Why the study?
Evaluating agonal cardiac function is critical for diagnosing sudden cardiac death in forensic medicine, but the postmortem diagnostic utility of BNP and NT-proBNP required investigation.
Does postmortem measurement of BNP and NT-proBNP differentiate sudden cardiac death from non-sudden cardiac death in forensic evaluations?
Does postmortem measurement of BNP and NT-proBNP differentiate sudden cardiac death from non-sudden cardiac death in forensic evaluations?
Postmortem NT-proBNP levels in pericardial fluid are significantly elevated in sudden cardiac death, serving as a useful ancillary biomarker for forensic diagnosis.
May aid forensic SCD differentiation as ancillary biomarker; confirms association via meta-analysis.
Sudden cardiac death (SCD) is an unexpected death caused by a sudden loss of cardiac function, which is currently a global public health problem. Evaluation of the agonal cardiac function of the deceased is a quite important task for the diagnosis of SCD in forensic medicine. Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are currently considered as significant biomarkers for the diagnosis of heart failure in both clinical and forensic practices. To investigate the postmortem evaluation roles of postmortem BNP and NT-proBNP levels for SCD, the present study meta-analyzed eight related studies from Embase, Cochrane Library, PubMed, China Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data. Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included literature, and the meta-analysis was performed by RevMan 5.3.5 software. Postmortem NT-proBNP in pericardial fluid showed higher levels in the SCD group than that of the non-SCD group with the weighted mean difference = 3665.74, 95% confidence interval: 1812.89-5518.59, and p = 0.0001. However, postmortem levels of BNP in pericardial fluid and NT-proBNP in serum revealed no statistical difference between SCD and non-SCD subjects. The results of present meta-analysis demonstrated that postmortem NT-proBNP in the pericardial fluid could be used as an ancillary indicator for evaluation of agonal cardiac function in forensic medicine.
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Cao et al. (2019) studied this question.
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