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Cardiac biomarker point-of-care testing (POCT) seems suitable for further improving postmortem diagnostics in legal medicine casework. Considering the preanalytic phase, the present study aims to define criteria for blood samples suitable for POCT and assess the diagnostic performance of postmortem cardiac biomarker POCT. A fluorescent immunoassay device was used. The biomarkers assessed were myoglobin, brain-type natriuretic peptide (BNP), N-terminal proBNP, creatine kinase muscle-brain type, and cardiac troponin\u00a0I. Blood was obtained from the intrapericardial inferior vena cava. In a prestudy, criteria for the selection of blood samples were established and the biomarker stability over time, test reliability and reproducibility of postmortem cardiac biomarker analyses were assessed. Afterward, blood samples from 150 autopsied individuals were evaluated for their diagnostic performance and compared with findings from autopsy as the postmortem diagnostic gold standard. In doing so, the assessed biomarkers provided valid and reproducible results. Cardiac troponin\u00a0I yielded the highest sensitivity for detecting cardiac death, whereas BNP had the highest specificity and positive predictive value for detecting cardiac death. Markers of myocardial damage had better negative than positive predictive value. NT-proBNP and BNP POCT seem applicable to support diagnosis of death associated with congestive heart failure. Postmortem cardiac biomarker POCT results need to be interpreted in conjunction with all available information, i.e., autopsy findings, medical history, investigatory results, and other test results.\n<\/jats:p>","DOI":"10.1007\/s00414-025-03517-y","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T23:23:40Z","timestamp":1748474620000},"page":"2577-2591","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of cardiac biomarker \u201cpoint-of-care\u201d testing as postmortem diagnostic tool"],"prefix":"10.1007","volume":"139","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-2658","authenticated-orcid":false,"given":"Jan Michael","family":"Federspiel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattias","family":"Kettner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Potente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Heinbuch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"Lux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel A.","family":"Verhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Ramsthaler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"8","key":"3517_CR1","doi-asserted-by":"publisher","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","volume":"143","author":"SS Virani","year":"2021","unstructured":"Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang N-Y, Tsao CW, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee (2021) Heart disease and stroke statistics\u20142021 update: a report from the American Heart Association. 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