CPK-MB test

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CPK MB

Presented byDr Haresh E.Memane

P.G.Scholar, Dept of Dravyaguna


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Introduction

The CPK-MB test is a cardiac marker used to assist diagnoses of

an acute myocardial infarction.

It measures the CKM and CKB isoenzymes of phosphocreatine

kinase.

Creatine Phosphokinase Test (Also known as CPK, Creatine

Kinase, or CK Test) CPK, also known as creatine kinase, or CK, is

a type of protein called an enzyme.

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Creatine phosphokinase-MB (CPK-MB) is the most sensitive and the

most specific indicator available for the diagnosis of an acute

myocardial infarction.

With the exception of after-cardiac surgical procedures, the degree

and the duration of CPK-MB elevation in serum approximates the

extent of an acute myocardial infarction, although a variety of factors

may affect the reliability of such an index.



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Content

Introduction

History

Function

Types

Specimen collection & preparation

Method of calibration Procedure

Interpretation of results

Application

Limitation of the procedure

Precautions Research work

Summary

Conclusion



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Objective

To know the methods and application of the

test.



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History

1950s: Clinical reports that transaminases released from

dying myocytes could be detected via laboratory testing,

aiding in the diagnosis of myocardial infarction.



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Function

The normal function of CPK in our cells is to turn creatine

into phosphate, which is burned as a quick source of energy

by our cells.

When muscle is damaged, muscle cells break open and spilltheir contents into the bloodstream. Because most of the CPK

in the body normally exists in muscle, a rise in the amount of

CPK in the blood indicates that muscle damage has occurred,

or is occurring. The type of CPK found in the blood determines what has been

damaged (i.e. heart, brain, muscle).



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Types

In the cells, the "cytosolic" CK enzymes consist of two

subunits, which can be eitherB (brain type) orM (muscle

type).

There are, therefore, three different isoenzymes: CK-MM,

CK-BB and CK-MB.



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SPECIMEN COLLECTION AND

PREPARATION The serum specimen should be collected under standard laboratory

conditions

Patient samples performed best when tested immediately after

collection. If the sample cannot be tested within 24 hours, freeze until

the test can be performed. Allow sample to reach room temperaturebefore proceeding.

Sodium azide can be added as a preservative up to 0.1% without

affecting the test results.

QUALITY CONTROL

The control band is an internal reagent and procedural control. It

will appear if the test has been performed correctly and the reagents

are reactive.

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Method of calibration

MATERIALS PROVIDED

1. Cortez Diagnostics CK-Mb Test device

MATERIALS REQUIRED BUT NOT PROVIDED

1. Serum collection containers

2. Timer or clock

STORAGE

Store the test device at 2 to 30oC. Do Not Freeze...

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PROCEDURE

Bring all materials and specimens to room temperature.

Remove the test card from the sealed foil pouch.

Place the transfer pipette in the specimen and depress the

bulb to withdraw a sample.

Hold the pipette in a vertical position over the sample

well of the test card and deliver 2-3 drops (100-150 l) of

sample into the sample well.

Read the result between 10 and 15 minutes.

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Normal value

Cardiac Tests

Total CK: 38-120 ng/mL

CK-MB : 0-3 ng/mL CK-index : 0-3

Troponin :


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INTERPRETATION OF RESULTS

Positive:

If two colored bands are visible within 15 minutes, the test result is

positive and valid. The test result can be read as soon as a distinct

colored band appears in the test area.

Negative:

If test area has no color band and the control area displays a colored

band, the result is negative and valid.

Invalid result: The test result is invalid if a colored band does not form in the

control region. The sample must be re-tested, using a new test device.

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Application

Lowered CK can be an indication of alcoholic liver

disease and rheumatoid arthritis.

Isoenzyme determination has been used extensively as an

indication for myocardial damage in heart attacks.

Troponin measurement has largely replaced this in many

hospitals, although some centers still rely on CK-MB.

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LIMITATIONS OF THE PROCEDURE

The test result should be used in conjunction with other clinical

information such as clinical signs and symptoms and other test results to

diagnose AMI.

A negative result obtained from a patient whose sample was taken at 4-20

hours after the onset of chest pain may help in ruling out AMI.

A positive result from a patient suspected of AMI may be used as a rule-in

diagnosis and requires further confirmation Cortez Diagnostics CK-Mb

test only provides qualitative result.

A quantitative assay method must be used to determine the CK-MB

concentration. As with all diagnostic tests, a definitive clinical diagnosis should not be

based on the single test, but should only be made by the physician after all

clinical and laboratory findings have been evaluated.

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Limitation of test

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-MB2isoforms

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.

Certain medicines may also affect the results of the test,

including aspirin.

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PRECAUTIONS

For in vitro diagnostic use only.

Do not use product beyond the expiration date.

Handle all specimens as potentially infectious.

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Research work

Creatine Phosphokinase-MB (CPK-MB)and the Diagnosis

of Myocardial Infarction.

Guzy PM: Creatine phosphokinase-MB (CPK-MB)

andthe diagnosis of myocardial infarction. West J Med

127:455-460, Dec 1977.

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Summary

Creatine kinase is a dimmer occurring in various in three isoenzymic forms,

depending on the particular combination of its non-identical subunits: BB

(brain type); MM (skeletal type); and MB (hybrid type).

Creatine kinase-MB isoenzyme is released into circulation later than

myoglubin, reaching abnormal levels within 4 to 6 hours after onset of

symptoms, it reaches its highest level with a typical range of 39-185 ng/ml

after about 18 to 24 hours, and returns to normal in about 2 to 3 days.

CK-MB is widely recognized as the traditional marker for the diagnosis of

acute myocardial infarction (AMI).

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Conclusion

Creatine phosphokinase-MB (CPK-MB) is the most

sensitive and the most specific indicator available for the

diagnosis of an acute myocardial infarction.

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Thank you

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Documents

CPK-MB test