Total CK comes from three isoenzymes: CK-MM (skeletal muscle), CK-MB (heart muscle), and CK-BB (brain). When CK is elevated, isoenzyme analysis identifies the tissue source. While troponin has largely replaced CK-MB for cardiac evaluation, isoenzyme analysis remains useful in selected cases.
This test is ordered when CK is elevated and the tissue source is unclear, in evaluation of unusual muscle or cardiac conditions, and to distinguish skeletal muscle injury from possible cardiac involvement. Sample type is serum.
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