Postmortem urine concentration of N-terminal pro-brain natriuretic peptide in relation to the cause of death.
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers
/ metabolism
Case-Control Studies
Cause of Death
Child
Creatine Kinase, MB Form
/ metabolism
Female
Forensic Medicine
Heart Failure
/ metabolism
Humans
Male
Middle Aged
Myocardial Infarction
/ metabolism
Natriuretic Peptide, Brain
/ metabolism
Peptide Fragments
/ metabolism
Pericardial Fluid
/ metabolism
Postmortem Changes
Sensitivity and Specificity
Sepsis
/ metabolism
Troponin
/ blood
Young Adult
Biochemical markers
Forensic
NT-proBNP
Postmortem
Urine
Journal
Forensic science international
ISSN: 1872-6283
Titre abrégé: Forensic Sci Int
Pays: Ireland
ID NLM: 7902034
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
13
09
2019
revised:
19
11
2019
accepted:
24
11
2019
pubmed:
8
12
2019
medline:
29
1
2020
entrez:
8
12
2019
Statut:
ppublish
Résumé
The utility of biochemical marker analysis in forensic autopsy cases is still uncertain due to the postmortem changes which they undergo. Thus, research is required to elucidate alternative samples and biochemical markers which are less affected by postmortem changes. Levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to be elevated in congestive heart failure (CHF), acute myocardial infarction (AMI), and sepsis patients. Although NT-proBNP is reportedly excreted into the urine, no study has previously evaluated the diagnostic efficacy of urinary concentrations in a forensic setting. The aim of this study was to evaluate the diagnostic efficacy of NT-proBNP concentration in urine obtained postmortem in a series of forensic autopsy cases. Urinary NT-proBNP was measured in 36 AMI, 10 CHF, and 19 sepsis cases, and in 124 control cases (all with postmortem interval [PMI]<72h). Urinary NT-proBNP was significantly higher in AMI, CHF, and sepsis cases than in control cases. Cut-off values for diagnosing AMI, CHF, and sepsis-related fatalities were 98 (sensitivity, 55.6 %; specificity, 73.4 %), 1050 (sensitivity, 80.0 %; specificity, 94.4 %), and 363pg/mL (sensitivity, 84.2 %; specificity, 85.5 %), respectively. Furthermore, we subdivided the control cases according to the death process as either acute death (87 cases) or prolonged death cases (37 cases). Although urine NT-proBNP of CHF and sepsis cases were significantly higher compared with both cases, the concentration in the AMI cases were significantly high only when compared with the acute death cases. This study is the first to elucidate the diagnostic utility of NT-proBNP measurement in urine obtained postmortem in a series of causes of death. This study suggests the diagnostic efficacy for AMI, CHF, and sepsis-related fatality in cases in which the PMI was within 72h.
Identifiants
pubmed: 31812084
pii: S0379-0738(19)30491-8
doi: 10.1016/j.forsciint.2019.110079
pii:
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
Troponin
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Creatine Kinase, MB Form
EC 2.7.3.2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
110079Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.