Key result
Cardiac troponins, particularly cardiac troponin I, have high sensitivity and specificity for diagnosing neonatal myocardial injury, unlike creatine-kinase MB, brain natriuretic peptide, and myoglobin.
Why the study?
While diagnostic strategies for myocardial infarction are sufficient in adults, diagnostic gaps remain for myocardial infarction in neonates.
Are biomarkers such as cardiac troponins effective for the early diagnosis of myocardial infarction in neonates?
Are biomarkers such as cardiac troponins effective for the early diagnosis of myocardial infarction in neonates?
Cardiac troponin I is a highly sensitive and specific biomarker for diagnosing myocardial injury in neonates, unlike creatine-kinase MB, BNP, or myoglobin.
May support troponin I for neonatal myocardial injury diagnosis; leaves open prospective validation before practice change.
Myocardial infarction is defined as the obstruction of blood flow to the heart, resulting in oxygen deprivation. While myocardial infarction in adults is common and has sufficient diagnostic strategies, there remain gaps in the diagnostic strategies for myocardial infarction in neonates. Presently, biomarkers such as creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin are believed to be potential diagnostic tools for neonatal myocardial infarction. This literature review explores the efficacy of biomarkers for early diagnosis of neonatal myocardial infarction. The review concludes that creatine-kinase MB, brain natriuretic peptide, and myoglobin do not serve as accurate biomarkers for myocardial infarction in neonates. However, cardiac troponins, in particular cardiac troponin I, have high sensitivity and specificity for diagnosing myocardial injury. Cardiac troponins experience rapid elevation upon myocardial injury, and they remain unaffected by gestational age and birth weight. In addition, they do not cross the placenta and are therefore intrinsic to the neonate. Future research should be conducted to verify the accuracy, sensitivity, and specificity of cardiac troponins as myocardial infarction biomarkers.
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Butani et al. (2021) conducted a review in Neonatal myocardial infarction. Cardiac biomarkers (creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin) was evaluated on Diagnosis of myocardial injury. Cardiac troponins, particularly cardiac troponin I, have high sensitivity and specificity for diagnosing neonatal myocardial injury, unlike creatine-kinase MB, brain natriuretic peptide, and myoglobin.
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