cpk-mb test
TRANSCRIPT
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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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