Test ID: CKMB
Creatine Kinase (CK) MB Isoenzyme, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
The serial quantitation of serum creatine kinase MB (CKMB) levels, often performed at admission and 8-hours, 16-hours, and 24-hours after admission, has traditionally been used as an aid in the diagnosis of myocardial injury. While CKMB has been replaced by troponin assays in the workup of many patients with acute chest pain, CKMB may be useful if the initial troponin determination is abnormal or if a hospitalized patient has a suspected reinfarction.
Method Name A short description of the method used to perform the test
Electrochemiluminescent Immunoassay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
CK-MB Fraction
CPK Isoenzymes
Creatine Kinase Isoenzymes
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top or rapid serum tube (RST)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross OK |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Frozen (preferred) | 90 days |
| Refrigerated | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
There are 3 isoenzymes of creatine kinase (CK)-CKBB, CKMM, and CKMB. The primary source of CKMB is myocardium although it is also found in skeletal muscle. CKMB levels increase with myocardial damage. Extreme elevations of CKMB can also be associated with skeletal muscle cell turnover as in polymyositis and to a lesser degree in rhabdomyolysis. It can also be elevated in cases of carbon monoxide poisoning, crush injuries, pulmonary embolism, hypothyroidism, and muscular dystrophy.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Males: <6.7 ng/mL
Females: <3.8 ng/mL
Interpretation Provides information to assist in interpretation of the test results
Creatine kinase MB (CKMB) levels can be detected within 3 to 8 hours of the onset of chest pain, peak within 12 to 24 hours, and usually return to baseline levels within 24 to 48 hours.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Creatine kinase MB (CKMB) values, which exceed 50% of the total CK, probably reflect unusual beta-subunit synthesis since the heart muscle rarely exceeds 30% CKMB.
The newer sandwich assays for CKMB have eliminated the confusion seen with older methodologies, but may result in the inability to detect some infrequent contributions to total CK (eg, macro and mitochondrial forms).
In patients receiving treatment with high biotin doses (>5 mg/day) there should be an interval of at least 8 hours between the last biotin administration and the collection of the specimen as biotin interferes with the assay.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Mair J, Artner-Dworzak E, Dienstl A, et al: Early detection of acute myocardial infarction by measurement of mass concentration of creatine kinase-MB. Am J Cardiol 1991;68:1545-1550
Method Description Describes how the test is performed and provides a method-specific reference
The E Modular CKMB method is a sandwich electrochemiluminescence immunoassay which employs 2 monoclonal antibodies. Creatine kinase MB (CKMB) in the specimen reacts with both a biotinylated monoclonal CKMB-specific antibody and a monoclonal CKMB-specific antibody labeled with a ruthenium complex to form a sandwich complex. Streptavidin-coated microparticles are added and the mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Application of voltage to the electrode induces the chemiluminescent emission, which is then measured. (Package insert: E Modular CK-MB STAT product. Roche Diagnostics Corporation, Indianapolis, IN)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
82553
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| CKMB | Creatine Kinase(CK) MB Isoenzyme, S | 13969-1 |
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