scholarly journals Predictive Factors of Medium-Large Coronary Artery Aneurysm in Children with Acute Kawasaki Disease: A Retrospective Cohort Study

2022 ◽  
Author(s):  
Jie Liu ◽  
Danyan Su ◽  
Bingbing Ye ◽  
Suyuan Qin ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Characteristic Curve ◽  
Artery Aneurysm ◽  
Risk Scores ◽  
Cardiac Complications ◽  
Close Monitoring ◽  
G Ratio

Abstract Background: The severity of the cardiac complications resulting from Kawasaki disease (KD) appears to be directly correlated to the magnitude of the coronary artery aneurysm (CAA). However, there remains some unclear about the risk factors for medium-large CAA identified after acute KD.Methods: We analyzed 90 patients diagnosed with CAA in KD hospitalized from January 2013 through August 2021. Patients were stratified based on the coronary artery z-score adjusted for body surface area as the medium-large CAA group and small-sized CAA group. The association of baseline characteristics was investigated within the groups. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with medium-large CAA development.Results: In total, 353 pediatric cases with KD were investigated during the study period, of whom 90 (25.5%) presented with CAA, including medium-large CAA in 20 patients (5.7%) after acute KD. The medium-large CAA group showed significantly higher Harada risk scores, the incidence of thrombosis, serum globulin concentration values, proportions of C-reactive protein > 40 mg/L, proportions of albumin < 35 g/L, and lower values of albumin-to-globulin ratio (A/G ratio) than those in the small-sized CAA group (P < 0.05). Medium-large CAA was significantly associated with the A/G ratio (odds ratio, 3.503; 95% confidence interval [CI]: 1.068–11.492). The area under the receiver operating characteristic curve was 0.684 (95% CI: 0.558–0.810), and the cutoff point of 1.35 showed a sensitivity and specificity for predicting medium-large CAA of 80% and 59%, respectively.Conclusions: A lower A/G ratio independently predicts medium-large CAA in patients with KD. Medium-large CAA is associated with greater odds of developing thrombosis. Thus, close monitoring with routine echocardiography is recommended.

Cardiac Complications in 38 Cases of Kawasaki Disease with Coronary Artery Aneurysm Diagnosed by Echocardiography

2015 ◽  
Vol 33 (5) ◽  
pp. 764-770 ◽  
Author(s):  
Ya Juan Wei ◽  
Xiao Lan Zhao ◽  
Bao Min Liu ◽  
Hua Niu ◽  
Qian Li
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Cardiac Complications

scholarly journals Analysis of Risk Factors of Kawasaki Disease With Coronary Artery Lesions

2021 ◽  
Author(s):  
Jinling Hu ◽  
Weidong Ren
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Cervical Lymphadenopathy ◽  
Artery Aneurysm ◽  
Pairwise Comparison ◽  
Coronary Artery Lesions ◽  
Independent Risk Factors

Abstract Objective:To identify factors predictive of coronary artery lesions (CALs) in children with Kawasaki disease (KD).Methods:The clinical data of 420 children with KD who were hospitalized between January 2018 and December 2020 were retrospectively evaluated after assignment to groups by the presence of coronary artery aneurysm (CAA), coronary artery dilation (CAD), or no CALs. The association between coronary artery damage and patient clinical and laboratory values was investigated by pairwise comparison of the three groups. Univariate and multivariate logistic regression identified independent risk factors. The predictive value of patient variables for development of CAA and CAD was estimated by receiver operating characteristic curve analysis.Results:CALs occurred in 17.6% (94/420) of children with KD. Duration of fever, cervical lymphadenopathy, intravenous immune globulin resistance, immunoglobulin (Ig)A, procalcitonin, hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein, and others differed between patients with CALs and without CALs and were significantly associated with the development of CAA and CAD. The largest area under the curve was for combined CAA or CAD indicators, 0.851 for CAA (sensitivity of 68.09% and specificity of 60.62%) and 0.714 for CAD (sensitivity of 65.96% and specificity of 70.77%). Fever of >7 days before treatment was predictive of severe CAA or CAD.Conclusion:Fever duration, ESR, IgA, Hb, and cervical lymphadenopathy were independent risk factors of CAA; CRP, ESR, and cervical lymphadenopathy were independent risk factors of CAD, with combined factors having increased sensitivity and specificity. Early, active treatment is essential to reduce the occurrence of CALs.

scholarly journals Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ge Haiyan ◽  
Lai Jianming ◽  
Tong Suqian ◽  
Qu Dong ◽  
Liu Shuang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Platelet Count ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Logistic Regression Analysis ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm

Abstract Objective The aims of this study were to characterize the evolution of routine blood values within the first 10 days of illness and coronary artery outcome in infants < 8 months with Kawasaki disease (KD) and to identify risk factors for coronary artery aneurysm (CAA). Methods Laboratory data, clinical features and coronary artery outcomes from 78 infants < 8 months old and 86 patients between 8 months and 7 years old were retrospectively analyzed. Logistic regression analysis was conducted to evaluate the potential risk factors for CAA. Results Infants < 8 months old were more likely to present with incomplete KD (37.2% vs 4.7%, P < 0.001), erythema and induration at the BCG inoculation site (24.4% vs 3.5%, P < 0.001) and CAA (47.4% vs 15.1%, P < 0.001) even with timely diagnosis and treatment with intravenous immunoglobulin (IVIG) compared with patients ≥8 months old. Clinical feature related to diagnostic criteria for KD including bilateral conjunctival injection, oral changes, unilateral cervical lymphadenopathy and extremity changes were less common in the younger group. During the acute phase, the percentage neutrophils and neutrophil to lymphocyte ratio [NLR] peaked on median illness day 3, followed by white blood cell (WBC) and CRP on median illness day 4, hemoglobin on median illness day 7 and platelet count on median illness day 9. CAA occurred on median illness day 6 and regressed on median illness day 28. Multivariate logistic regression analysis revealed that the peak percentage neutrophils (odds ratio [OR] per 0.1: 1.597, 95% confidence interval [CI]: 1.041–2.452, P = 0.032) and the peak platelet count (OR per 10 × 109/L: 1.029, 95% CI: 1.004–1.055, P = 0.024) were independent risk factors for CAA. Hemoglobin on the 5th day was associated with persistent CAA at 1 year after KD onset. Conclusion Factors associated with CAA include a high peak percentage neutrophils, increased peak platelet count, and reduced hemoglobin within 4–6 days during the acute phase of KD. Therefore, this population should receive primary therapy with IVIG and adjunctive anti-inflammatory medications.

An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States

2019 ◽  
Vol 29 (06) ◽  
pp. 828-832 ◽  
Author(s):  
Laxmi V. Ghimire ◽  
Fu-Sheng Chou ◽  
Narayan B. Mahotra ◽  
Sharan P. Sharma
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Length Of Stay ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Developed Countries ◽  
The United States ◽  
Hospital Charge ◽  
Acquired Heart Disease ◽  
The Developed Countries

AbstractBackground:Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries.Methods:Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed.Results:There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January–March quarter had the highest rate compared to the lowest in the July–September quarter (OR=1.62, p &lt; 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97–4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64–3.80), p &lt; 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12–4.54 days) versus 3.60 days (95 % CI: 3.48–3.72 days), p &lt; 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay.Conclusions:This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.

Abstract 34: Genome-wide Association Study Identified New Susceptibility Loci To Coronary Artery Aneurysm-related In Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kyu Yeun Kim ◽  
Mo Kyung Jung ◽  
Yoon-Sun Bae ◽  
Woohyuk Ji ◽  
Dongjik Shin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Association Study ◽  
Genome Wide Association Study ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Genome Wide Association ◽  
Korean Children ◽  
Genome Wide ◽  
Increased Risk

Kawasaki disease (KD) is an acute systemic vasculitis syndrome that predominantly affects children younger than 5 years of age, and may causes serious, sometimes life-threatening, cardiac sequela associated with coronary artery aneurysm (CAA). To identify genetic variants that confers a highly increased risk of coronary artery aneurysm-related in Kawasaki disease. In this study, we carried out genome-wide association study (GWAS) in a Korean children population including 102 CAA-related KD cases and 126 controls. Fifteen genetic loci were found to be significantly correlated with KD risk (P<1.0X10(-7)). Our case-control study revealed that rs4236089 C allele in chloride intracellular channel 5 (CLIC5) gene at 6p21.1 was significantly associated with KD patients with CAA (odds ratio (OR)=4.6, P=7.53X10(-7)). These findings suggest that the CLIC5 gene may play a crucial role in CAA development pathway of KD.

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