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Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death

In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the ci...

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Autores principales: Hernández-Romero, Diana, Valverde-Vázquez, María del Rocío, Hernández del Rincón, Juan Pedro, Noguera-Velasco, José A., Pérez-Cárceles, María D., Osuna, Eduardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067238/
https://www.ncbi.nlm.nih.gov/pubmed/33808170
http://dx.doi.org/10.3390/diagnostics11040614
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author Hernández-Romero, Diana
Valverde-Vázquez, María del Rocío
Hernández del Rincón, Juan Pedro
Noguera-Velasco, José A.
Pérez-Cárceles, María D.
Osuna, Eduardo
author_facet Hernández-Romero, Diana
Valverde-Vázquez, María del Rocío
Hernández del Rincón, Juan Pedro
Noguera-Velasco, José A.
Pérez-Cárceles, María D.
Osuna, Eduardo
author_sort Hernández-Romero, Diana
collection PubMed
description In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies.
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spelling pubmed-80672382021-04-25 Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death Hernández-Romero, Diana Valverde-Vázquez, María del Rocío Hernández del Rincón, Juan Pedro Noguera-Velasco, José A. Pérez-Cárceles, María D. Osuna, Eduardo Diagnostics (Basel) Article In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies. MDPI 2021-03-30 /pmc/articles/PMC8067238/ /pubmed/33808170 http://dx.doi.org/10.3390/diagnostics11040614 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hernández-Romero, Diana
Valverde-Vázquez, María del Rocío
Hernández del Rincón, Juan Pedro
Noguera-Velasco, José A.
Pérez-Cárceles, María D.
Osuna, Eduardo
Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title_full Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title_fullStr Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title_full_unstemmed Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title_short Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death
title_sort diagnostic application of postmortem cardiac troponin i pericardial fluid/serum ratio in sudden cardiac death
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067238/
https://www.ncbi.nlm.nih.gov/pubmed/33808170
http://dx.doi.org/10.3390/diagnostics11040614
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