Troponin T as a Diagnostic Marker in the Detection of Acute Myocardial Infarction at Autopsy

Sudden adult cardiac death accounts for a significant proportion of autopsies performed. In the clinical setting, electrocardiography and cardiac Troponin are the gold standard in detecting acute myocardial infarction. The use of cardiac Troponin at autopsy is less clear. This study evaluates the sensitivity and specificity of cardiac Troponin T in the detection of acute myocardial infarction at au- topsy. A retrospective study was performed, identifying autopsy cases where serum Troponin was requested. In these cases, cause of death was identified from autopsy reports, the histology reviewed and Troponin T levels were recorded. Acute myocardial infarction was confirmed as a cause of death in 72 out of the 196 cases with 66 cases having an elevated Troponin T. (Sensitivity: 92%; Specificity: 5%). The results of this study suggest that while Troponin T is sensitive marker, it is not specific as a diagnostic tool in the detection of acute myocardial infarction at autopsy. Histology remains the gold standard.