Utilidad de la determinación de la fracción I de la Troponina cardíaca (cTnI), en el diagnóstico de la muerte súbita de origen cardíaco en autopsias forenses

Abstract

Objetives: To evaluate practical usefulness of cardiac Troponin analysis (cTnI) in peripheral blood levels, in order to improve diagnosis of sudden cardiac death in routine forensic cases. Comparing these levels with Myoglobin and MB-CK blood levels in the same type of samples. Material and methods: We have studied 97 medico legal autopsies performed in the Pathology Service of the Institute of Legal Medicine (Alicante). In every case we analyzed sample of serum from peripheral blood (femoral), by Microparticle Enzyme Immunoassay (MEIA) Axsym system (Abbott Diagnostics). Causes of death were classified into 6 groups according: 1) Death of cardiac origin (n=42); 2) Traumatic deaths (n=19); 3) Death by asphyxia (n=12); 4) Natural deaths of non-cardiac origin (n=8); 5) Miscellaneous group (n=6), and 6) Traumatic death with Thoracic trauma (n=10). Data was analysed by means of SPSS 14.0 statistical software program (SPSS Inc, 2005). Results: cTnI levels were significantly high in cases of sudden cardiac death, but it were also high in the group of thoracic trauma, which could raise diagnosis problems between these groups, as was shown previously in the literature. Conclusions: The determination of cTnI is more efficient than CKMB and Myoglobine in the diagnosis of sudden cardiac death. However, the elevation of mean levels of this marker in cases of severe thoracic traumatism limits its diagnostic usefulness in these situations.