POSTMORTEM ASSESSMENT OF CARDIAC TROPONIN-T (TROPOMYCIN) AND CARDIAC TROPONIN-I (INHIBITOR) LEVELS TO DIAGNOSE MYOCARDIAL INFARCTION IN VICTIMS OF SUDDEN CARDIAC DEATHS

Background: Sudden cardiac death (SCD), which is caused by acute myocardial infarction (AMI), represents a considerable percentage of autopsy cases. In many situations in forensic medicine, the diagnosis of acute myocardial infarction based only on pathological findings is difficult, so the determination of biochemical markers in postmortem biological fluids may be of significant value. Objective: The present study has aimed to throw light upon the role of postmortem assessment of cardiac troponin-T and cardiac troponin-I levels in the diagnosis of AMI in SCDs. Methodology: This is a prospective study that was conducted on 50 deceased (who fulfilled inclusion criteria) of sudden death and a control group of 20 cases consisting of deaths due to causes other than sudden death, including poisoning, falling from height, and stab wounds, that were admitted to the Forensic Medicine Authority, Alexandria Department, from January 2018 to March 2019 for comparison. At the time of autopsy, hearts were exposed, from which blood was obtained during internal examination of the thoracic cavity. About 10 ml of blood was obtained from the heart left chamber by a sterile syringe and was used for the analysis of cardiac troponin T and cardiac troponin I levels after centrifugation to obtain plasma. Results: All the assessed parameters showed significant correlation with SCDs. The sensitivity of cTnI and cTnT for prediction of SCD was 100% with a specificity of 85%. Conclusion: Evaluation of the biocardiac enzymes of cTnI and cTnT represents a highly sensitive marker in postmortem determnination of myocardial lesions in SCD.