Background/Aim. In recent years, the focus of interest of the scientific
community is the application of heart markers as early indicators and
prognostic parameters of perinatal asphyxia (PA). The aim of this study was
to evaluate the significance of clinical application of heart markers in term
newborns with perinatal asphyxia. Methods. During a 3- year period we
analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia).
In all the subjects within the first 24-48 h after birth, we simultaneously
determined serum concentrations of cardiac troponin I, brain natriuretic
peptide, MB fraction of creatine kinase (CK-MB) and Creactive protein.
Results. In the group of full-term neonates with PA significantly higher
levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain
natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were
found, compared to the group of healthy full-term newborns. In merged group
(n = 91) cardiac troponin I level correlated with the fifth minute Apgar
score (r = - 0.637, p = 0.000) and the serum lactate concentration in the
first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac
troponin I > 0.135 ?g/L predicted the risk of death with the sensitivity of
84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain
natriuretic peptide and C-reactive protein did not have a predictive value
with respect to a mortality outcome. Conclusion. Among the tested cardiac
markers, cardiac troponin I is the most sensitive and the only reliable early
predictor of mortality in fullterm neonates with perinatal asphyxia.