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The University of Chicago Medicine Laboratories

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Mayo Clinic Laboratories

Test Code CKM CK-MB Isoenzyme with Total CK Panel

Important Note

This test may be affected by biotin interference. Patients on high dose biotin (5mg/day or more) should not have samples drawn until at least 24 hours after the last biotin administration.

Specimen and Container/Tube

Specimen Type: Plasma

Preferred Specimen: Li-Heparin Mint Green Top

Other Acceptable specimens: Serum/Gold Top, Serum/Red Top

Volume

Preferred Volume: 0.5 mL

Minimum Volume: 0.2 mL

Specimen Stability

Storage Temperature

Stability

Room Temperature

12 hours

Refrigerated

5 hours

Frozen

3 months

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

 

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

  • Collect specimen per standard collection procedure and send to laboratory immediately. 

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Samples should be centrifuged within 2 hours of collection.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Aliquot sample into plastic transport tube containing a minimum of 0.2 mL of specimen.
  • Samples must be sent frozen at -20oC.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that are clotted or grossly hemolyzed.
  • Specimens that were transported unspun/whole blood and draw time is greater than 6 hours

Reference Values

Test

Age

Sex

Reference Range

CK-MB

All

All

<9.9 ng/mL

CK-MB Relative Index

All

All

<3.9%

Creatine Kinase

All

All

15-59 U/L

Note: Reference ranges for CK-MB are based on in-house studies performed at the University of Chicago Medicine by the Clinical Chemistry Laboratories per the Roche cobas 8000 modular analyzer e801 System Installation Workbook and the e801 CK-MB product insert. Reference range for Total CK are based on in-house studies, recommendations from Tietz Textbook of Clinical Chemistry, and Roche product literature. 

Critical Values

Analyte

Unit

Low

High

Age

N/A

N/A

N/A

N/A

N/A

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: 1 hour

Routine Turnaround Time: up to 4 hours

Testing Schedule:  24/7

Clinical Indications

  • CK-MB is used as an aid in the diagnosis of myocardial ischemia, e.g. in acute myocarial infarction, myocarditis, etc.
  • The determination of CK and CK-isoenzyme activities is utilized in the diagnosis and monitoring of myocardial infarction and myopathies such as the progressive Duchenne muscular dystrophy.

Test Components

  • Creatinine Kinase MB Isoenzyme Fraction
  • Total CPK
  • CK-MB Relative Index (%) is a calculation of (CK-MB Mass Concentration (ng/mL) divided by the Total CK Activity (U/L)) times 100.

Methodology

  • Electrochemiluminescence immunoassay (ECLIA) (Roche Diagnostics)
  • Spectrophotometric (Activation by NAC) (Roche Diagnostics)

CPT Codes

82553, 82550

LOINC Codes

2157-6

Synonyms/Keyword Search

N/A

Additional Information

  • Elevated CK-MB is not specific for MI (myocardial infarction) and may be detected in other disease states. Results should always be assessed in conjunction with patient's medical history, clinical examination and other findings.
  • CK-MB is detectable in the blood about 3-8 hours after the onset of cardiac symptoms and can remain detectable over a lengthy period of time, depending on the course of the condition.
  • Sensitivity of a CK-MB determination is dependent upon the time at which the sample was collected. Follow-up assays are therefore meaningful.
  • CK-MB Relative Index is reported as a percentage only and has no other associated units of measure.
  • Following injury to the myocardium, such as occurs with acute myocardial infarcation, CK is released from the damaged myocardial cells. In early cases, a rise in the CK-activity can be found just 4 hours after an infarction. The CK-activity reaches a maximum after 12-24 hours and then falls back to the normal range after 3-4 days.
  • Cyanokit (hydroxocobalamin) at therapeutic concentrations interferes with the CK result.
  • CK varies with physical activity level and race in healthy individuals.
  • A test or panel may be ordered only when all components are medically necessary to diagnose or treat an individual patient. If all components are not medically necessary, a less inclusive panel and/or an individual test as appropriate to treat the individual patient should be ordered.

Last Review Date

8/19/2024

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