Roles of CK and CK-MB in suspected myocardial infarction

Dr P.J. Devereaux is a professor in the Department of Health Research Methods, Evidence, and Impact and Department of Medicine and director of the Division of Cardiology at McMaster University.

Is there still a role for creatine kinase (CK) or creatine kinase–myocardial band (CK-MB) in a patient with suspected myocardial infarction (MI)?

P.J. Devereaux, MD, PhD: Certainly troponin and specifically now high-sensitivity troponins are much more sensitive and specific than CK-MB.

In general, unless you are in a center that does not have troponin—which would be very few centers in the world—there is no longer a role for using CK. You should be relying on troponin. But if you are in a region of the world where you do not have access to troponin, then CK-MB will be the next best alternative.