Diagnostic Roles of Postmortem cTn I and cTn T in Cardiac Death with Special Regard to Myocardial Infarction: A Systematic Literature Review and Meta-Analysis

Int J Mol Sci. 2019 Jul 8;20(13):3351. doi: 10.3390/ijms20133351.

Abstract

Background: Cardiac troponin I (cTn I) and cardiac troponin T (cTn T) are currently widely used as diagnostic biomarkers for myocardial injury caused by ischemic heart diseases in clinical and forensic medicine. However, no previous meta-analysis has summarized the diagnostic roles of postmortem cTn I and cTn T. The aim of the present study was to meta-analyze the diagnostic roles of postmortem cTn I and cTn T for cardiac death in forensic medicine, present a systematic review of the previous literature, and determine the postmortem cut-off values of cTn I and cTn T.

Methods: We searched multiple databases for the related literature, performed a meta-analysis to investigate the diagnostic roles of postmortem cardiac troponins, and analyzed the receiver operating characteristic (ROC) curve to determine their postmortem cut-off values.

Results and conclusions: The present meta-analysis demonstrated that postmortem cTn I and cTn T levels were increased in pericardial fluid and serum in cardiac death, especially in patients with acute myocardial infarction (AMI). We determined the postmortem cut-off value of cTn I in the pericardial fluid at 86.2 ng/mL, cTn I in serum at 9.5 ng/mL, and cTn T in serum at 8.025 ng/mL.

Keywords: cTn I; cTn T; cardiac death; cut-off value; forensic medicine; medical laboratory science; meta-analysis; myocardial infarction; postmortem; postmortem biochemistry.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Autopsy
  • Biomarkers
  • Death*
  • Humans
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / metabolism*
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Postmortem Changes*
  • ROC Curve
  • Troponin I / metabolism*
  • Troponin T / metabolism*

Substances

  • Biomarkers
  • Troponin I
  • Troponin T