Usefulness of Rapid Test for Cardiac Troponin T in Postmortem Diagnosis of Sudden Cardiac Death

Kim, You Jin; Ahn, Yong Woo; Jo, Gam Rae; Lee, Sang Yong; Kim, Kwang Hoon; Huh, Gi Yeong

Abstract

BACKGROUND/AIMS
Sudden cardiac death (SCD), mostly related to myocardial infarction is a common cause of death on forensic autopsy. It is known that the morphologic evidence can not be detected in the early stage of myocardial infarction. Cardiac troponin T (cTnT) is a specific marker of myocardial damage, which is clinically used for the diagnosis of ischemic heart disease with rapid test kit. This study was aimed to evaluate the usefulness of rapid test kit for cTnT in postmortem diagnosis of sudden cardiac death. METHODS: We performed the test on heart blood during autopsy on SCD (n=35) and control (n=10, 5 trauma-related and 5 non-trauma-related) groups, using TROPT(R) sensitive assay kit. RESULTS: 68.6% of SCD was positive, compared with 20.0% of control. There was a statistically significant difference between two groups. Among non-traumatic control, drug intoxication and asphyxia due to O2 deficiency were positive, while all trauma-related cases were negative. 76.2% of SCD within PMI 24 hours was positive, compared with 57.1% after PMI 24 hours. Negative results among SCD were found in the cases died very shortly after the event, with acute change in atheromatous plaque of coronary atherosclerosis. CONCLUSIONS: This rapid test for cTnT could be an adjuvant tool of postmortem diagnosis of SCD. However, the result of this test should be interpreted with caution, considering the duration of the event in SCD and the false positivity on non-traumatic cause of death.