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Correlation of antemortem and postmortem digoxin levels.

T E Vorpahl1, J I Coe

  • 1Department of Anatomic and Clinical Pathology, St. Paul-Ramsey Hospital, Minn. 55101.

Journal of Forensic Sciences
|April 1, 1978
PubMed
Summary

Postmortem serum digoxin levels are higher than antemortem values, varying by sampling site. Femoral venous serum combined with vitreous humor best indicates antemortem digoxin toxicity.

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Area of Science:

  • Forensic Toxicology
  • Clinical Chemistry
  • Pharmacokinetics

Background:

  • Digoxin levels in postmortem serum often exceed antemortem measurements.
  • Understanding serum digoxin distribution postmortem is crucial for toxicological analysis.

Purpose of the Study:

  • To investigate the variation in serum digoxin levels between antemortem and postmortem samples.
  • To determine the optimal sampling site and combination of samples for assessing antemortem digoxin toxicity.

Main Methods:

  • Comparison of serum digoxin levels from heart, subclavian vein, and femoral vein samples.
  • Analysis of postmortem interval's effect on digoxin level changes.
  • Evaluation of combined femoral venous serum and vitreous humor for toxicity assessment.

Main Results:

  • Postmortem serum digoxin levels consistently exceeded antemortem values across all sampling sites.
  • Mean postmortem to antemortem ratios were 1.96 (heart), 1.63 (subclavian vein), and 1.42 (femoral vein).
  • No correlation was found between postmortem interval and the increase in serum digoxin levels.

Conclusions:

  • Serum digoxin levels increase significantly after death, with variations based on sampling location.
  • Combining femoral venous serum and vitreous humor provides the most reliable data for evaluating potential antemortem digoxin toxicity.

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