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Cardiac troponin T determination by a highly sensitive assay in postmortem serum and pericardial fluid

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Abstract

Purpose

The main objective of this study was to test, for the first time, a highly sensitive cardiac troponin T (cTnThs) assay in postmortem serum and pericardial fluid and to evaluate cardiac troponin T (cTnT) levels and their stability after death at different postmortem intervals, in an attempt to determine the viability of the cTnThs assay in the postmortem diagnosis of the cause of death.

Methods

cTnT levels were determined in serum and pericardial fluid samples taken from 58 cadavers at known postmortem intervals, whose causes of death were categorized into the following groups: (1) sudden cardiac deaths, (2) multiple trauma, (3) mechanical asphyxia, and (4) other natural deaths. cTnT was determined by inmunoassay, using the Troponin T highly sensitive STAT assay (Roche®).

Results

Average cTnT levels measured by a highly sensitive assay in postmortem serum were markedly higher than clinical serum levels. Moreover, similar results, higher cTnT levels in postmortem pericardial fluid, were obtained when compared to levels found in pericardial fluid taken from two living patients during coronary artery bypass surgery. cTnT levels in both postmortem fluids remained stable for up to 34 h after death. No differences in cTnT levels in either postmortem fluid by sex and age were detected. Levels of cTnT found in pericardial fluid in the other natural deaths group were significantly lower than the cTnT levels found in that postmortem fluid from any of the other causes of death groups.

Conclusion

It is therefore reasonable to conclude that determination of cTnT by a highly sensitive assay in pericardial fluid can provide forensic pathologists with a complementary test to the diagnosis of cause of death.

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Acknowledgments

The authors gratefully acknowledge Amanda Rocío González Ramírez for assistance with statistical studies. We also thank Richard Gautier for the English language revision of the manuscript. The authors acknowledge the funding from CEIFA (Centro para la Excelencia Forense en Andalucía).

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Authors and Affiliations

  1. Department of Forensic Medicine, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, 18071, Granada, Spain

    Lucas González-Herrera, Aurora Valenzuela & Enrique Villanueva

  2. Forensic Pathology Service, Instituto de Medicina Legal, Ciudad de la Justicia, Fiscal Luís Portero García 6, 29010, Málaga, Spain

    Valentín Ramos

  3. Clinical Analysis Service, San Cecilio’s Universitary Hospital, Avenida Doctor Olóriz 16, 18012, Granada, Spain

    Antonia Blázquez

Authors
  1. Lucas González-Herrera
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  2. Aurora Valenzuela
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  3. Valentín Ramos
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  4. Antonia Blázquez
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  5. Enrique Villanueva
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Correspondence to Lucas González-Herrera.

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González-Herrera, L., Valenzuela, A., Ramos, V. et al. Cardiac troponin T determination by a highly sensitive assay in postmortem serum and pericardial fluid. Forensic Sci Med Pathol 12, 181–188 (2016). https://doi.org/10.1007/s12024-016-9749-1

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