title: Cord blood cardiac troponin I as an early predictor of short-term outcome in perinatal hypoxia.
abstract: BACKGROUND
  In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inotropic support and oxygenation. The main problem related to outcome is cerebral damage.
  
  
  OBJECTIVE
  We tested the hypothesis that cardiac troponin I (cTnI), a known marker of myocardial injury, is also an early predictor of severity of cerebral damage and mortality in intrauterine hypoxia.
  
  
  METHODS
  Venous and arterial cord blood samples were collected at delivery from 54 consecutive newborns with hypoxic-ischemic encephalopathy and from 50 consecutive healthy controls. Arterial blood gas analysis was performed and levels of cTnI, creatine kinase and creatine kinase-MB in venous cord blood were measured. The same serum parameters were also measured on the 3rd and 7th day of life.
  
  
  RESULTS
  Infants with hypoxia had a significantly higher cord blood cTnI levels than controls (p < 0.0001). Cord blood and 3rd and 7th day serum cTnI values showed a significant increase with severity of HIE (p < 0.0001). In non-survivors cord blood cTnI levels were significantly higher than the survivors (5.9 ng/ml, range 2.1-12.8, and 1.6 ng/ml, range 0.4-5.8, respectively; p < 0.0001). Receiver-operator curve analysis revealed cord cTnI as the most sensitive factor for predicting early death (area under curve = 0.956; SE: 0.028; 95% CI: 0.9-1.01). Cord blood cTnI of 4.6 ng/ml was identified as the optimal cut-off level for predicting serious risk of early mortality.
  
  
  CONCLUSIONS
  The results suggest that significant elevation of cord cTnI is an excellent early predictor of severity of hypoxic-ischemic encephalopathy and mortality in term infants.
authors.affiliation: Neonatal Intensive Care Unit, Department of Pediatrics, Kocaeli University Hospital, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. glucanturker@superonline.com
authors.forename: Gülcan
authors.initials: G
authors.lastname: Türker
authors.forename: Kadir
authors.initials: K
authors.lastname: Babaoğlu
authors.forename: Ayşe S
authors.initials: AS
authors.lastname: Gökalp
authors.forename: Nazan
authors.initials: N
authors.lastname: Sarper
authors.forename: Emine
authors.initials: E
authors.lastname: Zengin
authors.forename: Ayşe Engin
authors.initials: AE
authors.lastname: Arisoy
mesh_terms: D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000401:mortality*; D007231:Infant, Newborn; D007527:Isoenzymes / Q000097:blood; D011379:Prognosis; D012372:ROC Curve; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form