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L'Interet en Medecine Legale de la Troponine Ic Devant Une Mort Suspecte

NCJ Number
223161
Journal
Canadian Society of Forensic Science Journal Volume: 41 Issue: 1 Dated: March 2008 Pages: 1-12
Author(s)
Hafid Belhadj-Tahar; Laurence Veneau; Et Nouredine Sadeg
Date Published
March 2008
Length
12 pages
Annotation
This article reports on the significance in forensic medicine of using Troponin Ic (Ic-Tn) at the time a body is removed from the discovery site, in order to determine the circumstances of suspicious deaths.
Abstract
Based on initial clinical observations, the global population was divided into four groups: those without the presence of lividity and rigidity (GI); those with the presence of lividity and rigidity (GII); those with signs of putrefaction (GIII); and the group that included the bodies kept in the funeral home at low temperature (GIV). There was no significant difference in the troponin levels between group GI (short postmortem delay) and GII (intermediate postmortem delay). A significant increase in this marker was observed in GIII (presence of putrefaction) compared with GI + GII (absence of putrefaction). For short and intermediate delays, storage in the funeral home did not modify the kinetic release of troponin. On the other hand, an increase in the level of Ic-Tn was positively correlated with the duration of cardiac massage. Since the troponin level rises during putrefaction, an exclusion limit was determined to be 11 mg/l, above which the results were deemed uninterpretable. Under these conditions, the predictive capacity of Troponin Ic for cardiac death is optimal at 0.8 mg/l with sensitivity and specificity estimated at 86 percent and 100 percent, respectively. Application of this marker requires knowledge of the circumstances of death and anamnestic elements, as well as observations and examinations of the body. Under these conditions, cardiac troponin apparently is a helpful element to use in determining suspicious deaths, particularly sudden deaths. The authors analyzed the Ic-Tn concentrations at the time of 32 body removals conducted from 2005 to 2006 in northern suburbs of Paris. 2 tables, 1 figure, and 26 references