Publication: Diagnostic application of postmortem cardiac troponin I pericardial fluid/serum ratio in sudden cardiac death
Authors
Valverde-Vázquez, María del Rocio ; Pérez Cárceles, María Dolores ; Osuna, Eduardo ; Noguera Velasco, José Antonio ; Hernández del Rincón, Juan Pedro ; Hernández Romero, Diana
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Publisher
MDPI
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DOI
https://doi.org/10.3390/diagnostics11040614
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info:eu-repo/semantics/article
Description
© 2021 by the authors. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/. This document is the Published version of a Published Work that appeared in final form in Diagnostics. To access the final edited and published work see https://doi.org/10.3390/diagnostics11040614
Abstract
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.
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Citation
Diagnostics 2021, 11(4), 614
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