scholarly journals The Occurrence of Coronary Artery Lesions in Kawasaki Disease Based on C-reactive Protein Levels: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Hyo Soon An ◽  
Gi-Beom Kim ◽  
Mi Kyoung Song ◽  
Sang Yun Lee ◽  
Hye Won Kwon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Demographic Data ◽  
Artery Aneurysm ◽  
Nationwide Survey ◽  
Coronary Artery Lesions ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Z Scores

Abstract BackgroundThis study aimed to assess the occurrence of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) according to serum C-reactive protein (CRP) levels. MethodsThis retrospective analysis was based on the nationwide survey of KD conducted in the Republic of Korea between 2015 and 2017. We enrolled 9131 patients and defined low (<3 mg/dL) and high (≥3 mg/dL) CRP groups. Demographic data, clinical characteristics, z-scores, and scores based on the Japanese criteria for CAL were compared between the two groups. Logistic regression analysis was used to identify CAL risk factors.ResultsThe low CRP group accounted for 23% of patients. A significant difference was observed for the mean age at diagnosis (high vs. low CRP, 34.4 ± 24.9 vs. 31.7 ± 24.8 months, p<0.001) and fever duration (high vs. low CRP, 6.6 ± 2.2 vs. 6.3 ± 2.5 days, p<0.001). A non-response to intravenous immunoglobulin treatment was found in 1377 patients (20.1%) and 225 patients (11.7%) in the high and low CRP groups, respectively (p<0.001). CAL were found in 12.9% and 18.3% of the high and low CRP patients, respectively (p<0.001), based on z-scores; and in 9.9% and 12.5%, respectively (p = 0.001), based on the Japanese criteria in the acute phase. The giant coronary artery aneurysm occurrence ratio was similar between groups (p=1.0).ConclusionsCAL occurred in patients with both high and low CRP. Therefore, patients with KD should be carefully monitored regardless of their CRP levels.

scholarly journals The occurrence of coronary artery lesions in Kawasaki disease based on C-reactive protein levels: a retrospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hyo Soon An ◽  
Gi Beom Kim ◽  
Mi Kyoung Song ◽  
Sang Yun Lee ◽  
Hye Won Kwon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Demographic Data ◽  
Artery Aneurysm ◽  
Nationwide Survey ◽  
Coronary Artery Lesions ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Z Scores

Abstract Background This study aimed to assess the occurrence of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) according to serum C-reactive protein (CRP) levels. Methods This retrospective analysis was based on the nationwide survey of KD conducted in the Republic of Korea between 2015 and 2017. We enrolled 9131 patients and defined low (< 3 mg/dL) and high (≥3 mg/dL) CRP groups. Demographic data, clinical characteristics, z-scores, and scores based on the Japanese criteria for CAL were compared between the two groups. Logistic regression analysis was used to identify CAL risk factors. Results The low CRP group accounted for 23% of patients. The mean age at diagnosis was higher in high CRP group compared to the low CRP group (34.4 ± 24.9 vs 31.7 ± 24.8 months, p < 0.001). Fever duration before treatment was not significantly different between the two groups (5.1 ± 1.7 days vs. 5.2 ± 2.1 days; p = 0.206). A non-response to intravenous immunoglobulin treatment was found in 1377 patients (20.1%) and 225 patients (11.7%) in the high and low CRP groups, respectively (p < 0.001). CAL were found in 12.9 and 18.3% of the high and low CRP patients, respectively (p < 0.001), based on z-scores; and in 9.9 and 12.5%, respectively (p = 0.001), based on the Japanese criteria in the acute phase. The giant coronary artery aneurysm occurrence ratio was similar between groups (p = 1.0). Conclusions CAL occurred in patients with both high and low CRP. Therefore, patients with KD should be carefully monitored regardless of their CRP levels.

scholarly journals Prediction of Coronary Artery Aneurysms in Children With Kawasaki Disease Before Starting Initial Treatment

2021 ◽  
Vol 9 ◽  
Author(s):  
Ching-Ying Huang ◽  
Nan-Chang Chiu ◽  
Fu-Yuan Huang ◽  
Yen-Chun Chao ◽  
Hsin Chi
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Predictive Value ◽  
Primary Treatment ◽  
C Reactive Protein ◽  
Coronary Artery Aneurysms ◽  
Reactive Protein ◽  
Clinical Challenge ◽  
Z Scores ◽  
Sensitivity Specificity

Background: Precisely predicting coronary artery aneurysms (CAAs) remains a clinical challenge. We aimed to investigate whether coronary dimensions adjusted for body surface area (Z scores) on baseline echocardiography and clinical variables before primary treatment could predict the presence of late CAAs.Methods: We conducted a retrospective study including children hospitalized for Kawasaki disease and received intravenous immunoglobulin within 10 days of illness. We defined late CAAs as a maximum Z score (Zmax) ≥2.5 of the left main, right, or left anterior descending coronary artery at 11–60 days of illness. Associations between late CAAs and clinical parameters and baseline maximum Z scores were analyzed.Results: Among the 314 included children, 31 (9.9%) had late CAAs. Male, higher C-reactive protein, and higher baseline Zmax were risk factors of late CAAs. Late CAAs were significantly associated with baseline Zmax ≥2.0 vs. &lt;2.0 (25 [32.5%] vs. 6 [2.5%], P &lt; 0.001). The odds ratio for late CAAs among the patients with baseline Zmax ≥2.0 vs. &lt;2.0 was 18.5 (95% confidence interval, 7.23 to 47.41, P &lt; 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of baseline Zmax ≥2.0 for the presence of later CAAs were 80.6, 81.6, 32.5, and 97.5%, respectively.Conclusions: Findings from this study suggest that Zmax ≥2.0 of coronary arteries on baseline echocardiography may be used to predict children at a high risk of late CAAs and allow for targeted early intensification therapy.

scholarly journals AB0735 POLYMORPHISMS OF GENES CD14, C-REACTIVE PROTEIN, FIBRINOGEN BETA CHAIN, ASSOCIATED WITH THE DEVELOPMENT OF KAWASAKI DISEASE AND CORONARY ARTERY ANEURYSMS IN CHILDREN FROM CENTRAL RUSSIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1397.2-1397
Author(s):  
M. Kantemirova ◽  
S. Kurbanova ◽  
Y. Novikova ◽  
A. Glazyrina ◽  
M. Azova ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Gene Polymorphism ◽  
Control Group ◽  
Beta Chain ◽  
C Reactive Protein ◽  
Coronary Artery Aneurysms ◽  
Allele Distribution ◽  
Reactive Protein ◽  
Significant Difference

Background:Kawasaki disease (KD) is a multifactorial disease with a genetic predisposition, systemic vasculitis complicated by the formation of coronary artery aneurysms (CAA). Its pathogenesis is based on immune inflammation with an increase in the concentration of pro-inflammatory cytokines, the level of C-reactive protein (CRP), and coagulation disorder.Objectives:to search for polymorphisms of genes cluster of differentiation CD14, CRP, fibrinogen beta chain (FGB), associated with the KD development and a predisposition to the CAA formation among patients with KD living in Moscow and the Moscow region.Methods:genotyping for gene polymorphisms CD14 –159 C>T (rs2569190), CRP 3872 C>T (rs1205), FGB – 455 G>A (rs1800790) by PCR in 31 children 1 month – 10 years old (median age 19 months [9,0; 38,5]) with KD, among them, in 10 patients the disease was complicated by CAA formation according to echocardiography, and 30 children of the control group.Results:Three out of six investigated SNPs showed statistically significant difference in genotype and allele distribution: СRP C3872T, CD14 C159T and FGB G455A. CRP gene polymorphism: in patients with KD significantly less frequent is homozygous type TT (RR 0,22, 95% CI: 0,05–0,91, p=0,0168).CD14 gene polymorphism: in control group heterozygous genotype CT is predominant, (RR 0,58, 95% CI: 0,4–0,83, p=0,0017) among patients with KD homozygous genotypes CC and TT are predominant. (RR 3,61, 95% CI: 1,14–11,49, p=0,0057).FGB gene polymorphism: genotype GA is predominant in control group (RR 0,48, 95% CI: 0,26–0,9, p=0,0149). In patients with KD significantly less frequent is homozygous type GG (RR 1,69, 95% CI: 1,03–2,8, p=0,0297).We didn’t find any significant difference in genotype and allele distribution in KD patients with and without CA lesions.Conclusion:statistically significant differences (p<0,05) were revealed in the distribution of genotypes for polymorphisms of the CD14 –159 C>T, CRP 3872 C>T and FGB –455 G>A genes among patients with KD and children of the control group; when comparing the results of KD patients with CAA and the control group, statistically significant differences (p<0,05) were revealed only in the polymorphism CD14 –159 C>T. It can be assumed that these polymorphisms are associated with the development of KD and CAA in these patients.Disclosure of Interests:None declared

Association of MnSOD gene polymorphism with susceptibility to Kawasaki disease in Chinese children

2020 ◽  
pp. 1-7
Author(s):  
Jiping Wu ◽  
Meng Yu ◽  
Lihua Huang ◽  
Yujie Qian ◽  
Min Kong ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Human Body ◽  
Gene Polymorphisms ◽  
Coronary Artery Lesion ◽  
Nucleotide Polymorphisms ◽  
Coronary Artery Lesions ◽  
Single Nucleotide ◽  
Significant Difference ◽  
Mnsod Gene

Abstract Background: Kawasaki disease is a type of acute febrile rash disease that is common in children and is characterised by primary lesions of systemic middle and small vasculitis, which can lead to coronary artery lesions. Manganese superoxide dismutase (MnSOD), one of the most important antioxidases in the human body, plays a key role in maintaining the balance of free radicals in the human body. Two single-nucleotide polymorphisms (SNPS) (rs4880 and rs5746136) in the MnSOD gene were related to oxidative stress disease. The purpose of this study is to explore the possible relationship between MnSOD gene polymorphisms and Kawasaki disease susceptibility. Methods: This study included 100 Kawasaki disease children and 102 healthy children. Two single-nucleotide polymorphisms (rs4880 and rs5746136) were detected by polymerase chain reaction sequence-based typing. Results: There was a significant difference in both the genotype frequency (χ2 = 10.805, p = 0.005) and the allele frequency (χ2 = 7.948, p = 0.005) of rs5746136 between the Kawasaki disease group and the control group. Children with the A allele had a 0.558 times lower risk of Kawasaki disease than those without the A allele (χ2 = 7.948, p = 0.005, odds ratio = 0.558, 95% confidence interval = 0.371–0.838). There was no significant difference in the genotype and gene frequencies of rs5746136 between the Kawasaki disease-coronary artery lesion and Kawasaki disease-without coronary artery lesion groups (p > 0.05), and there was no significant difference in the rs4880 genotype and allele frequencies between the Kawasaki disease and healthy control groups or between the Kawasaki disease-coronary artery lesion and Kawasaki disease-without coronary artery lesions groups (p > 0.05). Conclusion: This study provides evidence supporting an association between MnSOD gene polymorphisms and susceptibility to Kawasaki disease. The genotype AA and the allele A of the MnSOD gene locus rs5746136 were risk factors for Kawasaki disease.

Prevalence and predictors of coronary artery disease in adults with Kawasaki disease

2014 ◽  
Vol 25 (6) ◽  
pp. 1124-1129 ◽  
Author(s):  
Jalaj Garg ◽  
Parasuram Krishnamoorthy ◽  
Chandrasekar Palaniswamy ◽  
Rajiv Paudel ◽  
Saurav Chatterjee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Hospital Admissions ◽  
Artery Aneurysm ◽  
Adult Patients ◽  
Significant Difference ◽  
Traditional Risk Factors ◽  
Artery Disease

AbstractBackground: Accelerated coronary atherosclerosis in patients with Kawasaki disease, in conjunction with coronary artery aneurysm and stenosis that characterise this disease, are potential risk factors for developing coronary artery disease in young adults. We aimed to determine the prevalence and predictors of coronary artery disease in adult patients with Kawasaki disease. Methods: All patients aged 18−55 years of age diagnosed with Kawasaki disease were sampled from Nationwide Inpatient Sample database using International Classification of Diseases 9th revision (ICD 9 code 446.1) from 2009 to 2010. Demographics, prevalence of coronary artery disease, and other traditional risk factors in adult patients with Kawasaki disease were analysed using ICD 9 codes. Results: The prevalence of Kawasaki disease among adults was 0.0005% (n=215) of all in-hospital admissions in United States. The mean age was 27.3 years with women (27.6 years) older than men (27.1 years). Traditional risk factors were hypertension (21%), hyperlipidaemia (15.6%), diabetes (11.5%), tobacco use (8.8%), and obesity (8.8%), with no significant difference between men and women. Coronary artery disease (32.4%), however, was more prevalent in men (44.7%) than in women (12.1%; p=0.03). In multivariate regression analysis, after adjusting for demographics and traditional risk factors, hypertension (OR=13.2, p=0.03) was an independent risk factor of coronary artery disease. Conclusion: There was increased preponderance of coronary artery disease in men with Kawasaki disease. On multivariate analysis, hypertension was found to be the only independent predictor of coronary artery disease in this population after adjusting for other risk factors.

scholarly journals Correlation between endothelial dysfunction, inflammatory status, oxidative stress and total (nitrite/ nitrate) in subjects with diabetes mellitus type 2

2017 ◽  
Vol 6 (10) ◽  
pp. 2317
Author(s):  
C. Prabhakar Reddy ◽  
Uday Kumar Chiranjeevi ◽  
Chandrasekhar N. ◽  
Kiran Kishore K. ◽  
Kishan P. V.
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Augmentation Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Artery Disease ◽  
Nitrite Nitrate

Background: Diabetes Mellitus is a systemic metabolic disorder associated with Endothelial dysfunction and increased systemic inflammatory state with oxidative stress leading to increased Cardiovascular risk. This study planned to correlate the level of Endothelial dysfunction with oxidative stress and inflammatory status.Methods: Study was conducted in 60 Diabetes Mellitus subjects of both genders with duration of more than two years. Endothelial dysfunction assessed as Augmentation Pressure and Augmentation Index generated from Radial artery waveforms by tonometer using Spygmocor PWA system. Plasma Total Nitrite/ Nitrate, High sensitive C - Reactive Protein, Malondialdehyde and Glutathione were measured.Results: Out of total 60 Diabetes Mellitus subjects 16 subjects were with Coronary Artery Disease. There was no significant difference in High sensitive C - Reactive Protein, Glutathione, Malondialdehyde and Total Nitrite/ Nitrate between Diabetes Mellitus with Coronary Artery Disease and without Coronary Artery Disease, however significant difference (p=0.02) was observed Augmentation Pressure between Diabetic alone (12.8±5.19 mm of Mercury) and diabetics with Coronary Artery Disease (16.13±33.47 mm of Mercury) and Augmentation Index (p=0.04) between Diabetic alone (29.8±5.68 mm of Mercury) and diabetics with Coronary Artery Disease (40.01±5.74). As endothelial function is age dependent the subjects were divided into three age groups (20-40 years, 40-60 years and more than 60 years). High sensitive C - Reactive Protein, Glutathione, Malondialdehyde, Total Nitrite/ Nitrate and Augmentation Index did not differ in the three age groups while Augmentation Pressure (p=0.0096) showed significant difference between age group 20-40 years (10.59±3.24) and age group more than 60 years (15.83±3.92).Conclusions: There is significant endothelial dysfunction observed in Diabetes Mellitus subjects and Diabetes Mellitus with coronary artery disease showed greater endothelial dyfunction. Thereby concluding that Diabetes Mellitus subjects were at higher risk for development of coronary artery disease and as endothelial dysfunction is an early event, it may have some prognostic value.

Abstract 76: Clinical Usefulness Of Serum Procalcionin Level In Kawasaki Disease Children.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Hee Joung Choi ◽  
Tae Chan Kwon
Keyword(s):  
Kawasaki Disease ◽  
Bacterial Infection ◽  
Viral Infection ◽  
Systemic Inflammation ◽  
Clinical Usefulness ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Significant Difference ◽  
Immunoglobulin Treatment

Purpose: Procalcitonin (PCT) is one of acute phase reactants such as C-reactive protein (CRP), and is likely to elevate in systemic inflammation, especially bacterial infection. As we know, the CRP level rise in the patients with high fever including Kawasaki disease (KD) and bacterial infection. So we investigated the clinical usefulness of serum PCT level in Kawasaki disease (KD), which is a systemic inflammation caused by vasculitis. Method: From August 2013 to June 2014, a total 336 patients were studied serum PCT level during hospitalization. We enrolled 41 patients of KD, 83 patients with viral infection, and 21 patients with bacterial infection. Result: The patients with KD had significantly higher mean age (24.4±18.1 months), mean body weight (12.1±3.9 Kg), and mean duration of fever prior to admission (4.4±1.8 days) than other patients (p<0.05). The serum PCT level, white blood cell (WBC) and platelet count, neutrophil proportion, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in KD patients than viral infection patients (p<0.05). Although not statistically significant, the serum PCT level was lower in KD patients than bacterial infection patients, whereas the CRP was higher in KD patients than bacterial infection patients. No significant difference in serum PCT level was showed between complete KD patients and incomplete KD patients. Also there was no significant difference in serum PCT level between responders to an initial intravenous immunoglobulin treatment and nonresponders. Conclusion: Serum PCT level may help to differentiate KD from viral infection, but we did not find a significant difference in PCT level between KD and bacterial infection. And the utility of PCT level as clinical marker in KD may be limited.

Coronary artery lesions of incomplete Kawasaki disease: a nationwide survey in Japan

2011 ◽  
Vol 171 (4) ◽  
pp. 651-656 ◽  
Author(s):  
Daisuke Sudo ◽  
Yoshiro Monobe ◽  
Mayumi Yashiro ◽  
Makiko Naka Mieno ◽  
Ritei Uehara ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Nationwide Survey ◽  
Coronary Artery Lesions ◽  
Incomplete Kawasaki Disease

scholarly journals Predicting IVIG resistance in UK Kawasaki disease

2015 ◽  
Vol 100 (4) ◽  
pp. 366-368 ◽  
Author(s):  
Sarah Davies ◽  
Natalina Sutton ◽  
Sarah Blackstock ◽  
Stuart Gormley ◽  
Clive J Hoggart ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Corticosteroid Treatment ◽  
C Reactive Protein ◽  
Japanese Children ◽  
Coronary Artery Abnormalities ◽  
Reactive Protein ◽  
Ivig Resistance ◽  
Increased Risk

The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.

Sign in / Sign up

Export Citation Format

Share Document