The evaluation of apoptosis in myocardial injury in medicolegal death cases

It is known that the most common cause of sudden unexpected deaths is cardiovasculary system diseases. Ischemic heart injuries take the biggest part in this group. Cardiac diseases such as coronary artery disease and myocardial infarction take a significant place in forensic medicine practice due to being very common and fatal. Therefore, many methods are being tried in postmortem diagnosis and reliability and specifity studies are performed for these methods.In this study; we aimed to investigate the postmortem diagnostic features of apoptosis in the myocytes in myocardial injury. For this reason, apoptosis conditions were evaluated using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), bcl-2, bax, Fas, p53 immunohistochemical staining methods in the myocardial tissues of 43 cases in whom we performed medicolegal autopsies.It attracts attention that in the cases that have 75% or more stenosis in at least one of the coronary arteries and that had been diagnosed with myocardial infarction apoptosis markers are stained in a higher rate. In the cases that have 50% or more stenosis in at least one coronary artery, Fas and bax stainings were detected as statistically significant. It is thought that apoptosis may be helpful in diagnosing the cases with myocardial injury such as acute myocardial infarction and Bcl-2, bax, Fas, p53 markers and TUNEL staining method may be used for this purpose. We think that usage of these methods may be insufficient due to the low specificity and it would be useful to support them with other methods.Key words: Myocardial infarction, apoptosis, postmortem, forensic medicine