Bagcilar Medical Bulletin (Sep 2021)
Evaluation of Two Consecutive High Sensitivity Cardiac Troponin T Measurements in Healthy Newborns and Newborns with Respiratory Failure
Abstract
Objective:Data on the umbilical cord and postnatal physiological limits of the high sensitivity cardiac troponin T (hs cTnT) in newborns are scarce. This study aims to determine the normal values and upper limits of hs cTnT in healthy newborns. In addition, its clinical significance and usability in neonatal respiratory failure were analyzed.Method:In this non-invasive and retrospective, cross-sectional study, 113 healthy newborns and 93 newborns with non-cardiac respiratory failure, born between July 2018 and January 2020, were evaluated. Hs cTnT was measured in the umbilical cord and 24-96 h after birth in infants.Results:In the healthy group, the median umbilical cord hs cTnT was 38 (17-156) ng/L and 99th percentile hs cTnT was 122 ng/L, and in the respiratory failure group, the median umbilical cord hs cTnT was 72 (27-326) ng/L. Postnatal day 2-4 median hs cTnT was 75 (10-194) ng/L and 99th percentile value was 194 ng/L in the healthy group, and the median hs cTnT was 145 (41-409) ng/L in the respiratory failure group. The calculated area under the ROC curve for umbilical cord hs cTnT was 0.848 [cut-off: 64, 95% confidence interval (CI): 0.79-0.90, sensitivity: 62.4%, specificity: 93.7%], suggesting that umbilical cord hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure. The calculated area under the ROC curve for control hs cTnT was 0.851 (cut-off: 121.5, 95% CI: 0.79-0.90, sensitivity: 71%, specificity: 86.8%), suggesting that control hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure.Conclusion:The results show that the reference range of umbilical cord and postnatal hs cTnT in healthy newborns is higher than that in adults. Both hs cTnT values were higher in the neonatal respiratory failure group than those in the healthy group.
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