CDOS

Creatine Kinase (CK), Total Plus Isoenzymes

Test Code: 002154

Performing Lab: LabCorp

CPT Code: 82552 001 82550 001

Test Link (Copy)

Synonym

CK Fractionation; CK Isoenzymes; CPK Isoenzymes; Creatine Phosphokinase Isoenzymes

Specimen Type

Serum

Specimen Container

Red-top tube or gel-barrier tube

Volume

1 mL (CK, Total) AND 1 mL (Isoenzymes)

Minimum Volume

0.7 mL (CK, Total) AND 0.8 mL (Isoenzymes) (NOTE: This volume does NOT allow for repeat testing.)

Specimen Handling

Submit two separate serum aliquots. To avoid delays in turnaround time when requesting multiple tests on frozen samples, PLEASE SUBMIT SEPARATE FROZEN SPECIMENS FOR EACH TEST REQUESTED.

Patient Prep

CK is most commonly elevated in acute myocardial infarction (AMI) in which it has its greatest usefulness. Collection of specimen at onset of symptoms to establish baseline values is needed. A patient at onset of AMI will have normal results, but some patients reach medical attention at or beyond CK peak. To support the diagnosis of AMI, three CK isoenzyme determinations have classically been recommended, one on admission, a second 12 hours after admission, a third 24 hours after admission. Another at 48 hours may be needed. CK-MB usually peaks between 15 and 20 hours after the onset of a myocardial infarction. Pappas summarizes current literature regarding timing as follows. In non-Q wave, incomplete occlusion, nontransmural MI, CK-MB peaks on the average 15 hours from onset. In Q wave (complete occlusion) (transmural) infarction, CK-MB average peak is 17 to 20 hours after onset of symptoms. He emphasizes the importance of a sample for CK-MB drawn 16 hours after onset.1 When increased CK-MB values have returned to normal, CK isoenzyme determinations are usually no longer required.

Unacceptable Conditions

Moderate or excessive hemolysis

Temperature

CK Total aliquot: Maintain at room temperature Isoenzymes aliquot: Refrigerate at 2(degrees)C to 8(degrees)C up to 48 hours.

Methodology

Total: kinetic; isoenzymes: agarose gel electrophoresis with densitometry

Stability

Room Temperature: CK: 14 days
Refrigerated: CK: 14 days Isoenzymes: 48 hours (stability determined by manufacturer or literature reference)
Frozen: CK: 14 days Isoenzymes: 14 days (stability determined by manufacturer or literature reference)

Result Code	Result Name	LOINC
001362	Creatine Kinase,Total	2157-6
002164	Macro Type 2	26020-8
002156	CK-MM	15049-0
002165	Macro Type 1	26019-0
002157	CK-MB	12187-1
002158	CK-BB	15048-2

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