Cardiac Troponin T in Healthy Full-Term Infants
Jonna Karlén1,2, Mathias Karlsson3, Håkan Eliasson4,5
1Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden. jonna.karlen@sll.se.
Insights
High-sensitivity cardiac troponin T (hs-cTnT) levels are elevated in newborn cord blood and increase significantly in the first few days of life. These findings highlight the need for caution when interpreting hs-cTnT in infants.
Area of Science:
- Neonatal physiology
- Pediatric cardiology
- Biomarker research
Background:
- Cardiac troponin T (cTnT) is elevated in newborns, but reference ranges are not established.
- Previous studies used assays predating high-sensitivity cardiac troponin T (hs-cTnT).
- Understanding hs-cTnT in neonates is crucial for accurate cardiac assessment.
Purpose of the Study:
- To determine hs-cTnT levels in cord blood of healthy full-term infants.
- To assess the change in hs-cTnT levels during the first days of life.
- To compare neonatal hs-cTnT values with adult reference ranges.
Main Methods:
- Prospective cohort study of 158 healthy, full-term newborns.
- hs-cTnT analysis in umbilical cord blood samples.
- hs-cTnT analysis in blood samples collected at 2-5 days of age.
Main Results:
- Median hs-cTnT in cord blood was 34 ng/L (99th percentile: 88 ng/L).
- Median hs-cTnT at 2-5 days of age increased to 92 ng/L (99th percentile: 664 ng/L).
- Neonatal hs-cTnT levels were significantly higher than adult reference values.
Conclusions:
- hs-cTnT is elevated in cord blood of healthy newborns compared to adults.
- hs-cTnT levels significantly increase in the first few days of life.
- Caution is advised when using hs-cTnT for cardiac assessment in newborns.
Abstract:
In this prospective cohort study of healthy full-term infants, we hypothesized that high-sensitivity cardiac troponin T (hs-cTnT) would be elevated in cord blood, compared with adult reference values, and that it would further increase over the first days of age. Cardiac troponin T has been shown to be significantly increased in healthy full-term newborns compared with adult reference values, but there is no established reference range. Most studies of cTnT in newborns have been performed before the introduction of high-sensitivity cTnT (hs-cTnT) assay. We conducted a study including 158 full-term newborns, at Stockholm South General Hospital. High-sensitivity cTnT was analyzed in umbilical cord blood and at 2-5 days of age. Median hs-cTnT (interquartile range) in cord blood was 34(26-44) ng/L; 99th percentile 88 ng/L. Median hs-cTnT at 2-5 days of age was 92(54-158) ng/L; 99th percentile 664 ng/L. We conclude that hs-cTnT is elevated in cord blood in healthy, full-term newborn infants compared with adult reference values, and that it increases significantly during the first days of life. Our findings further underline the need of caution when using hs-cTnT as a measurement of cardiac impact in newborns.
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