Serum periostin levels in myocardial infarction: Findings from forensic autopsy cases

Acute myocardial infarction (AMI) remains one of the leading causes of sudden death with significant implications in both clinical and forensic practice. In forensic settings, AMI diagnosis traditionally relies on gross and histopathological findings. However, when ischemic changes are subtle or insufficiently developed, various cardiac biomarkers have been investigated to support postmortem diagnosis. Periostin, a matricellular protein involved in tissue remodeling and repair, has recently garnered attention for its role in cardiac pathology. Emerging evidence suggests that serum periostin may be a valuable biomarker for assessing cardiac injury and predicting outcomes after AMI. This study aimed to evaluate serum periostin levels in forensic autopsy cases of AMI. The subjects were 80 autopsy cases, categorized into AMI (n = 46), fatal asthma (n = 16), and traumatic deaths (n = 18). Serum periostin levels were significantly elevated in AMI compared with asthma and trauma cases, with median values of 728.50 ng/mL (IQR 465.25-1139.75) in AMI, 410.50 ng/mL (IQR 253.00-756.00) in asthma, and 386.50 ng/mL (IQR 229.75-532.50) in trauma. Serum periostin showed no significant correlation with postmortem interval and was minimally influenced by patients' characteristics or comorbidities. These findings provide baseline data on serum periostin levels in forensic autopsy cases and suggest that periostin measurement may assist in the postmortem evaluation of AMI.