Evaluating the use of biomarkers for the diagnosis of myocardial injury in neonates

Abstract

Myocardial infarction is defined as the obstruction of blood flow to the heart, resulting in oxygen deprivation. While myocardial infarction in adults is common and has sufficient diagnostic strategies, there remain gaps in the diagnostic strategies for myocardial infarction in neonates. Presently, biomarkers such as creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin are believed to be potential diagnostic tools for neonatal myocardial infarction. This literature review explores the efficacy of biomarkers for early diagnosis of neonatal myocardial infarction. The review concludes that creatine-kinase MB, brain natriuretic peptide, and myoglobin do not serve as accurate biomarkers for myocardial infarction in neonates. However, cardiac troponins, in particular cardiac troponin I, have high sensitivity and specificity for diagnosing myocardial injury. Cardiac troponins experience rapid elevation upon myocardial injury, and they remain unaffected by gestational age and birth weight. In addition, they do not cross the placenta and are therefore intrinsic to the neonate. Future research should be conducted to verify the accuracy, sensitivity, and specificity of cardiac troponins as myocardial infarction biomarkers.