Key result
Postmortem cardiac marker levels vary widely by anatomic site, with only three combinations identifying acute MI.
Why the study?
The utility of cardiac markers in the autopsy setting for diagnosing acute myocardial infarction has not been fully established.
Does postmortem testing of cardiac markers (creatine kinase, CK-MB, troponin-I) differentiate acute myocardial infarction from noncardiac death in decedents?
Case-Control (n=10)
Does postmortem testing of cardiac markers (creatine kinase, CK-MB, troponin-I) differentiate acute myocardial infarction from noncardiac death in decedents?
Postmortem cardiac markers are significantly elevated compared to living reference ranges and vary by sampling site, complicating their utility for diagnosing acute MI at autopsy.
Postmortem cardiac markers should not guide acute MI diagnosis at autopsy; leaves open standardized sampling for forensic differentiation.
Sudden cardiac deaths because of acute myocardial infarction (MI) constitute a significant percentage of the caseload for death investigators, coroners, and forensic pathologists. Clinicians use cardiac markers, highly sensitive and specific for myocardial damage, to screen living patients for acute MI; however, to this point, the utility of these markers in the autopsy setting has not been fully established. The current study included 10 decedents, five who died of acute MI, and five subjects who died of noncardiac disease. Samples of pericardial fluid and blood from multiple sites were tested for creatine kinase, creatinine kinase MB, and troponin-I. Three main conclusions were drawn: the levels of cardiac markers from all patients are significantly higher than the reference range for living patients, there are significant differences in cardiac marker levels between samples from different anatomic locations, and only three cardiac marker/anatomic site combinations were significantly different between the control and study groups.
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Batalis et al. (2010) conducted a case-control in Acute Myocardial Infarction (n=10). Postmortem cardiac markers (creatine kinase, CK-MB, troponin-I) vs. Noncardiac disease deaths was evaluated on Cardiac marker levels in pericardial fluid and blood from multiple sites. Postmortem cardiac marker levels varied significantly by anatomic location, with only three marker/site combinations differing significantly between acute MI and noncardiac deaths.
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