Requiem for a Heavyweight:The Demise of Creatine Kinase-MB

Amy K. Saenger, PhD; Allan S. Jaffe, MD
The Mayo Clinic in Rochester recently removed CK-MB from its cardiac biomarker panel after extensive collaboration with clinicians. Several other institutions have taken similar actions without any discernible negative effects on clinical care. We suspect that clinical care would be simplified and improved if this step were taken more widely because, as we have attempted to underscore above, the clinical issues that we need to address are best addressed by the use of troponin, and try as we might, it has been hard to find situations in which CK-MB adds substantially. It adds only cost and, from our perspective, confusion. Accordingly, after >10 years of experience using troponin in the clinical arena, it is time for clinicians to learn how to use cardiac troponin properly and, in doing so, let our old friend CK-MB rest. /.../