[Cardiac troponin I and the post-mortem diagnosis of myocardial damage]

The aim of this study is to analyse the diagnostic efficacy of post-mortem dosage of cardiac troponine I in cadaver fluids in detection of myocardial damage.

Our study is prospective, interesting 72 corps autopsied at the Department of Forensic Medicine of the University Hospital Fattouma Bourguiba of Monastir-Tunisia. Were excluded from the study, resuscitated cases and those examined more than 48h after death. Levels of cardiac troponine I were measured in pericardial fluid, cardiac blood and peripheral blood. Statically significant correlations between different variables levels of cardiac troponine I and cardiac damage were studied. Receiver-operator characteristic (ROC) curves were generated and areas under the curves were determined. SPSS (version 12.0) et MedCalc statistical software (version 11.0) were used for statistical analysis. Results were considered to be statistically significant when P<0.05.

Cardiac troponin I levels in pericardial fluid, cardiac and peripheral blood are correlated significantly between subject with and without observable signs of myocardial damage with a P value respectively at 0.0007, 0.0009 and 0.004. ROC curves analysis showed that the pericardial fluid have the best sensibility and specificity with a cut-off level at 108ng/ml and an area under the curve at 0.925.

Our data indicate that cardiac troponin I may be a powerful aid in the diagnosis of myocardial damages. This biological test can be used in triaging sudden deaths before to external examination versus complete autopsy.