Diagnostic Efficacy of Cardiac Isoenzyme CK-MB in Pericardial Fluid for Post-mortem Diagnosis of Myocardial Infarction

Sudden cardiac death due to acute myocardial infarction is the most prevalent cause of death in adults and constitutes a significant portion of the autopsies that are conducted by Forensic pathologists. Serum cardiac isoenzymes Creatine phosphokinase-MB (CK-MB) has high sensitivity and specificity for cardiac damage and routinely used for clinical diagnosis of myocardial infarction (MI). However, in Forensic Medicine, diagnostic utility of this cardiac marker for post-mortem diagnosis of MI has not been fully established. Present study is carried out with aim to evaluate the diagnostic efficacy of CK-MB in pericardial fluid for autopsy diagnosis of MI. This study included 119 medico-legal autopsy cases selected during a period of two years. Four study groups were formed depending upon final cause of death Biochemical analysis of pericardial fluid was carried out. Highest levels of CK-MB were noted in deaths due to IHD. By this cardiac marker, early infarcts can be predicted in sudden cardiac deaths associated with severe coronary artery disease & inconclusive histopathological findings.

We obtained high diagnostic sensitivity and negative predictive value of CPK-MB for autopsy diagnosis of MI in pericardial fluid comparable to the clinical analyses on serum.