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 T at autopsy is less clear. This study evaluates the sensitivity and specificity of cardiac Troponin in the detection of acute myocardial infarction at autopsy. 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.