Creatine kinase enzymes occur in three isoenzymes found in various organs and tissues. Creatine kinase CK-MM are specific to skeletal muscle while creatine kinase CK-BB are specific to the brain and nervous tissue. Creatine kinase CK-MB is a cardiac enzyme used to measure skeletal muscle injury of the heart. Elevations of CK-MB indicate myocardial injury or infarction. The cardiac-specific isoenzyme is released during myocardial tissue injury and help quantify myocardial damage.
Serum levels of creatine kinase CK-MB begin to elevate 4-8 hours after the onset of chest pain.
Elevations of creatine kinase CK-MB levels peak after 12-24 hours after the onset of symptoms. Patients with a large myocardial infarction may experience a delay in peak levels since it takes a longer time to account for the myocardial damage.
Creatine kinase CK-MB levels return to baseline within 48-72 hours after the initial myocardial injury. Large myocardial infarctions may cause a delay in a return to baseline. Patients who are quickly and successfully treated for a myocardial infarction will have their creatine kinase CK-MB levels return to baseline more quickly.
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