text: CK is often determined routinely in a medical laboratory. It used to be determined specifically in patients with chest pain, but this test has been replaced by troponin. Normal values at rest are usually between 60 and 400 IU/L, where one unit is enzyme activity, more specifically the amount of enzyme that will catalyze 1 μmol of substrate per minute under specified conditions (temperature, pH, substrate concentrations and activators.) This test is not specific for the type of CK that is elevated.
  Creatine kinase in the blood may be high in health and disease. Exercise increases the outflow of creatine kinase to the blood stream for up to a week, and this is the most common cause of high CK in blood. Furthermore, high CK in the blood may be related to high intracellular CK such as in persons of African descent.
  Finally, high CK in the blood may be an indication of damage to CK-rich tissue, such as in rhabdomyolysis, myocardial infarction, myositis and myocarditis. This means creatine kinase in blood may be elevated in a wide range of clinical conditions including the use of medication such as statins; endocrine disorders such as hypothyroidism; and skeletal muscle diseases and disorders including malignant hyperthermia, and neuroleptic malignant syndrome.
  Furthermore, the isoenzyme determination has in the past been used extensively as an indication for myocardial damage in heart attacks. Troponin measurement has largely replaced this in many hospitals, although some centers still rely on CK-MB.