Cardiac Troponin I Level in Multiple Traumatic Injuries and its Relation to type of Injury, site of Injury, and Postmortem Interval (PMI): A Cross Sectional Cadaveric Study in Babylon

Hassoni Mahdi, Neamah; Al-Mukhtar, Mahmoud; Gabar Kahadeam, Ahmad; G. Abdelzaher, Heba

doi:10.21608/ejhc.2024.362520

Cardiac Troponin I Level in Multiple Traumatic Injuries and its Relation to type of Injury, site of Injury, and Postmortem Interval (PMI): A Cross Sectional Cadaveric Study in Babylon

Document Type : Original Article

Authors

¹ Anesthesia Techniques Department, College of Health and Medical Techniques, Al-Mustaqbal University, 51001, Babylon, Iraq.

² Wasit Health Directorate, Department of laboratories, Al-kut. Wasit, 52007 Iraq.

³ Department of Clinical pharmacy, Faculty of Pharmacy, Minia University, 61519 Minia, Egypt

10.21608/ejhc.2024.362520

Abstract

Background: Cardiac troponins are regulatory proteins that govern the interaction between actin and myosin filaments in muscles, this interaction is mediated by calcium. Troponins form an integral part of the cardiac and skeletal muscles. High levels of Troponin I (cTnI) were reported to be common after trauma. Forensic investigation requires the use of more precise biochemical markers to diagnose acute myocardial infarction and other causes of death, particularly in cases involving trauma or violent fatalities. Aim of the study: This study is to measure level of troponin I in human cadavers who died after sever trauma, and to find its relation with type of injury, site of injury, postmortem interval (PMI), and cause of death. Methodology and Participants: A cross-sectional investigation was done on 50 cadavers, 33 males and 17 females. Ten ml of blood from each case were drawn directly from the heart. The samples of blood were centrifuged and the sera were submitted to chemical analysis. The cTnI and ELISA, test is utilized, employing the principle of a solid phase enzyme-linked immunosorbent assay. The spectrophotometric measurement of absorbance was conducted at a wavelength of 450 nm. Another 40-living people were also included in this study for measurement of cTnI level as control for dead people. Data processing was performed using SPSS statistical software. Results: Mean troponin level in males vs. females was 14.86ng/ml and 14.13ng/ml respectively. The difference between cadaveric troponin and living people. The results are statistically significant with a p-value of less than 0.0001. The highest levels of troponin were observed in bullet injuries; 19.44ng/l. and in trauma to thorax 16.38ng/l. The level of troponin showed increase with elapse of time, but this increase was not steady; no linear relationship. Before 12 hours the level of troponin reached was 10.4ng\\l and peaked at 48 hours to reach 22045ng/ml. The age group with the greatest troponin level was 41–50 years old, with a concentration of 15.91ng/l. Similarly, live individuals had a troponin level of 3.19ng/l. Conclusion: Cardiac troponin the serum levels of deceased individuals showed a marked elevation compared to those in healthy populations. Serum troponin level is elevated in all kind of trauma however; it is significantly higher in deaths due to chest trauma compared to other sites of trauma. The levels of troponin showed marked increase after 12 hours of death.

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