1Associate Professor, Department of Forensic Medicine, Viswabharathi Medical College, Kurnool
2Assistant Professor, Department of Forensic Medicine, Osmania Medical College, Hyderabad
3Assistant Professor, Department of Forensic Medicine, Viswabharathi Medical College, Kurnool
*Corresponding author: Dr. K Subba Reddy, Associate Professor, Department of Forensic Medicine, Viswabharathi Medical College, R T Nagar, Penchikalapadu (V), Kurnool, Andhra Pradesh-518 463. Email: drsubbareddy007@gmail.com
Online published on 17 August, 2016.
A prospective of Troponin T as a diagnostic marker in the detection of acute myocardial infarction at autopsy.
The internal autopsy was done for 50 sudden death bodies and 5 deaths consisting of deaths due to poisoning, stroke, tuberculosis etc. Adult dead body with cause of death unexplained by external examination were studied and autopsy was done within 48 hours of death.
AMI was established as a cause of death in 19 of the 50 cases (36.7%) and confirmed on histological examination. Of the 19 cases of AMI, 17 (92%) showed an elevated Troponin T level [> 0.03mg/L]. There were 31 cases where the Troponin T levels were elevated but the cause of death was due to alternate causes other than an AMI. This yielded a sensitivity of 92% and a specificity of 5% (p=0.62; chi-squared test) for Troponin T in predicting an AMI at autopsy. Correspondingly, the positive and negative predictive value of Troponin T was 36% and 57% respectively.
In clinical practice, Troponin T has been extensively investigated and found to be a sensitive marker of myocardial infarction. While our study confirms that Troponin T is sensitive at detecting AMI, it is unfortunately not specific to this disease process.
Troponin T, Acute myocardial infraction, Autopsy
