Risk factors for coronary artery lesions in children with Kawasaki disease

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.

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852 Risk Factors for Coronary Artery Lesions in Kawasaki Disease

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302724.0852 ◽

2012 ◽

Vol 97 (Suppl 2) ◽

pp. A245-A245

Author(s):

A. Azhar ◽

A. Al-Attas

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Kawasaki Disease ◽

Coronary Artery Lesions

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Evaluating the added predictive ability of MMP-9 in serum for Kawasaki disease with coronary artery lesions

Journal of Investigative Medicine ◽

10.1136/jim-2020-001281 ◽

2020 ◽

Vol 69 (1) ◽

pp. 13-19

Author(s):

Lixia Wang ◽

Yinan Yang ◽

Quanmiao Cui ◽

Ya Cui ◽

Qiaoe Li ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Coronary Artery ◽

Kawasaki Disease ◽

Area Under The Curve ◽

Predictive Ability ◽

Immunoglobulin Therapy ◽

Coronary Artery Lesions ◽

Intravenous Immunoglobulin Therapy ◽

Net Reclassification Improvement

To investigate the predictive ability of serum matrix metalloproteinase-9 (MMP-9) in the acute phase of Kawasaki disease (KD) with coronary artery lesions (CALs). Patients with KD hospitalized in Lanzhou University Second Hospital, Northwest China, from November 2015 to January 2018 were retrospectively reviewed, and clinical trial indicators and peripheral blood specimens were collected before intravenous immunoglobulin therapy treatment. The independent risk factors were determined using multivariate regression analysis. The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to quantitatively evaluate the ability of MMP-9 to improve the efficiency of predicting KD with CALs. The white cell, neutrophil percentage, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were higher in patients with higher MMP-9, and the monocyte percentage was higher in patients with lower MMP-9. Logistic regression analysis revealed that long-term fever; elevated CRP, ESR, platelets (PLT), and MMP-9; and low albumin (ALB) levels were independent predictors of KD with CALs. A predictive model of KD with CALs using fever duration, CRP, ESR, PLT, and ALB showed significantly improved predictive ability when MMP-9 was added to the model (the area under the curve increased by 0.02; no change in sensitivity; specificity increased from 81.48% to 87.04%; NRI value: 13.46%; IDI value: 5.00%, p<0.05). Adding MMP-9 to traditional risk factors may improve prediction of CALs, the overall predictive ability of model 2 was increased by 5%.

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