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검안 시 급성심근경색 진단을 위한 심근효소 검사의 유용성

Evaluation of the Usefulness of Cardiac Enzyme Analysis for the Diagnosis of Acute Myocardial Infarction in Postmortem Inspection

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주제분류기타의약학

초록

Acute myocardial infarction is one of the most common causes of unexpected deaths, but there are limitations to its diagnosis in postmortem inspection. In this study, we aimed to investigate the usefulness of cardiac marker analysis for the diagnosis of acute myocardial infarction in postmortem inspection. This study was conducted on 30 postmortem inspection cases conducted by the National Forensic Service from 2016 to 2018. Tests for three myocardial enzymes (myoglobin, creatinine kinase-MB, and cardiac troponin I) were performed in each case, and the relationships between enzyme levels, cause of death, and factors affecting the postmortem tests were analyzed. Cardiac enzyme concentrations were not significantly different between the heart disease group and other disease groups, and the false-positive rate was increased due to postmortem changes. Therefore, we can conclude that it is not appropriate to use cardiac enzyme analysis for the diagnosis of acute myocardial infarction in postmortem inspection.

Abstract

Acute myocardial infarction is one of the most common causes of unexpected deaths, but there are limitations to its diagnosis in postmortem inspection. In this study, we aimed to investigate the usefulness of cardiac marker analysis for the diagnosis of acute myocardial infarction in postmortem inspection. This study was conducted on 30 postmortem inspection cases conducted by the National Forensic Service from 2016 to 2018. Tests for three myocardial enzymes (myoglobin, creatinine kinase-MB, and cardiac troponin I) were performed in each case, and the relationships between enzyme levels, cause of death, and factors affecting the postmortem tests were analyzed. Cardiac enzyme concentrations were not significantly different between the heart disease group and other disease groups, and the false-positive rate was increased due to postmortem changes. Therefore, we can conclude that it is not appropriate to use cardiac enzyme analysis for the diagnosis of acute myocardial infarction in postmortem inspection.

참고문헌 (8)

  1. 박지혜, "2017년도 법의부검에 대한 통계적 고찰", 대한법의학회지, 42(4), pp.111~125 (2018), 대한법의학회[DOI]
  2. Palmiere C, "Postmortem chemistry update part II", Int J Legal Med, 126, pp.199~215 (2012)
  3. 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)
  4. Burns J, "Necropsy study of association between sudden death and cardiac enzymes", J Clin Pathol, 45, pp.217~220 (1992)
  5. Carvajal-Zarrabal O, "Use of cardiac injury markers in the postmortem diagnosis of sudden cardiac death", J Forensic Sci, 62, pp.1332~1335 (2017)
  6. 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)
  7. Rahimi R, "Post mortem troponin T analysis in sudden death : is it useful?", Malays J Pathol, 40, pp.143~148 (2018)
  8. 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)

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