Multiplex Detection of B-Type Natriuretic Peptide, Cardiac Troponin I and C-Reactive Protein with Photonic Suspension Array

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.

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Faculty of 1000 evaluation for Simultaneous measurement of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein for the prediction of long-term cardiac outcome after cardiac surgery.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.1163593.1866054 ◽

2010 ◽

Author(s):

Yukio Hayashi

Keyword(s):

Cardiac Surgery ◽

Natriuretic Peptide ◽

Simultaneous Measurement ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

C Reactive Protein ◽

Reactive Protein ◽

Cardiac Outcome

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Simultaneous Measurement of Cardiac Troponin I, B-type Natriuretic Peptide, and C-reactive Protein for the Prediction of Long-term Cardiac Outcome after Cardiac Surgery

Anesthesiology ◽

10.1097/aln.0b013e3181a1f720 ◽

2009 ◽

Vol 111 (2) ◽

pp. 250-257 ◽

Cited By ~ 22

Author(s):

Jean-Luc Fellahi ◽

Jean-Luc Hanouz ◽

Yannick Le Manach ◽

Xavier Gué ◽

Emmanuel Monier ◽

...

Keyword(s):

Cardiac Surgery ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

Major Adverse Cardiac Events ◽

C Reactive Protein ◽

Cardiac Events ◽

Reactive Protein ◽

Adverse Cardiac Events

Background Simultaneous assessment of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein has been found to provide unique prognostic information in acute coronary syndromes. The current study addressed the prognostic implication of a multiple-marker approach in cardiac surgery. Methods Two hundred twenty-four patients undergoing cardiac surgery were included and followed up within 12 months after surgery. Serial blood samples were drawn in all patients the day before surgery, at the end of surgery, and 6, 24, and 120 h after surgery. Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia, myocardial infarction, congestive heart failure, the need for myocardial revascularization, and/or death from cardiac cause. Predictive ability of each cardiac biomarker was assessed using logistic regression. Results Accuracies of C-reactive protein, cardiac troponin I, and B-type natriuretic peptide, considered as continuous variables, to predict the occurrence of major adverse cardiac events were limited (area under receiver operating characteristic curve: 0.54 [0.47-0.60], P = 0.42; 0.62 [0.55-0.68], P = 0.01; and 0.68 [0.61-0.74], P < 0.001, respectively). When biomarkers were considered as 75% specificity dichotomized variables, elevated C-reactive protein (> 180 mg/l), cardiac troponin I (> 3.5 ng/ml), and B-type natriuretic peptide (> 880 pg/ml) were independent predictors of major adverse cardiac events (odds ratio: 2.14 [1.03-4.49], P = 0.043; 2.37 [1.25-5.64], P = 0.011; and 2.65 [1.16-4.85], P = 0.018, respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score. Conclusions Simultaneous measurement of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.

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