among those without symptoms suggestive of acute coronary syndrome (ACS), which should drive such testing, according to a study published online Nov. 17 in JAMA Internal Medicine. The researchers say that extrapolating their findings to all ED visits nationally shows that over a two-year period, there could have been 8.5 million instances of inappropriate testing, a pattern they define as “concerning.” Cardiac biomarker testing is not routinely indicated in the emergency department for all chest pain patients because of low utility and potential downstream consequences from false positive results. However, with the emergence of increasingly sensitive assays, testing for cardiac biomarkers is seen as a powerful tool to rapidly detect myocardial necrosis, a hallmark of ACS. The researchers analyzed retrospective data from the 2009 and 2010 National Hospital Ambulatory Medical Care Survey, a probability sample of ED visits in the United States. Of the 44,448 visits analyzed, cardiac biomarkers were tested in 16.9 percent of visits, representing 28.6 million visits nationally over a two-year period. In patients lacking ACS-related symptoms, biomarker testing occurred in 8.2 percent of visits, almost one-third of all visits with biomarker testing. The researchers estimate […]