CK, CK-MB, Troponin-I Levels in Perinatal Asphyxiated Infants during the First Four Hours of Life: a Retrospective Study

Abstract

Objective: To compare serum cardiac troponin-I (cTnI), creatine kinase (CK), creatine kinase-MB (CK-MB), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels within the first 4 hours of life in asphyxiated and non-asphyxiated term newborn infants. Methods: This is a retrospective study of asphyxiated term infants (gestational age from 37 to 42 weeks) born at Cathay General Hospital during the study period (January 1, 1995 – December 31, 2005). Ninety five asphyxiated cases and 76 non-asphyxiated cases were enrolled in the study. We classified the study cases into a control group, group Ⅰ (asphyxiated newborns without multiorgan failure) and group Ⅱ (asphyxiated newborns with multiorgan failure). Serum cTnI, CK, CK-MB, AST and ALT levels were measured within the first 4 hours of life. The inclusion criteria for asphyxia consisted of positive history of perinatal fetal distress and at least one of the following features of perinatal asphyxia: (1) arterial pH ＜7.25; (2) arterial base excess ＜-8 mmol/L within 4 hours after delivery. Results: CK was not statistically different among the 3 groups. CK-MB, AST and ALT levels were statistically different between any 2 groups within the first 4 hours of life (group Ⅱ＞control, group Ⅰ＞control, group Ⅱ＞group Ⅰ). Further, infants in group Ⅱ had higher concentrations of cTnI than group Ⅰ and the control group. However, cTnI was not statistically different between group Ⅰ and the control group. The CK-MB/CK ratio was only statistically different between group Ⅰ and the control group. Conclusion: CK-MB, cTnI, AST and ALT may be good early indicators of cardiac and hepatic injury within the first 4 hours of life in perinatal asphyxiated newborns.