II. Physiology

  1. Transferase class enzyme activated by Magnesium
  2. Catalyzes ATP energy storage as Phosphocreatine
  3. Phosphocreatine stored in Muscle and brain
  4. Phosphocreatine keeps ATP constant at Exercise start

IV. Isoenzymes:

  1. MB: Heart
  2. MM: Skeletal Muscle
  3. BB:
    1. Brain
    2. Bowel infarction
    3. Neoplasm (Prostate, GI, Breast, Ovary, Lung, Brain)

V. Protocol: Acute Coronary Syndrome Evaluation (listed for historical reasons)

  1. Older protocol - replaced in United States with Troponin
  2. Obtain Serial CPK every 6 hours for total of 3 values
  3. Fractionate to CK-MB only if CPK increased
  4. CK-MB >5% of total CPK suggests Myocardial Infarction

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