Nuclear morphometry of the myocardial cells as a diagnostic tool in cases of sudden death due to coronary thrombosis

Sudden cardiac death due to underlying coronary artery thrombosis is one of the leading causes of death. However, in a significant percentage of indiv iduals who died suddenly, no indication of myocardial infarction is found d uring post-mortem examination, especially when the time interval between ap pearance of symptoms and death is short. In the present study, we have eval uated certain nuclear morphometric parameters, such as, minimum, maximum, m ean and standard deviation of perimeter and area in 20 individuals who died of coronary artery thrombosis, within 1 h from symptoms onset. Furthermore , the above parameters were compared with those of a control population of 20 individuals whose sudden death was caused by traffic accidents. Statisti cal elaboration of the results by means of t-test, Mann-Whitney (U-test) an d analysis of covariance (adjusting for age), showed a statistically signif icant difference for all variables except for the minimum area. With stepwi se discriminant analysis method, the mean perimeter was selected as the bes t predictor of cardiac death. Mean perimeter achieved a correct reclassific ation percentage (based on Fisher's linear discriminant function) of 92.5% (85% and 100% for cases and controls, respectively). Moreover, by applying the cut-off of 172 mu m, we could identify the individuals who died suddenl y because of coronary artery thrombosis with a specificity of 100% (sensiti vity 85%, P<0.001). Our results show that nuclear morphometry of the myocar dial cells is a reliable diagnostic tool for the diagnosis of coronary thro mbosis based lesion in cases of sudden death, even when methods trying to v erify the presence of infarction fail to do so. (C) 1998 Elsevier Science I reland Ltd. All rights reserved.