CK-MB
CKMproteinCK-MB is a cardiac enzyme released following myocardial necrosis and serves as a diagnostic and prognostic biomarker of infarct size and adverse outcomes in acute MI.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleCardiac-specific isoform of creatine kinase released upon cardiomyocyte necrosis; AMI diagnostic and prognostic marker.
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableYes
Antibody tractableNo
EnsemblENSG00000104879
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II50
A — assay feasibility96
E — evidence strength100
T1DI (composite)68
Specificity differential (R−C)+40.7
Direct evidence: higher in Type I (D=+2)
CK-MB levels/rises were higher in Type-1 MI compared to Type-2 MI patients in studies directly comparing the two groups.
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationn/a
2anemia / acute blood lossmag 0
3hypovolemia / dehydrationmag 2
4tachyarrhythmiamag 2
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 1
7high-demand / peri-operative stressmag 2
Coverage: 6/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 17 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
Chemiluminescent sandwich immunoassay (mass); or enzymatic activity
Reagent / substrate
Anti-CK-MB antibody pair (mass); or CK-MB immunoinhibition + coupled hexokinase/G6PD (activity)
Platform
Automated core-lab analyzer
Turnaround · availability
STAT–routine · FDA-cleared
Literature evidence(51)
- Jia-Wei-Si-Miao-Yong-An decoction modulates intestinal flora and metabolites in acute coronary syndrome model.Frontiers in cardiovascular medicine · 2023 · PMID 36684592 · doi
- Multiomics uncover the proinflammatory role ofdeletion after myocardial infarction in mice.American journal of physiology. Heart and circulatory physiology · 2023 · PMID 36800508 · doi
- Efficacy and Mechanism of Qianshan Huoxue Gao in Acute Coronary Syndrome via Regulation of Intestinal Flora and Metabolites.Drug design, development and therapy · 2023 · PMID 36855515 · doi
- A plasma proteomic approach in patients with heart failure after acute myocardial infarction: insights into the pathogenesis and progression of the disease.Frontiers in cardiovascular medicine · 2023 · PMID 37265567 · doi
- High expression of lncRNA PELATON serves as a risk factor for the incidence and prognosis of acute coronary syndrome.Scientific reports · 2022 · PMID 35577857 · doi
- Urgent Percutaneous Coronary Artery Intervention and Coronary Artery Bypass Grafting in STEMI Patients with Confirmed COVID-19.The heart surgery forum · 2021 · PMID 34173766 · doi
- β-Caryophyllene inhibits Fas- receptor and caspase-mediated apoptosis signaling pathway and endothelial dysfunction in experimental myocardial infarction.Journal of biochemical and molecular toxicology · 2021 · PMID 34816538 · doi
- Molecular miR-19a in Acute Myocardial Infarction: Novel Potential Indicators of Prognosis and Early Diagnosis.Asian Pacific journal of cancer prevention : APJCP · 2020 · PMID 32334458 · doi
- Changes in the Serum Metabolome of Acute Myocardial Ischemia Rat Pretreatment with Electroacupuncture.The American journal of Chinese medicine · 2019 · PMID 31327237 · doi
- Discovery of potential plasma protein biomarkers for acute myocardial infarction via proteomics.Journal of thoracic disease · 2019 · PMID 31656670 · doi
- Circulating miR-379 as a potential novel biomarker for diagnosis of acute myocardial infarction.European review for medical and pharmacological sciences · 2018 · PMID 29424915 · doi
- Anti-inflammatory, Antithrombotic and Cardiac Remodeling Preventive Effects of Eugenol in Isoproterenol-Induced Myocardial Infarction in Wistar Rat.Cardiovascular toxicology · 2016 · PMID 26391896 · doi
- Plasma microRNA-21 is a potential diagnostic biomarker of acute myocardial infarction.European review for medical and pharmacological sciences · 2016 · PMID 26875904
- Ultrasmall superparamagnetic iron oxide nanoparticles acutely promote thrombosis and cardiac oxidative stress and DNA damage in mice.Particle and fibre toxicology · 2016 · PMID 27138375 · doi
- Circulating miR-181a as a Potential Novel Biomarker for Diagnosis of Acute Myocardial Infarction.Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology · 2016 · PMID 27997916 · doi
- The Time Course of Markers of Neutrophil Extracellular Traps in Patients Undergoing Revascularisation for Acute Myocardial Infarction or Stable Angina Pectoris.Mediators of inflammation · 2016 · PMID 28074081 · doi
- Non-O blood groups can be a prognostic marker of in-hospital and long-term major adverse cardiovascular events in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention.Thrombosis research · 2015 · PMID 26251078 · doi
- Treg/Th17 ratio acts as a novel indicator for acute coronary syndrome.Cell biochemistry and biophysics · 2014 · PMID 24798119 · doi
- Eosinophils count and periprocedural myocardial infarction in patients undergoing percutaneous coronary interventions.Atherosclerosis · 2014 · PMID 25055060 · doi
- Plaque shift and distal embolism in patients with acute myocardial infarction: a volumetric intravascular ultrasound analysis from the HORIZONS-AMI trial.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2013 · PMID 22936619 · doi
- Coronary microemboli effects in preexisting acute infarcts in a swine model: cardiac MR imaging indices, injury biomarkers, and histopathologic assessment.Radiology · 2013 · PMID 23592769 · doi
- Unrecognized diabetes and myocardial necrosis: predictors of hyperglycemia in myocardial infarction.Arquivos brasileiros de cardiologia · 2013 · PMID 23598457
- OCT analysis in patients with very late stent thrombosis.JACC. Cardiovascular imaging · 2013 · PMID 23643282 · doi
- Potential clinical application of novel cardiac biomarkers for acute myocardial infarction.Acta medica Indonesiana · 2013 · PMID 24045397
- Proteomic analysis of adverse outcomes in patients with acute coronary syndromes.Clinica chimica acta; international journal of clinical chemistry · 2012 · PMID 23195030 · doi
- Time course proteomic profiling of human myocardial infarction plasma samples: an approach to new biomarker discovery.Clinica chimica acta; international journal of clinical chemistry · 2011 · PMID 21356205 · doi
- The implications of serum enzymes and coagulation activities in postinfarction myocardial rupture.Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular · 2011 · PMID 21881705 · doi
- The role of postmortem cardiac markers in the diagnosis of acute myocardial infarction.Journal of forensic sciences · 2010 · PMID 20345772 · doi
- Utility of placental growth factor for prediction of 30-day adverse event in emergency department population with non-ST elevation acute coronary syndrome.Clinical laboratory · 2010 · PMID 20575469
- The value of procalcitonin, a novel inflammatory marker, in the diagnosis of myocardial infarction and evaluation of acute coronary syndrome patients.The Journal of emergency medicine · 2010 · PMID 20813483 · doi
- Peri-procedural myocardial injury during percutaneous coronary intervention: an important target for cardioprotection.European heart journal · 2010 · PMID 21037252 · doi
- Time course proteomic profile of rat acute myocardial infarction by SELDI-TOF MS analysis.International journal of cardiology · 2008 · PMID 18180059 · doi
- [Redefinition of myocardial infarction--relevance of biomarkers].Herz · 2008 · PMID 18344030 · doi
- Platelet reactivity and the identification of acute coronary syndromes in the emergency department.Journal of thrombosis and thrombolysis · 2008 · PMID 18600429 · doi
- The role of existing and novel cardiac biomarkers for cardioprotection.Current opinion in investigational drugs (London, England : 2000) · 2007 · PMID 17729182
- Antiphospholipid antibodies in young myocardial infarction patients.Indian journal of biochemistry & biophysics · 2007 · PMID 18320848
- Difference in elevation of N-terminal pro-BNP and conventional cardiac markers between patients with ST elevation vs non-ST elevation acute coronary syndrome.Circulation journal : official journal of the Japanese Circulation Society · 2006 · PMID 17062956 · doi
- Evaluation and management of the acutely dyspneic patient: the role of biomarkers.The American journal of emergency medicine · 2005 · PMID 15915417 · doi
- Diagnosis of acute coronary syndrome.American family physician · 2005 · PMID 16035692
- Prognostic value of myeloperoxidase in patients with chest pain.The New England journal of medicine · 2003 · PMID 14573731 · doi
Showing 40 of 51 linked references.
Clinical trials(1)
- High-sensitivity Cardiac Troponin and CK-MB Concentrations in Patients Undergoing Cardiac SurgeryNCT01913873 · PHASE4 · COMPLETED · serum concentration changes cardiac biomarkers