CPK-MB test: Difference between revisions

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{{Infobox diagnostic
== CPK-MB Test ==
| Name            = CPK-MB test
| Image          = AMI bloodtests engl.png
| Alt            =
| Caption        = Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment.
| DiseasesDB      =
| ICD10          =
| ICD9            =
| ICDO            =
| MedlinePlus    =
| eMedicine      =
| MeshID          =
| LOINC          = {{LOINC|49551-5}}, {{LOINC|51506-4}}, {{LOINC|2154-3}}, {{LOINC|13969-1}}, {{LOINC|32673-6}}, {{LOINC|38482-6}}
| HCPCSlevel2    =
| Reference_range = 
}}
==Definition==


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The '''CPK-MB test''' is a blood test used to measure the level of the MB isoenzyme of [[Creatine kinase]] (CK) in the blood. This test is primarily used to diagnose [[myocardial infarction]] (heart attack) and to assess the extent of heart muscle damage.
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The CPK-MB, often abbreviated as CKMB, is a very [[sensitivity|sensitive]] and [[specificity|specific]] test for the diagnosis of an [[acute myocardial infarction]]
[[File:AMI_bloodtests_engl.png|thumb|right|Diagram showing blood tests used in diagnosing acute myocardial infarction, including CPK-MB.]]
==What does the test measure?==
The CPK-MB test measures the amount of creatine kinase (CK) MB fraction in the blood.  


==What is CPK?==
=== Background ===
CK stands for [[creatine kinase]] or creatine phospokinase (CPK), which is a type of protein that acts as an [[enzyme]].


==Where is CPK found?==
[[Creatine kinase]] is an enzyme found in various tissues, including the heart, brain, and skeletal muscle. It plays a crucial role in energy production by catalyzing the conversion of creatine and utilizing adenosine triphosphate (ATP) to create phosphocreatine and adenosine diphosphate (ADP). CK has three isoenzymes: CK-MM, CK-BB, and CK-MB. The CK-MB isoenzyme is predominantly found in cardiac muscle, making it a useful marker for heart muscle damage.
CK is mostly found in your skeletal muscles and heart, with lesser amounts in the brain.  


==What are the types of CPK enzymes?==
=== Clinical Use ===
* CK-MM, found in skeletal muscles
* CK-MB, found in the heart muscle
* CK-BB, found in brain tissue


==What does CPK-MB test measure?==
The CPK-MB test is particularly useful in the context of [[acute coronary syndrome]] (ACS) and suspected [[myocardial infarction]]. When heart muscle is damaged, as in the case of a heart attack, CK-MB is released into the bloodstream. Measuring the levels of CK-MB can help determine the presence and severity of a myocardial infarction.
* The '''CPK-MB test''' is a [[cardiac marker]]<ref name="pmid339548">{{cite journal |author=Guzy PM |title=Creatine phosphokinase-MB (CPK-MB) and the diagnosis of myocardial infarction |journal=West. J. Med. |volume=127 |issue=6 |pages=455–60 |date=December 1977 |pmid=339548 |pmc=1237914 |doi= |url=}}</ref> used to assist diagnoses of an acute [[Acute myocardial infarction|myocardial infarction]].  
* It measures the blood level of CK-MB (creatine kinase-muscle/brain), the bound combination of two variants (isoenzymes [[CKM (gene)|CKM]] and [[CKB (gene)|CKB]]) of the enzyme [[phosphocreatine kinase]].
==Is troponin test better?==
* In some locations, the test has been superseded by the [[troponin test]].
* However, recently, there have been improvements to the test that involve measuring the ratio of the CK-MB1 and CK-MB2 isoforms.<ref name="urlUse of Cardiac Markers in the Emergency Department: - eMedicine">{{cite web |url=http://emedicine.medscape.com/article/811905-overview |title=Use of Cardiac Markers in the Emergency Department: - eMedicine |format= |website= |accessdate=2009-01-10}}</ref>
==What are the cardiac related isoforms?==
The newer test detects different [[isoforms]] of the B subunit specific to the myocardium whereas the older test detected the presence of cardiac-related [[isoenzyme]] dimers.
==Variations==
* Many cases of CK-MB levels exceeding the blood level of total CK have been reported, especially in newborns with cardiac malformations, especially ventricular septal defects.
* The reversal of ratios is in favor of pulmonary emboli or vasculitis.
* An autoimmune reaction creating a complex molecule of CK and IgG should be taken into consideration.<ref>{{cite journal |author1=Boucek RJ Jr |author2=Kasselberg AG |author3=Boerth RC |author4=Parrish MD |author5=Graham TP Jr |title=Myocardial injury in infants with congenital heart disease: evaluation by creatine kinase MB isoenzyme analysis |journal=Am J Cardiol |volume=50 |issue=1 |pages=129–35 |date=July 1982 |pmid=7090995 |pmc= |doi= 10.1016/0002-9149(82)90018-2|url=}}</ref>


==References==
=== Procedure ===
{{reflist|2}}
{{faq1}}
* What is CK-MB in MI?
* What is normal CK-MB?
* Why CPK test is done?
* How is CK-MB test done?
* How do you calculate CPK?
* What is a good CPK value?
* Is CK-MB cardiac specific?
* How can I reduce my CK-MB?
* When should CK-MB be tested?
* Can stress increase CK levels?
* What happens if CPK MB is high?
* What are the 3 cardiac enzymes?
* What does MB stand for in CK-MB?
* What causes CK-MB to be elevated?
* How can I lower my CPK naturally?
* How long does CK-MB stay elevated?
* Which rises first troponin or CK-MB?
* Is CK-MB more specific than troponin?
* Why CK-MB is important in myocardial infarction?
{{stb2}}
{{Blood tests}}


[[Category:Blood tests]]
The test involves drawing a blood sample from a vein, usually in the arm. The blood is then analyzed in a laboratory to measure the concentration of CK-MB. Elevated levels of CK-MB in the blood can indicate heart muscle damage.
 
=== Interpretation ===
 
- '''Normal Range:''' The normal range for CK-MB is typically 0-5 ng/mL, but this can vary slightly depending on the laboratory.
- '''Elevated Levels:''' Elevated CK-MB levels suggest myocardial damage. Levels typically rise within 4-6 hours after a heart attack, peak at 12-24 hours, and return to normal within 48-72 hours.
 
=== Limitations ===
 
While the CPK-MB test is useful, it is not as specific as newer markers such as [[troponin]]. CK-MB can also be elevated in conditions other than myocardial infarction, such as [[myocarditis]], [[pericarditis]], and [[muscular dystrophy]].
 
== Related Pages ==
 
* [[Myocardial infarction]]
* [[Creatine kinase]]
* [[Troponin]]
* [[Acute coronary syndrome]]
 
[[Category:Medical tests]]
[[Category:Cardiology]]
[[Category:Cardiology]]
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Latest revision as of 11:00, 15 February 2025

CPK-MB Test[edit]

The CPK-MB test is a blood test used to measure the level of the MB isoenzyme of Creatine kinase (CK) in the blood. This test is primarily used to diagnose myocardial infarction (heart attack) and to assess the extent of heart muscle damage.

Diagram showing blood tests used in diagnosing acute myocardial infarction, including CPK-MB.

Background[edit]

Creatine kinase is an enzyme found in various tissues, including the heart, brain, and skeletal muscle. It plays a crucial role in energy production by catalyzing the conversion of creatine and utilizing adenosine triphosphate (ATP) to create phosphocreatine and adenosine diphosphate (ADP). CK has three isoenzymes: CK-MM, CK-BB, and CK-MB. The CK-MB isoenzyme is predominantly found in cardiac muscle, making it a useful marker for heart muscle damage.

Clinical Use[edit]

The CPK-MB test is particularly useful in the context of acute coronary syndrome (ACS) and suspected myocardial infarction. When heart muscle is damaged, as in the case of a heart attack, CK-MB is released into the bloodstream. Measuring the levels of CK-MB can help determine the presence and severity of a myocardial infarction.

Procedure[edit]

The test involves drawing a blood sample from a vein, usually in the arm. The blood is then analyzed in a laboratory to measure the concentration of CK-MB. Elevated levels of CK-MB in the blood can indicate heart muscle damage.

Interpretation[edit]

- Normal Range: The normal range for CK-MB is typically 0-5 ng/mL, but this can vary slightly depending on the laboratory. - Elevated Levels: Elevated CK-MB levels suggest myocardial damage. Levels typically rise within 4-6 hours after a heart attack, peak at 12-24 hours, and return to normal within 48-72 hours.

Limitations[edit]

While the CPK-MB test is useful, it is not as specific as newer markers such as troponin. CK-MB can also be elevated in conditions other than myocardial infarction, such as myocarditis, pericarditis, and muscular dystrophy.

Related Pages[edit]

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