title: Sensitivity and specificity of NT-proBNP to detect heart failure at post mortem examination.
abstract: NT-proBNP, a marker of cardiac failure, has been shown to be stable in post mortem samples. The aim of this study was to assess the accuracy of NT-proBNP to detect heart failure in the forensic setting. One hundred sixty-eight consecutive autopsies were included in the study. NT-proBNP blood concentrations were measured using a chemiluminescent immunoassay kit. Cardiac failure was assessed by three independent forensic experts using macro- and microscopic findings complemented by information about the circumstances of body discovery and the known medical story. Area under the receiving operator curve was of 65.4% (CI 95%, from 57.1 to 73.7). Using a standard cut-off value of >220 pg/mL for NT-proBNP blood concentration, heart failure was detected with a sensitivity of 50.7% and a specificity of 72.6%. NT-proBNP vitreous humor values were well correlated to the ones measured in blood (r                         (2) = 0.658). Our results showed that NT-proBNP can corroborate the pathological findings in cases of natural death related to heart failure, thus, keeping its diagnostic properties passing from the ante mortem to the post mortem setting. Therefore, biologically inactive polypeptides like NT-proBNP seem to be stable enough to be used in forensic medicine as markers of cardiac failure, taking into account the sensitivity and specificity of the test.
authors: University Centre of Legal Medicine, Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, Lausanne, Switzerland. sara.sabatasso@ana.unibe.ch
authors: Sara
authors: S
authors: Sabatasso
authors: Paul
authors: P
authors: Vaucher
authors: Marc
authors: M
authors: Augsburger
authors: Nicolas
authors: N
authors: Donzé
authors: Patrice
authors: P
authors: Mangin
authors: Katarzyna
authors: K
authors: Michaud
references: Int J Legal Med. 2011 Jan;125(1):45-50
references: 20623132
references: Int J Legal Med. 2000;114(1-2):29-35
references: 11197624
references: Eur J Heart Fail. 2004 Mar 15;6(3):289-93
references: 14987578
references: N Engl J Med. 2005 Feb 17;352(7):666-75
references: 15716560
references: Circulation. 1996 Jun 1;93(11):1963-9
references: 8640969
references: Am Heart J. 2002 May;143(5):923-9
references: 12040359
references: Leg Med (Tokyo). 2006 Mar;8(2):94-101
references: 16413814
references: Int J Legal Med. 2010 Nov;124(6):537-42
references: 19894059
references: Forensic Sci Int. 1981 Jan-Feb;17(1):27-36
references: 7216079
references: Eur Heart J. 2003 Oct;24(19):1710-8
references: 14522565
references: Eur Heart J. 2006 Oct;27(19):2353-61
references: 16952921
references: Scand J Clin Lab Invest. 2001 Feb;61(1):33-42
references: 11300609
references: J Forensic Leg Med. 2009 Nov;16(8):437-40
references: 19782311
references: Forensic Sci Int. 2006 Jan 27;156(2-3):102-5
references: 16410159
references: J Physiol. 1978 Apr;277:367-77
references: 650542
references: Forensic Sci Int. 2000 Jul 3;111(1-3):5-58
references: 10987107
references: Am J Forensic Med Pathol. 1998 Dec;19(4):335-42
references: 9885927
references: Forensic Sci Int. 1983 Jul;22(1):23-30
references: 6618358
references: Int J Cardiol. 2006 Jun 28;110(3):324-33
references: 16213609
references: Eur Heart J. 1999 Dec;20(23):1736-44
references: 10562482
references: J Thromb Thrombolysis. 2008 Oct;26(2):132-7
references: 18064406
references: Scand J Clin Lab Invest. 1997 Oct;57(6):529-40
references: 9350073
references: Am J Forensic Med Pathol. 2004 Sep;25(3):213-5
references: 15322463
references: Forensic Sci Int. 2006 Jul 13;160(2-3):127-33
references: 16269219
references: Int J Cardiol. 2008 Nov 28;130(3):426-37
references: 18178273
references: Clin Chem. 1993 Apr;39(4):561-77
references: 8472349
references: J Physiol. 1978 Jul;280:423-33
references: 690898
references: Curr Probl Cardiol. 2004 Dec;29(12):707-69
references: 15550914
references: Eur J Heart Fail. 2004 Mar 15;6(3):295-300
references: 14987579
references: Clin Chem. 2004 Jan;50(1):33-50
references: 14633912
references: Int J Legal Med. 2008 Sep;122(5):415-20
references: 18553094
references: Hum Exp Toxicol. 2004 Dec;23(12):571-7
references: 15688985
references: Clin Chem. 2003 Sep;49(9):1560-2
references: 12928253
references: Clin Chem. 2007 Apr;53(4):547-51
references: 17384000
references: Int J Legal Med. 2007 Jan;121(1):28-35
references: 16741745
references: Circulation. 1998 May 19;97(19):1921-9
references: 9609085
references: J Clin Pathol. 1995 Feb;48(2):124-8
references: 7745110
references: Am J Forensic Med Pathol. 2005 Sep;26(3):213-5
references: 16121074
references: Lancet. 2003 Jul 26;362(9380):316-22
references: 12892964
references: Eur J Heart Fail. 2004 Mar 15;6(3):257-60
references: 14987573
references: Biometrics. 1977 Mar;33(1):159-74
references: 843571
references: Clin Chem. 2007 Apr;53(4):552-74
references: 17384001
references: Forensic Sci Int. 2001 Nov 1;122(2-3):107-23
references: 11672964