Abstract
Coronary heart disease (CHD) is the major cause of death in sudden unexpected death (SUD) cases. Tryptophan (TRP) and its metabolites are correlated with the CHD patient but less studies in the SUD. The aim of this study was to evaluate the relationship of TRP and its metabolites with the CHD in the SUD cases. Blood samples and heart tissues were collected from CHD subjects (n = 31) and the control group (n = 72). Levels of kynurenine (KYN), kynurenic acid (KYA), xanthurenic acid (XAN), 3-hydroxyanthranillic acid (HAA), quinolinic acid (QA), picolinic acid (PA) and 5-hydroxyindoleacetic acid (HIAA) were determined by HPLC-DAD. A severity of heart occlusion was categorized into four groups, and the relationship was measured with the TRP metabolites. The HIAA and The KYN levels significantly differed (p < 0.01) between the CHD group and the control group. Lower levels of QA/XAN, PA/KA, HAA/XAN, KYN/XAN and KYN/TRP were found in the CHD group. However, PA/HAA, PA/HIAA, PA/KYN and XAN/KA values in the CHD group were higher than the control group (p < 0.05). This study revealed that the values of PA/KA and PA/HAA provided better choices for a CHD biomarker in postmortem bodies.
Highlights
Sudden unexpected death (SUD) is defined as a natural, nonviolent, unexpected death occurring within twenty-four hours of the onset of symptoms [1]
hydroxyindoleacetic acid (HIAA) was found in the coronary heart disease (CHD) group (p = 0.018) but the KYN level was higher than the control group and
Mean ratios of picolinic acid (PA)/hydroxyanthranillic acid (HAA), PA/HIAA, PA/KYN and xanthurenic acid (XAN)/kynurenic acid (KA) were significantly increased of deaths from noncoronary artery diseases
Summary
Sudden unexpected death (SUD) is defined as a natural, nonviolent, unexpected death occurring within twenty-four hours of the onset of symptoms [1]. A SUD is found in about 56% of medicolegal cases in Thailand [2]. Cardiovascular disease (CVD), including heart and blood vessel disorders, hypertension, coronary heart disease (CHD), cerebrovascular disease, peripheral vascular disease, heart failure, rheumatic heart disease, congenital heart disease and cardiomyopathies, is the major cause of morbidity and mortality worldwide [3]. CHD is the most common cause of SUD [4]. Under the Thai criminal justice system, causes of death in SUD cases are necessary to be identified. Many cases lacked reliable medical documents regarding underlying diseases that could help to explain the causes of death. Both external examination of the heart gross morphology and microscopic findings were appropriate methods for SUD diagnosis
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