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CPK isoenzymes test

Creatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes; Heart attack - CPK; Crush - CPK

The creatine phosphokinase (CPK) isoenzymes test measures the different forms of CPK in the blood. CPK is an enzyme found mainly in the heart, brain, and skeletal muscle.

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Blood test

How the Test is Performed

A blood sample is needed. This may be taken from a vein. The test is called a venipuncture.

If you are in the hospital, this test may be repeated over 2 or 3 days. A significant rise or fall in the total CPK or CPK isoenzymes can help your health care provider diagnose certain conditions.

How to Prepare for the Test

No special preparation is needed in most cases.

Tell your provider about all the medicines you are taking. Some drugs can interfere with test results. Drugs that can increase CPK measurements include the following:

This list is not all-inclusive.

How the Test will Feel

You may feel slight pain when the needle is inserted to draw blood. Some people feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

This test is done if a CPK test shows that your total CPK level is elevated. CPK isoenzyme testing can help find the exact source of the damaged tissue.

CPK is made of three slightly different substances:

What Abnormal Results Mean

Higher-than-normal CPK-1 levels:

Because CPK-1 is found mostly in the brain and lungs, injury to either of these areas can increase CPK-1 levels. Increased CPK-1 levels may be due to:

Higher-than-normal CPK-2 levels:

CPK-2 levels rise 3 to 6 hours after a heart attack. If there is no further heart muscle damage, the level peaks at 12 to 24 hours and returns to normal 12 to 48 hours after tissue death.

Increased CPK-2 levels may also be due to:

Higher-than-normal CPK-3 levels are most often a sign of muscle injury or muscle stress. They may be due to:

Considerations

Factors that can affect test results include cardiac catheterization, intramuscular injections, recent surgery, and vigorous and prolonged exercise or immobilization.

Isoenzyme testing for specific conditions is about 90% accurate.

Related Information

Creatine phosphokinase test
Enzyme
Heart attack
Chest pain
Angina
Pulmonary embolus
Heart failure
Brain tumor - children
Head injury - first aid
Seizures
Crush injury
Muscular dystrophy
Myositis
Rhabdomyolysis

References

Anderson JL. St segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.

Marshall WJ, Day A, Lapsley M. Plasma proteins and enzymes. In: Marshall WJ, Day A, Lapsley M, eds. Clinical Chemistry. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 16.

Nagaraju K, Gladue HS, Lundberg IE. Inflammatory diseases of muscle and other myopathies. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 85.

Selcen D. Muscle diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 421.

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Review Date: 1/28/2019  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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