CK-MB study in myocardial infarction and sudden cardiac death. This paper is meant to evaluate the usefulness of CK-MB enzymes in order to improve a post-mortem diagnosis of myocardial infarction causing death. We studied 784 autopsies. 147 were related to sudden cardiac death. The biological samples used herein were blood (cemtral -heart- and periferic) and pericardial fluid; the sampling was done at 16-24h, 34-36h and 46-48h postmortem interval, PMI. A witness lot was taken into account (violent death both asphixia related and nonasphyxia related +i.e. electrocution, mad traffic accident). 60 cases have a myocardial ischemia diagnostic clinically confirmed ex..myocadial infarction (Group 1). We used the immunological dosage of fluorescent monoclonal antibodies CK-MB by chemiluminiscence IMMULITE (R) CK-MB. Results proved that within group 1, CK-MB levels enzymes were higher than the normal values and, therefore, relevant for diagnosis; at 16-24 In PMI: in central blood 1200-1800 UI/L, periferic blod 144-237 UI/L, pericardial fluid 760-1650; 34-36 h PMI: in central blood 2140-3658 UI/L, periferic blod 230-270 UI/L, pericardial fluid 1810-2140 UI/L, 4648 h PMI: in central blood 4760-5886 UI/L, periferic blod 240-325UI/L, pericardial fluid 2670- 3600 UI/L. The control (witness) nonasphyxic lot proved at 16-24 In PM 14-316 (central blood), 4-17 (periferic fluid), 172-269 (pericardial fluid). Asphyxicial control (witness) lot proved at 16-24 In PMI 195-1060 (central blood), 13-93 (periferic fluid), 250-1500 (pericardial fluid). Furthermore, regarding the death by asphyxia cases, the markers were significantly higher than the normal ones, with no physiopathological reasons and independently of the methodology used. By way of conclusion, autolysis and putrefaction phenomena have a significant impact upon the CK-MB enzyme growth. Therefore, in order to get a precise diagnosis, less possible as time runs out a rapid autopsy is mandatory within 24 hours of the onset of myocardial infarction or death. CK-MB is a useful tool in myocardial ischemia diagnostic. Ashyxia increase CK-MB and should be revised in all sudden cardiac death (some cardiac insuficiency may associate severe hypoxia).
