Comparison between ante-mortem and post-mortem Troponin T

P. S. Lai, S. M. Nur, S. Kunasilan, S. R. Nur, L. S. Khoo, H. b. S. Mohd

Abstract: Introduction. Sudden cardiac death due to acute myocardial infarction (AMI) comprises a significant proportion of autopsy cases. Troponin levels act as a specific and sensitive indicator of myocardial infarction in the living. Methods. This retrospective study of post-mortem and antemortem cases (n= 154) in the year of 2016 at Hospital Kuala Lumpur. Blood Troponin T was analyzed from these cases. Results and Discussion. Average troponin T values for non-cardiac related death cases (5.322 ng/mL) were higher than cardiac-related death (4.916 ng/mL) with no significant difference between them although Trop T values were highly sensitive to myocardial infarction (MI) with limited specificity. There was also no correlation between post-mortem Trop T levels to the cardiac-related cause of death. The minimum Trop T value amongst the MI post-mortem cases was 0.390 ng/mL. Post-mortem troponin T values were affected by multiple factors which includes post-mortem interval and the severity of myocardial damage at the time of death. We also have analyzed 4 ante-mortem samples and compared it to post-mortem Troponin T. All four samples showed marked disproportionate rise. Conclusion. Post-mortem troponin T has limited value in establishing the cardiac-related cause of death.
Keywords: Troponin T, cardiac death, post-mortem, myocardial infarction.