Cardiac troponins and NT-proBNP in the forensic setting: Overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature
•Cardiac troponins and NT-proBNP may be reliably measured in postmortem serum from femoral blood.•Postmortem intervals over 48h may cause increased levels of cardiac troponins in postmortem serum from femoral blood.•Cardiopulmonary resuscitation does not influence cardiac troponins and NT-proBNP lev...
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| Veröffentlicht in: | Forensic science international 2018-01, Vol.282, p.211-218 |
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| creator | Palmiere, Cristian Tettamanti, Camilla Bonsignore, Alessandro De Stefano, Francesco Vanhaebost, Jessica Rousseau, Guillaume Scarpelli, Maria Pia Bardy, Daniel |
| description | •Cardiac troponins and NT-proBNP may be reliably measured in postmortem serum from femoral blood.•Postmortem intervals over 48h may cause increased levels of cardiac troponins in postmortem serum from femoral blood.•Cardiopulmonary resuscitation does not influence cardiac troponins and NT-proBNP levels.
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16). Levels of these markers were also compared in cases characterized by various postmortem intervals (n=48, consisting of 24 ischemic heart disease cases and 24 controls) as well as in cases with and without cardiopulmonary resuscitation (n=22, consisting of 14 cases of hanging and 8 cases of drug intoxication). Our results indicate that N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I values determined in postmortem serum from femoral blood (collected up to 24h after death) do not differ significantly from those measured in venous blood antemortem serum samples (collected at the upper limbs). In addition, our results reveal that the time elapsed after death should always be taken into consideration when cardiac troponins are measured in postmortem samples. Lastly, our findings reveal the absence of statistically significant differences between levels of the tested biomarkers (in postmortem serum from femoral blood) in cases without cardiopulmonary resuscitation compared to cases with cardiopulmonary resuscitation (at least for postmortem intervals up to 24h). |
| doi_str_mv | 10.1016/j.forsciint.2017.11.034 |
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The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16). Levels of these markers were also compared in cases characterized by various postmortem intervals (n=48, consisting of 24 ischemic heart disease cases and 24 controls) as well as in cases with and without cardiopulmonary resuscitation (n=22, consisting of 14 cases of hanging and 8 cases of drug intoxication). Our results indicate that N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I values determined in postmortem serum from femoral blood (collected up to 24h after death) do not differ significantly from those measured in venous blood antemortem serum samples (collected at the upper limbs). In addition, our results reveal that the time elapsed after death should always be taken into consideration when cardiac troponins are measured in postmortem samples. Lastly, our findings reveal the absence of statistically significant differences between levels of the tested biomarkers (in postmortem serum from femoral blood) in cases without cardiopulmonary resuscitation compared to cases with cardiopulmonary resuscitation (at least for postmortem intervals up to 24h).</description><identifier>ISSN: 0379-0738</identifier><identifier>EISSN: 1872-6283</identifier><identifier>DOI: 10.1016/j.forsciint.2017.11.034</identifier><identifier>PMID: 29227899</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Biochemical markers ; Biomarkers ; Blood ; Brain natriuretic peptide ; Calcium-binding protein ; Cardiac troponins ; Cardiopulmonary resuscitation ; Cardiovascular disease ; Coronary artery disease ; Coronary vessels ; CPR ; Disease control ; Femur ; Fluids ; Forensic engineering ; Forensic science ; Forensic sciences ; Heart ; Heart attacks ; Heart diseases ; Intervals ; Intoxication ; Investigations ; Ischemia ; Literature reviews ; Myocardial ischemia ; NT-proBNP ; Postmortem biochemistry ; Postmortem interval ; Resuscitation ; Sampling ; Sampling site ; Serum levels ; Statistical analysis ; Statistical methods ; Trauma ; Troponin ; Troponin I ; Troponin T ; Veins & arteries</subject><ispartof>Forensic science international, 2018-01, Vol.282, p.211-218</ispartof><rights>2017 Elsevier B.V.</rights><rights>Copyright © 2017 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-ee000e91577c4a911f95cc09de9f6666dac4ef6a374a23eebbadaa1c1d0744d13</citedby><cites>FETCH-LOGICAL-c448t-ee000e91577c4a911f95cc09de9f6666dac4ef6a374a23eebbadaa1c1d0744d13</cites><orcidid>0000-0002-5799-9893</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0379073817304929$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29227899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Palmiere, Cristian</creatorcontrib><creatorcontrib>Tettamanti, Camilla</creatorcontrib><creatorcontrib>Bonsignore, Alessandro</creatorcontrib><creatorcontrib>De Stefano, Francesco</creatorcontrib><creatorcontrib>Vanhaebost, Jessica</creatorcontrib><creatorcontrib>Rousseau, Guillaume</creatorcontrib><creatorcontrib>Scarpelli, Maria Pia</creatorcontrib><creatorcontrib>Bardy, Daniel</creatorcontrib><title>Cardiac troponins and NT-proBNP in the forensic setting: Overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature</title><title>Forensic science international</title><addtitle>Forensic Sci Int</addtitle><description>•Cardiac troponins and NT-proBNP may be reliably measured in postmortem serum from femoral blood.•Postmortem intervals over 48h may cause increased levels of cardiac troponins in postmortem serum from femoral blood.•Cardiopulmonary resuscitation does not influence cardiac troponins and NT-proBNP levels.
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16). Levels of these markers were also compared in cases characterized by various postmortem intervals (n=48, consisting of 24 ischemic heart disease cases and 24 controls) as well as in cases with and without cardiopulmonary resuscitation (n=22, consisting of 14 cases of hanging and 8 cases of drug intoxication). Our results indicate that N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I values determined in postmortem serum from femoral blood (collected up to 24h after death) do not differ significantly from those measured in venous blood antemortem serum samples (collected at the upper limbs). In addition, our results reveal that the time elapsed after death should always be taken into consideration when cardiac troponins are measured in postmortem samples. Lastly, our findings reveal the absence of statistically significant differences between levels of the tested biomarkers (in postmortem serum from femoral blood) in cases without cardiopulmonary resuscitation compared to cases with cardiopulmonary resuscitation (at least for postmortem intervals up to 24h).</description><subject>Biochemical markers</subject><subject>Biomarkers</subject><subject>Blood</subject><subject>Brain natriuretic peptide</subject><subject>Calcium-binding protein</subject><subject>Cardiac troponins</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiovascular disease</subject><subject>Coronary artery disease</subject><subject>Coronary vessels</subject><subject>CPR</subject><subject>Disease control</subject><subject>Femur</subject><subject>Fluids</subject><subject>Forensic engineering</subject><subject>Forensic science</subject><subject>Forensic sciences</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Intervals</subject><subject>Intoxication</subject><subject>Investigations</subject><subject>Ischemia</subject><subject>Literature reviews</subject><subject>Myocardial ischemia</subject><subject>NT-proBNP</subject><subject>Postmortem biochemistry</subject><subject>Postmortem interval</subject><subject>Resuscitation</subject><subject>Sampling</subject><subject>Sampling site</subject><subject>Serum levels</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>Trauma</subject><subject>Troponin</subject><subject>Troponin I</subject><subject>Troponin T</subject><subject>Veins & 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Francesco</au><au>Vanhaebost, Jessica</au><au>Rousseau, Guillaume</au><au>Scarpelli, Maria Pia</au><au>Bardy, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac troponins and NT-proBNP in the forensic setting: Overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature</atitle><jtitle>Forensic science international</jtitle><addtitle>Forensic Sci Int</addtitle><date>2018-01</date><risdate>2018</risdate><volume>282</volume><spage>211</spage><epage>218</epage><pages>211-218</pages><issn>0379-0738</issn><eissn>1872-6283</eissn><abstract>•Cardiac troponins and NT-proBNP may be reliably measured in postmortem serum from femoral blood.•Postmortem intervals over 48h may cause increased levels of cardiac troponins in postmortem serum from femoral blood.•Cardiopulmonary resuscitation does not influence cardiac troponins and NT-proBNP levels.
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16). Levels of these markers were also compared in cases characterized by various postmortem intervals (n=48, consisting of 24 ischemic heart disease cases and 24 controls) as well as in cases with and without cardiopulmonary resuscitation (n=22, consisting of 14 cases of hanging and 8 cases of drug intoxication). Our results indicate that N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I values determined in postmortem serum from femoral blood (collected up to 24h after death) do not differ significantly from those measured in venous blood antemortem serum samples (collected at the upper limbs). In addition, our results reveal that the time elapsed after death should always be taken into consideration when cardiac troponins are measured in postmortem samples. Lastly, our findings reveal the absence of statistically significant differences between levels of the tested biomarkers (in postmortem serum from femoral blood) in cases without cardiopulmonary resuscitation compared to cases with cardiopulmonary resuscitation (at least for postmortem intervals up to 24h).</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>29227899</pmid><doi>10.1016/j.forsciint.2017.11.034</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5799-9893</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Forensic science international, 2018-01, Vol.282, p.211-218 |
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| source | Elsevier ScienceDirect Journals |
| subjects | Biochemical markers Biomarkers Blood Brain natriuretic peptide Calcium-binding protein Cardiac troponins Cardiopulmonary resuscitation Cardiovascular disease Coronary artery disease Coronary vessels CPR Disease control Femur Fluids Forensic engineering Forensic science Forensic sciences Heart Heart attacks Heart diseases Intervals Intoxication Investigations Ischemia Literature reviews Myocardial ischemia NT-proBNP Postmortem biochemistry Postmortem interval Resuscitation Sampling Sampling site Serum levels Statistical analysis Statistical methods Trauma Troponin Troponin I Troponin T Veins & arteries |
| title | Cardiac troponins and NT-proBNP in the forensic setting: Overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature |
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