Korean J Leg Med.  2019 Aug;43(3):91-96. 10.7580/kjlm.2019.43.3.91.

Evaluation of the Usefulness of Cardiac Enzyme Analysis for the Diagnosis of Acute Myocardial Infarction in Postmortem Inspection

Affiliations
  • 1Department of Forensic Medicine, Yonsei University College of Medicine, Seoul, Korea. parkjp@yuhs.ac
  • 2Division of Forensic Medicine Investigation, National Forensic Service Seoul Institute, Seoul, Korea.
  • 3Medical Examiner's Office, National Forensic Service, Wonju, Korea.
  • 4Gyeonggi Nambu Provincial Police Agency, Suwon, Korea.

Abstract

Acute myocardial infarction is one of the most common causes of unexpected deaths, but there are limitations to its diagnosis in postmortem inspection. In this study, we aimed to investigate the usefulness of cardiac marker analysis for the diagnosis of acute myocardial infarction in postmortem inspection. This study was conducted on 30 postmortem inspection cases conducted by the National Forensic Service from 2016 to 2018. Tests for three myocardial enzymes (myoglobin, creatinine kinase-MB, and cardiac troponin I) were performed in each case, and the relationships between enzyme levels, cause of death, and factors affecting the postmortem tests were analyzed. Cardiac enzyme concentrations were not significantly different between the heart disease group and other disease groups, and the false-positive rate was increased due to postmortem changes. Therefore, we can conclude that it is not appropriate to use cardiac enzyme analysis for the diagnosis of acute myocardial infarction in postmortem inspection.

Keyword

Myocardial infarction; Diagnosis; Postmortem changes; Troponin I

MeSH Terms

Cause of Death
Creatinine
Diagnosis*
Heart Diseases
Myocardial Infarction*
Postmortem Changes
Troponin
Troponin I
Creatinine
Troponin
Troponin I

Reference

1. Park JH, Na JY, Lee BW, et al. A statistical analysis on forensic autopsies performed in Korea in 2017. Korean J Leg Med. 2018; 42:111–25.
Article
2. Palmiere C, Mangin P. Postmortem chemistry update part II. Int J Legal Med. 2012; 126:199–215.
Article
3. Barberi C, van den Hondel KE. The use of cardiac troponin T (cTnT) in the postmortem diagnosis of acute myocardial infarction and sudden cardiac death: a systematic review. Forensic Sci Int. 2018; 292:27–38.
Article
4. Burns J, Milroy CM, Hulewicz B, et al. Necropsy study of association between sudden death and cardiac enzymes. J Clin Pathol. 1992; 45:217–20.
Article
5. Carvajal-Zarrabal O, Hayward-Jones PM, Nolasco-Hipolito C, et al. Use of cardiac injury markers in the postmortem diagnosis of sudden cardiac death. J Forensic Sci. 2017; 62:1332–5.
Article
6. Palmiere C, Tettamanti C, Bonsignore A, et al. Cardiac troponins and NT-proBNP in the forensic setting: overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature. Forensic Sci Int. 2018; 282:211–8.
Article
7. Rahimi R, Dahili ND, Anuar Zainun K, et al. Post mortem troponin T analysis in sudden death: is it useful? Malays J Pathol. 2018; 40:143–8.
8. Kim YJ, Ahn YW, Jo GR, et al. Usefulness of rapid test for cardiac troponin T in postmortem diagnosis of sudden cardiac death. Korean J Leg Med. 2008; 32:6–12.
Full Text Links
  • KJLM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr