Cardiac troponin I (cTn I) and the postmortem diagnosis of myocardial infarction

Abstract

In clinical practice several biochemical markers are used for the diagnosis of myocardial infarction. Because of its extremely high specificity for myocardial damage, cardiac troponin I (cTn I) is frequently used. The aim of this study was to evaluate the diagnostic efficacy of postmortem cTn I determinations in pericardial fluid and serum and to compare these results with other biochemical markers and with structural findings used to diagnose acute myocardial ischaemia. We studied 89 cadavers with a mean age of 51.38 +/- 2.04 (SD 19.27 years). Cases were allocated to 1 of 4 diagnostic groups depending on the probable intensity of myocardial damage and cause of death. In pericardial fluid we obtained statistically significant differences for the four biochemical parameters, while in serum myosin heavy chains and myoglobin showed statistically significant differences. The highest levels of biochemical markers in pericardial fluid were observed in subjects who had died from definite myocardial infarction.

Serum procalcitonin (PCT): a valuable biochemical parameter for the post-mortem diagnosis of sepsis

“…In a variety of forensic studies, the post-mortem determination of biochemical parameters has been recognized as useful in establishing the post-mortem diagnosis of the underlying cause of death, e.g. the autopsy diagnosis of diabetes mellitus based on biological compounds in vitreous humour or cerebrospinal fluid [14,23,24], the elucidation of sudden cardiac death and acute myocardial infarction by the estimation of plasma lipids, apolipoproteins or cardiac troponin I [8,21,22,34] and the detection of acetone and HbA1 in blood to support the diagnosis of ketoacidosis and lactoacidosis as the cause of death in chronic alcoholics [5]. However, the present prospective study assessing the course of serum PCT levels in sepsisassociated fatalities, is the first to deal with the post-mortem diagnosis of sepsis with the aid of a biochemical parameter.…”

Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis

“…Pericardial fluid has been used in forensic practice for several applications to measure different markers, including glucose, ketone bodies, calcium, sodium, potassium, magnesium, urea nitrogen, creatinine, uric acid, markers of myocardial ischemia and cardiac function, insulin, C-peptide and serotonin [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Pericardial fluid levels have been found to be as reliable as blood levels for some of these parameters, thus suggesting that this substrate could be used for postmortem analyses when postmortem biochemical investigations are required to circumstantiate the pathogenesis of death and sufficient amounts of blood are unavailable.…”

Postmortem chemistry update part II

“…Biochemical markers of myocardial ischemia (cardiac troponin I, cardiac troponin T, myosin, myoglobin, creatine kinase, and creatine kinase MB) have been investigated by several authors in postmortem serum from different sampling sites and pericardial fluid, with sometimes controversial results [61][62][63][64][65][66][67].…”

“…Osuna et al [61] evaluated the diagnostic efficacy of cardiac troponin I (cTnI) determination to diagnose acute myocardial ischemia in pericardial fluid and postmortem serum from femoral blood. This was carried out on 89 medico-legal autopsy cases, 25 of which were myocardial infarction, classified into four groups according to autopsy and histological findings.…”