Significance of elevated MB creatine kinase in patients after cardiac catheterization

To clarify the etiology of elevations in plasma MB creatine kinase (CK) in patients after cardiac catheterization, we studied 32 consecutive patients undergoing cardiac catheterization and coronary arteriography. Total CK and MB CK were within the normal range in all patients prior to catheterization. Total CK activity rose from a mean of 61.46 +/- 33.8 IU/1 (SD) to 141 +/- 105 in the first sample after catheterization (p less than .005) and 121.6 +/- 92.4 in the second catheterization sample (p less than .0005). The MB CK activity also rose from a mean of 3.2 +/- 1.6 IU/1 prior to catheterization to a maximum value of 5.0 +/- 2.9. The mean increase in MB CK, though statistically significant (p less than .005), was only 1.8 IU/1. Only one patient's value for MB CK rose to outside of the normal range (greater than 12) likely due to cardiac injury. Thus, our data document that marked elevations in MB CK after cardiac catheterization are unusual. They likely represent cardiac muscle injury rather than MB CK released due to skeletal muscle injury induced by the catheterization itself.