CPK-MB test

CPK-MB test
Diagnostics
Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment.
LOINC	49551-5, 51506-4, 2154-3, 13969-1, 32673-6, 38482-6

The CPK-MB test is a cardiac marker^[1] used to assist diagnoses of an acute myocardial infarction. It measures the blood level of CK-MB, the bound combination of two variants (isoenzymes CKM and CKB) of the enzyme phosphocreatine kinase.

In some locations, the test has been superseded by the troponin test.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.^[2]

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.

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. This 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. ^[3]

References

↑ Guzy PM (December 1977). "Creatine phosphokinase-MB (CPK-MB) and the diagnosis of myocardial infarction". West. J. Med. 127 (6): 455–60. PMC 1237914. PMID 339548.
↑ "Use of Cardiac Markers in the Emergency Department: - eMedicine". Retrieved 2009-01-10.
↑ Boucek RJ Jr, Kasselberg AG, Boerth RC, Parrish MD, Graham TP Jr (July 1982). "Myocardial injury in infants with congenital heart disease: evaluation by creatine kinase MB isoenzyme analysis". Am J Cardiol. 50 (1): 129–35. doi:10.1016/0002-9149(82)90018-2. PMID 7090995.

References ranges for blood tests (CPT 82000–84999)

Electrolytes	Sodium Potassium Chloride Calcium Renal function Creatinine Urea BUN-to-creatinine ratio Plasma osmolality Serum osmolal gap

Acid-base	Anion gap Arterial blood gas Base excess Bicarbonate CO₂ content

Iron tests	Ferritin Serum iron Transferrin saturation Total iron-binding capacity Transferrin Transferrin receptor

Hormones	ACTH stimulation test Thyroid function tests Thyroid-stimulating hormone

Metabolism	Blood lipids

Cardiovascular	Cardiac marker Troponin test CPK-MB test Lactate dehydrogenase Myoglobin Glycogen phosphorylase isoenzyme BB

Liver function tests	Proteins Human serum albumin Serum total protein ALP transaminases ALT AST AST/ALT ratio Bilirubin Unconjugated Conjugated

Pancreas	Amylase Lipase Pancreatic lipase

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