Log in

Postmortem cardiac troponin-I levels predict intramyocardial damage at autopsy

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

Serum cardiac troponin levels are now widely used in the diagnosis of myocardial infarct (MI) and injury in living patients, but their utility in postmortem diagnosis has not been established. We evaluated postmortem cardiac troponin-I (cTnI) levels in serum from 53 hospital patients undergoing autopsy and correlated the levels with anatomic findings at postmortem examination. Among patients with nonischemic cardiac disease, those with intramyocardial disease (e.g., cardiac transplant rejection, intramyocardial tumor) had significantly higher cTnI levels than those with disease confined to the pericardium (e.g., epicardial tumor implants, pericarditis) (p = 0.004). No correlation was found between recent MI and cTnI level. There was also no correlation between cTnI level and the presence of chronic ischemic features, a history of cardiopulmonary resuscitation, or postmortem interval. We conclude that cTnI is detectable in postmortem serum samples and, although its levels did not correlate specifically with ischemia or infarction in our series, its levels appear to correlate significantly with intramyocardial injury. Use of cardiac troponin in the postmortem diagnosis of cardiac disease may be warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bodor GS, Porterfield D, Voss EM et al (1995) Cardiac troponin-I is not expressed in fetal and healthy or diseased adult human skeletal muscle tissue. Clin Chem 41:1710–1715

    PubMed  CAS  Google Scholar 

  2. Sasse S, Brand N, Kyprianou P et al (1993) Troponin I gene expression during human cardiac development and in end stage heart failure. Circ Res 72:932–938

    PubMed  CAS  Google Scholar 

  3. Lie JT, Titus JL (1975) Pathology of the myocardium and the conduction system in sudden coronary death. Circulation 52:III141–III152

    Google Scholar 

  4. Lovegrove T (1977) Sudden death from ischaemic heart disease: a review of five hundred consecutive cases. Med J Aust 1:128–129

    PubMed  CAS  Google Scholar 

  5. Virmani R, Ursell PC, Fenoglio JJ (1991) Examination of the heart. In: Virmani R, Atkinson JB, Fenoglio JJ (eds) Cardiovascular Pathology. W.B. Saunders, Philadelphia, pp 1–20

    Google Scholar 

  6. Larue C, Calzolari C, Bertinchant JP et al (1993) Cardiac-specific immunoenzymometric assay of troponin I in the early phase of acute myocardial infarction. Clin Chem 39:972–979

    PubMed  CAS  Google Scholar 

  7. Vargas SO, Sampson BA, Schoen FJ (1999) Pathologic detection of early myocardial infarction: a critical review of the evolution and usefulness of modern techniques. Mod Pathol 12:635–645

    PubMed  CAS  Google Scholar 

  8. Antman EM, Tanasijevic MJ, Thompson B et al (1996) Cardiac-specific troponin-I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 335:1342–1349

    Article  PubMed  CAS  Google Scholar 

  9. Burns J, Milroy CM, Hulewicz B et al (1992) Necropsy study of association between sudden death and cardiac enzymes. J Clin Pathol 45:217–220

    Article  PubMed  CAS  Google Scholar 

  10. Hougen HP, Valenzuela A, Lachica E, Villanueva E (1992) Sudden cardiac death: a comparative study of morphological, histochemical and biochemical methods. Forensic Sci Int 52:161–169

    Article  PubMed  CAS  Google Scholar 

  11. Perez-Carceles, Osuna E, Vieira DN et al (1995) Biochemical assessment of acute myocardial ischaemia. J Clin Pathol 48:124–128

  12. Stewart RV, Zumwalt RE, Hirsh CS, Kaplan L (1984) Postmortem diagnosis of myocardial disease by enzyme analysis of pericardial fluid. Am J Clin Pathol 82:411–417

    PubMed  CAS  Google Scholar 

  13. Cina SJ, Thompson WC, Fischer JR Jr, Brown DK, Titus JM, Smialek JE (1999) A study of various morphologic variables and troponin I in pericardial fluid as possible discriminators of sudden cardiac death. Am J Forensic Med Pathol 20:333–337

    Article  PubMed  CAS  Google Scholar 

  14. Varga M, Zsonda L (1988) A simple method for postmortem detection of acute myocardial infarction. Forensic Sci Int 37:259–263

    Article  PubMed  CAS  Google Scholar 

  15. Pedersen PK (1980) Determination of potassium/sodium ratio in heart tissue. Evaluation of its use as an index of myocardial ischaemic damage: comparison with the nitro-BT test. Forensic Sci Int 16:271–280

    Article  PubMed  CAS  Google Scholar 

  16. McVie JG (1970) Postmortem detection of inapparent myocardial infarction. Clin Path 23:203–209

    Article  CAS  Google Scholar 

  17. Luna A, Carmona A, Villanueva E (1983) The postmortem determination of CK isoenzymes in the pericardial fluid in various causes of death. Forensic Sci Int 22:23–30

    Article  PubMed  CAS  Google Scholar 

  18. Cummins B, Auckland L, Cummins P (1987) Cardiac specific troponin I radioimmunoassay in the diagnosis of acute myocardial infarction. Am Heart J 113:1333–1344

    Article  PubMed  CAS  Google Scholar 

  19. Jaffe AS, Landt Y, Parvin CA et al (1996) Comparative sensitivity of cardiac troponin I and lactate dehydrogenase isoenzymes for diagnosing acute myocardial infarction. Clin Chem 42:1770–1776

    PubMed  CAS  Google Scholar 

  20. Voss EM, Sharkey SW, Gernert AE et al (1995) Human and canine cardiac troponin T and creatine kinase-MB distribution in normal and diseased myocardium: infarct sizing using serum profiles. Arch Pathol Lab Med 119:799–806

    PubMed  CAS  Google Scholar 

  21. Volk AL, Hardy R, Robinson CA, Konrad RJ (1999) False-positive cardiac troponin I results: two case reports. Lab Med 30:610–612

    Google Scholar 

  22. Adams JE III, Davila-Roman VG, Bessey PQ et al (1996) Improved detection of cardiac contusion with cardiac troponin I. Am Heart J 131:308–312

    Article  PubMed  Google Scholar 

  23. Mattana J, Singhal PC (1992) Determinants of elevated creatine kinase activity and creatine kinase MB-fraction following cardiopulmonary resuscitation. Chest 101:1386–1392

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

The authors thank Tom Reilly for his assistance in collecting the serum samples.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Milenko J. Tanasijevic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vargas, S.O., Grudzien, C. & Tanasijevic, M.J. Postmortem cardiac troponin-I levels predict intramyocardial damage at autopsy. J Thromb Thrombolysis 26, 132–137 (2008). https://doi.org/10.1007/s11239-007-0173-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11239-007-0173-y

Keywords

Navigation