Affiliations: [a] Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
| [b] Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| [c] Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
Correspondence:
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Address for correspondence: Dr. Niranjan Thomas, Department of Neonatology, 3rd floor, ISSCC Building, Christian Medical College, Vellore; Tamil Nadu, India. Tel.: +91 416 2283311; E-mail: niranjan@cmcvellore.ac.in.
Abstract: BACKGROUND:Troponin-T is a commonly used cardiac biomarker, which could be useful in perinatal asphyxia. We aimed to analyze troponin-T concentrations in asphyxiated neonates and to correlate the concentrations with clinical outcomes. METHODS:Data were collected from electronic medical records of neonates diagnosed with perinatal asphyxia over a period of four years. RESULTS:There were 63 neonates with moderate to severe encephalopathy, in whom serial troponin-T concentrations had been done on days 1, 3, and 7. 53 (84%) asphyxiated infants had troponin-T concentration >100 pg/ml at 2–4 h of life.The difference in troponin-T concentrations between moderate and severe encephalopathy was not statistically significant (173 vs. 263 pg/ml, p value 0.40). The difference in the concentrations at 72 hours between cooled and non-cooled neonates was not significant (48.5 vs. 62.5 pg/ml, p value 0.22). Troponin-T concentration was significantly higher in babies with hypotensive shock and hepatic injury, but not acute kidney injury. There was no significant correlation between troponin-T and the extent of resuscitation needed.Troponin-T concentration on day 1 of life was significantly higher in babies who died than who survived (407 vs. 168 pg/ml, p value 0.03). ROC curve for troponin-T to predict mortality had an area under the curve (AUC) of 0.803; the best cut-off value (190 pg/ml) had 82% sensitivity and 80% specificity. CONCLUSION:There was no significant difference in troponin-T concentrations between cooled and non-cooled neonates. Troponin-T concentration had a good predictive accuracy for mortality before discharge.
