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Cardiac-specific troponin-I (cTnI) in a post-mortem setting
Ethan D Sutton1, Sarah Parsons2,3, Maria Pricone4
1Bachelor of Biomedical Science Honours, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
International Journal of Legal Medicine
|May 23, 2025
Summary
Post-mortem cardiac troponin I (cTnI) testing is often available but highly unstable after death. Interpret results cautiously, especially from decomposed bodies or delayed samples.
Area of Science:
- Forensic Pathology
- Clinical Chemistry
- Biomarker Analysis
Background:
- Cardiac-specific troponin (cTn) aids acute myocardial infarction diagnosis.
- Post-mortem cTn testing has potential but faces limitations.
- Factors influencing post-mortem cTn utility require further investigation.
Purpose of the Study:
- To assess the availability and stability of cardiac-specific Troponin I (cTnI) post-mortem.
- To determine factors affecting post-mortem cTnI test success.
- To evaluate cTnI stability and interpretability in deceased individuals.
Main Methods:
- Analyzed 250 high-sensitivity (hs-)cTnI tests on post-mortem blood samples.
- Correlated test success with sample location, type, post-mortem interval, and decomposition.
- Assessed cTnI stability by comparing paired samples from different post-mortem times.
Main Results:
- hs-cTnI tests succeeded in 86.4% of cases; decomposition and extended post-mortem intervals reduced success.
- Visible decomposition precluded successful testing.
- Post-mortem cTnI demonstrated significant instability, with large, erratic variations between samples from the same individual over time.
Conclusions:
- Post-mortem hs-cTnI testing is generally feasible but requires careful sample selection.
- Prioritize earliest available blood samples; avoid testing decomposed individuals.
- Severe post-mortem cTnI instability necessitates cautious interpretation of results.
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