Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants.
BACKGROUND
There is little consensus regarding the use of echocardiography in patent ductus arteriosus (PDA) treatment in preterm infants. The use of troponin T (cTnT) and N-terminal Pro-BNP (NTpBNP) in combination with echocardiography assessment may facilitate the development of a superior predictive model.


OBJECTIVE
To investigate the ability of cTnT, NTpBNP and a PDA scoring system applied at 48 h of life to predict death before discharge and neurodevelopmental outcome at 2 years of age.


METHODS
Infants <32 weeks and <1500 g were prospectively enrolled. Echocardiography evaluation coupled with cTnT and NTpBNP measurements were done at 48 h. The ductus arteriosus was scored (0-6) according to echocardiography markers of haemodynamic significance. Infants were assessed at 2 years using the Bayley scales and categorised into two groups: Severe Disability/Death before discharge or Normal/Mild Disability.


RESULTS
Sixty infants with a median gestation of 27.7 weeks (26.2-29.4) and a median birth weight of 1.01 kg (0.86-1.22) were followed up to 2 years of age. Plasma cTnT and NTpBNP were higher in the Severe Disability/Death compared to the Normal/Mild Disability group (2.30 μg/l vs 0.19 μg/l, p<0.001; 9209 pmol/l vs 1664 pmol/l, p<0.001, respectively). The severe group had a higher PDA score compared to the mild and normal groups (5 vs 2, p<0.001).


CONCLUSIONS
Blood cTnT, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age.
Department of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. afif_faisal@hotmail.com
Afif F
AF
El-Khuffash
Marie
M
Slevin
Patrick J
PJ
McNamara
Eleanor J
EJ
Molloy
D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D002658:Developmental Disabilities / Q000209:etiology*; D004185:Disability Evaluation; D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000000981:diagnostic imaging / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000523:psychology; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D020107:Troponin T / Q000097:blood*; D014463:Ultrasonography
D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain