급성심근경색 사후 진단을 위한 심장 표지자 검사의 유용성
Evaluation of the Usefulness of Cardiac Marker Analysis for Postmortem Diagnosis of Acute Myocardial Infarction
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Acute myocardial infarction is one of the main causes of unusual death. However, diagnosing acute myocardial infarction based on post-mortem examination may be difficult; notably, it cannot be diagnosed based on postmortem inspection. In this study, we aimed to investigate the usefulness of cardiac marker analysis in the diagnosis of acute myocardial infarction and to review the possibility of its application in post-mortem inspections. This study included 69 autopsy cases, including 29 cases in which the post-mortem interval was ≤24 hours, performed at the National Forensic Service Seoul Institute from July to November 2018. Tests for three cardiac markers (myoglobin, creatinine kinase-MB, and cardiac troponin I) were performed in each case using portable equipment, Triage Meter. The reliability of the equipment enzyme levels according to cause of death, and factors affecting the postmortem test results were analyzed. Cardiac marker concentrations were not significantly different between the heart disease and other disease groups, and Triage Meter was not found to be suitable for postmortem examination. Therefore, we can conclude that using cardiac marker analysis in the diagnosis of acute myocardial infarction using portable equipment at the scene of postmortem inspection is inappropriate.
Abstract
Acute myocardial infarction is one of the main causes of unusual death. However, diagnosing acute myocardial infarction based on post-mortem examination may be difficult; notably, it cannot be diagnosed based on postmortem inspection. In this study, we aimed to investigate the usefulness of cardiac marker analysis in the diagnosis of acute myocardial infarction and to review the possibility of its application in post-mortem inspections. This study included 69 autopsy cases, including 29 cases in which the post-mortem interval was ≤24 hours, performed at the National Forensic Service Seoul Institute from July to November 2018. Tests for three cardiac markers (myoglobin, creatinine kinase-MB, and cardiac troponin I) were performed in each case using portable equipment, Triage Meter. The reliability of the equipment enzyme levels according to cause of death, and factors affecting the postmortem test results were analyzed. Cardiac marker concentrations were not significantly different between the heart disease and other disease groups, and Triage Meter was not found to be suitable for postmortem examination. Therefore, we can conclude that using cardiac marker analysis in the diagnosis of acute myocardial infarction using portable equipment at the scene of postmortem inspection is inappropriate.
참고문헌 (13)
- 박지혜, "2017년도 법의부검에 대한 통계적 고찰", 대한법의학회지, 42(4), pp.111~125 (2018), 대한법의학회[DOI]
- Thygesen K, "Fourth universal definition of myocardial infarction (2018)", J Am Coll Cardiol, 72, pp.2231~2264 (2018)
- "2018 Annual report on the causes of death statistics" (2019)[URL]
- 박종필, "검안 시 급성심근경색 진단을 위한 심근효소 검사의 유용성", 대한법의학회지, 43(3), pp.91~96 (2019), 대한법의학회[DOI]
- Chen JH, "Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: a reassessment with special regard to postmortem interval", Leg Med (Tokyo), 17, pp.343~350 (2015)
- Banon R, "Combined determination of B-type natriuretic peptide and high-sensitivity troponin I in the postmortem diagnosis of cardiac disease", Forensic Sci Med Pathol, 15, pp.528~535 (2019)
- Barberi C, "The use of cardiac troponin T(cTnT)in the postmortem diagnosis of acute myocardial infarction and sudden cardiac death : a systematic review", Forensic Sci Int, 292, pp.27~38 (2018)
- Burns J, "Necropsy study of association between sudden death and cardiac enzymes", J Clin Pathol, 45, pp.217~220 (1992)
- Carvajal-Zarrabal O, "Use of cardiac injury markers in the postmortem diagnosis of sudden cardiac death", J Forensic Sci, 62, pp.1332~1335 (2017)
- Kim YJ, "Usefulness of rapid test for cardiac troponin T in postmortem diagnosis of sudden cardiac death", Korean J Leg Med, 32, pp.6~12 (2008)
- Palmiere C, "Postmortem chemistry update part II", Int J Legal Med, 126, pp.199~215 (2012)
- Palmiere C, "Cardiac troponins and NT-proBNP in the forensic setting: overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature", Forensic Sci Int, 282, pp.211~218 (2018)
- Rahimi R, "Post mortem troponin T analysis in sudden death: Is it useful?", Malays J Pathol, 40, pp.143~148 (2018)