Postmortem cardiac troponin-I levels predict intramyocardial damage at autopsy

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.