Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the ci...
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MDPI AG
2021-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/4/614 |
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| author | Diana Hernández-Romero María del Rocío Valverde-Vázquez Juan Pedro Hernández del Rincón José A. Noguera-Velasco María D. Pérez-Cárceles Eduardo Osuna |
| author_facet | Diana Hernández-Romero María del Rocío Valverde-Vázquez Juan Pedro Hernández del Rincón José A. Noguera-Velasco María D. Pérez-Cárceles Eduardo Osuna |
| author_sort | Diana Hernández-Romero |
| collection | DOAJ |
| description | In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies. |
| first_indexed | 2024-03-10T12:47:35Z |
| format | Article |
| id | doaj.art-91e687b20bba4295a8f360ed39696f92 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T12:47:35Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-91e687b20bba4295a8f360ed39696f922023-11-21T13:22:49ZengMDPI AGDiagnostics2075-44182021-03-0111461410.3390/diagnostics11040614Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac DeathDiana Hernández-Romero0María del Rocío Valverde-Vázquez1Juan Pedro Hernández del Rincón2José A. Noguera-Velasco3María D. Pérez-Cárceles4Eduardo Osuna5Department of Legal and Forensic Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Biomedical Research Institute (IMIB), University of Murcia, 30100 Murcia, SpainDepartment of Legal and Forensic Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Biomedical Research Institute (IMIB), University of Murcia, 30100 Murcia, SpainInstitute of Legal Medicine, 30003 Murcia, SpainClinical Analysis Service, Hospital University “Virgen de la Arrixaca”, El Palmar, 30120 Murcia, SpainDepartment of Legal and Forensic Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Biomedical Research Institute (IMIB), University of Murcia, 30100 Murcia, SpainDepartment of Legal and Forensic Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Biomedical Research Institute (IMIB), University of Murcia, 30100 Murcia, SpainIn approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies.https://www.mdpi.com/2075-4418/11/4/614cardiac troponin Ipericardial fluidserummyocardial infarctionpostmortem diagnosis |
| spellingShingle | Diana Hernández-Romero María del Rocío Valverde-Vázquez Juan Pedro Hernández del Rincón José A. Noguera-Velasco María D. Pérez-Cárceles Eduardo Osuna Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death Diagnostics cardiac troponin I pericardial fluid serum myocardial infarction postmortem diagnosis |
| title | Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death |
| title_full | Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death |
| title_fullStr | Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death |
| title_full_unstemmed | Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death |
| title_short | Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death |
| title_sort | diagnostic application of postmortem cardiac troponin i pericardial fluid serum ratio in sudden cardiac death |
| topic | cardiac troponin I pericardial fluid serum myocardial infarction postmortem diagnosis |
| url | https://www.mdpi.com/2075-4418/11/4/614 |
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