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Creatine Kinase (CK), MB

CPT: 82553
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Synonyms

  • CK-2
  • CK-MB

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.


Expected Turnaround Time

1 - 2 days


Related Information


Related Documents


Specimen Requirements


Specimen

Serum


Volume

0.8 mL


Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube or gel-barrier tube


Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube.


Storage Instructions

Refrigerate.


Stability Requirements

Temperature

Period

Room temperature

1 day

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Patient Preparation

The MB isoenzyme of CK is most commonly elevated in acute myocardial infarction (AMI). In AMI, plasma CK-MB typically rises some four to six hours after the onset of chest pains, peaks within 12 to 24 hours, and returns to baseline levels within 24 to 48 hours. The pattern of serial CK-MB determinations is more informative than a single determination.


Causes for Rejection

Citrate plasma specimen; improper labeling


Test Details


Use

Confirm and monitor therapy after acute myocardial infarction


Methodology

Electrochemiluminescence immunoassay (ECLIA)


Reference Interval

• Male: 0.0−10.4 ng/mL

• Female: 0.0−5.3 ng/mL


Additional Information

Creatine kinase (CK) is an enzyme, found primarily in muscle and brain tissue, which exists as three dimeric isoenzymes: CK-MM (CK-3), CK-MB (CK-2), and CK-BB (CK-1) − built from subunits designated M and B. The CK-MB isoenzyme, which has a molecular mass of approximately 87 kilodaltons, accounts for 5% to 50% of total CK activity in myocardium. In skeletal muscle, by contrast, it normally accounts for ≤1%, CK-MM being the dominant form, though the percentage can be as high as 10% in conditions reflecting skeletal muscle injury and regeneration (eg, severe exercise, muscular dystrophy, polymyositis).1

CK-MB is one of the most important myocardial markers (in spite of not being altogether cardiac-specific), with well-established roles in confirming acute myocardial infarction (AMI) and in monitoring reperfusion during thrombolytic therapy following AMI.1

In AMI, plasma CK-MB typically rises some four to six hours after the onset of chest pains, peaks within 12 to 24 hours, and returns to baseline levels within 24 to 48 hours. The pattern of serial CK-MB determinations is more informative than a single determination: one CK-MB measurement, even when taken at an appropriate time, cannot definitively confirm or rule out the occurrence of AMI. High levels might reflect skeletal injury rather than myocardial damage. A value within the reference range might be significant if it represents an increase from the patient's baseline level. (Low baseline levels are sometimes encountered in the elderly.) Accordingly, it has been recommended that CK-MB be measured on admission to the emergency room and at intervals thereafter (eg, at three-hour intervals over a six-hour to nine-hour period in patients with nonspecific electrocardiogram changes;1,2 or at six-hour to eight-hour intervals over a 24-hour period and more frequently if thrombolytic therapy has been instituted).1


Footnotes

1. Apple FS, Preese LM. Creatine kinase-MB: Detection of myocardial infarction and monitoring reperfusion. J Clin Immunoassay. 1994; 17:24-29.
2. Gibler WB, Lewis LM, Erb RE, et al. Early detection of acute myocardial infarction in patients presenting with chest pain and nondiagnostic ECGs: serial CK-MB sampling in the emergency department. Ann Emerg Med. 1990 Dec; 19(12):1359-1366.2240745

References

Adams JE 3rd, Schechtman KB, Landt Y, Ladenson JH, Jaffe AS. Comparable detection of acute myocardial infarction by creatine kinase MB isoenzyme and cardiac troponin I. Clin Chem. 1994 Jul; 40(7 Pt 1):1291-1295. 8013101
Bhayana V, Cohoe S, Leung FY, Jablonsky G, Henderson AR. Diagnostic evaluation of creatine kinase-2 mass and creatine kinase-3 and -2 isoform ratios in early diagnosis of acute myocardial infarction. Clin Chem. 1993 Mar; 39(3):488-495. 8448862
Bruns DE. Diagnosis of acute myocardial infarction when skeletal muscle damage is present: A caveat regarding use of creatine kinase isoenzymes. Clin Chem. 1989 Apr; 35(4):705.2702763

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
120816 Creatine Kinase (CK), MB 13969-1 120817 Creatine Kinase (CK), MB ng/mL 13969-1

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