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Arch Dis Child Fetal Neonatal Ed. 2011 Mar;96(2):F133-7. doi: 10.1136/adc.2010.185967. Epub 2010 Nov 11.

Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants.

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Department of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.



There is little consensus regarding the use of echocardiography in patent ductus arteriosus (PDA) treatment in preterm infants. The use of troponin T (cTnT) and N-terminal Pro-BNP (NTpBNP) in combination with echocardiography assessment may facilitate the development of a superior predictive model.


To investigate the ability of cTnT, NTpBNP and a PDA scoring system applied at 48 h of life to predict death before discharge and neurodevelopmental outcome at 2 years of age.


Infants <32 weeks and <1500 g were prospectively enrolled. Echocardiography evaluation coupled with cTnT and NTpBNP measurements were done at 48 h. The ductus arteriosus was scored (0-6) according to echocardiography markers of haemodynamic significance. Infants were assessed at 2 years using the Bayley scales and categorised into two groups: Severe Disability/Death before discharge or Normal/Mild Disability.


Sixty infants with a median gestation of 27.7 weeks (26.2-29.4) and a median birth weight of 1.01 kg (0.86-1.22) were followed up to 2 years of age. Plasma cTnT and NTpBNP were higher in the Severe Disability/Death compared to the Normal/Mild Disability group (2.30 μg/l vs 0.19 μg/l, p<0.001; 9209 pmol/l vs 1664 pmol/l, p<0.001, respectively). The severe group had a higher PDA score compared to the mild and normal groups (5 vs 2, p<0.001).


Blood cTnT, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age.

[Indexed for MEDLINE]

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