ABSTRACT
INTRODUCTION: Ischemic heart disease (IHD) related to atherosclerotic coronary artery disease (CAD) is one of the most prevalent causes of death in Europe. Also post-mortem evaluation of IHD remains a challenge because of possible non-specific autopsy finding in some autopsy cases, especially in early myocardial ischemia. High-sensitive troponin T (hs- TnT) is used today in clinical practice as the “gold standard” to diagnose the myocardial ischemia, and might also be applied as an ancillary tool for post-mortem evaluation.
PURPOSE: The goal of this study is to evaluate the diagnostic value of post-mortem serum hs-TnT assay in cases of sudden death related to IHD. We will also investigate the influence of cardiopulmonary resuscitation (CPR) attempts on post-mortem hs-TnT levels.
METHODS: The hs-TnT values in serum were retrospectively analysed in 85 autopsy data (2012-2015, University Center of Legal Medicine in Lausanne). 52 cases with clinical history and morphological results suggesting cardiac ischemia were included in the study group (mean age 53.5; age range 34-75), 33 in the control group (mean age 40.4; age range 15-69). The group’s statistical comparison was performed using logistic regression model.
RESULTS: Our study showed a significant non-linear association between hs-TnT serum values and post-mortem diagnosis of sudden deaths related to IHD (p-value 0.005). The shape of the relationship is showing that the probability of death due to IHD increases quickly with a light level of hs-TnT (maximum around 90ng/L), then decreases slightly while remaining at high in values. No significant difference in the hs-TnT serum values was found between the CPR and the non-CPR cases (p-value 0.304).
CONCLUSION: The measurement of Hs-TnT serum values might be considered as an ancillary tool for the evaluation of death related to IHD, while taking necessary precautions in the interpretation of the results.