Diagnostic efficacy of troponin - I qualitative rapid test in sudden cardiac deaths

Everyone knows by conducting autopsy cause of sudden unexpected death can be established. However due to limitations of staff, budget and time it forces the autopsy surgeon to triage the cases. Out of which sudden cardiac deaths because of acute myocardial infarction constitute a significant percentage of caseload. When an autopsy is performed, there may be significant cardiovascular disease but there will be no gross or histological evidence of an acute myocardial infarct unless the patient survived for few hours. Troponin I (cTnI) done using peripheral blood was sampled percutaneously before conducting internal examination of each of 60 autopsies. The rapid assay result, histopathological results were tabulated and subsequently correlated. Out of 30 cases all showed positive result but in 30 controls 11 showed false positive results and 19 showed negative results. This result was statistically significant according to the chi-square test. The sensitivity of this assay in detecting cardiac-related death was 100%, with a specificity of 63.33%. In the appropriate setting, this rapid assay for cTnI can provide valuable data supportive of a cardiac-related death. This inexpensive test may best be used in triaging sudden deaths in persons and may optimize the use of the time and resources of the autopsy pathologist.