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Identification of clinical risk factors for coronary artery lesions in children with Kawasaki disease: a retrospective cohort study

Published online by Cambridge University Press:  05 November 2024

Xiangna Yang ,
Jiayi Zou ,
Hao Nie ,
Gang Zhang ,
Yin Liao ,
Jian Deng Open the ORCID record for Jian Deng [Opens in a new window]  and
Yanfei Wang Open the ORCID record for Yanfei Wang [Opens in a new window]
Xiangna Yang
Affiliation:
Department of Pediatric Traditional Chinese Medicine Clinic, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong, China
Jiayi Zou
Affiliation:
The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
Hao Nie
Affiliation:
The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
Gang Zhang
Affiliation:
Department of Pediatric Traditional Chinese Medicine Clinic, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong, China
Yin Liao
Affiliation:
College of Pediatrics, Guangzhou Medical University, Guangzhou, China
Jian Deng*
Affiliation:
Department of Pediatric Traditional Chinese Medicine Clinic, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong, China
Yanfei Wang*
Affiliation:
Department of Pediatric Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
*
Corresponding authors: Jian Deng; Email: dengjian512@21cn.com; Yanfei Wang; Email: wangyanfei19831983@126.com
Corresponding authors: Jian Deng; Email: dengjian512@21cn.com; Yanfei Wang; Email: wangyanfei19831983@126.com
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Abstract

Background:

Coronary artery lesions are the most severe complications of Kawasaki disease. Despite recent advances, evidence of the association between risk factors and coronary artery lesion is lacking. In this study, we demonstrated the potential clinical indicators that could assist to evaluate the prevalence of coronary artery lesion among paediatric patients with Kawasaki disease.

Methods:

We retrospectively enrolled 260 paediatric patients with Kawasaki disease. Patients with coronary dilation, coronary aneurysm, and intimal thickening of coronary arteries were included in this study. Medical records of each patient were collected. Logistic regression analysis was performed to explore risk factors and the occurrence of coronary artery lesion in patients with Kawasaki disease.

Results:

Respectively, 64 (24.6%), 39 (15%), and 56 patients (21.5%) of the participants had coronary dilation, coronary aneurysm, and intimal thickening of coronary arteries. Univariate analysis revealed that age, gender, duration of fever, time of initial use of intravenous immunoglobulin, erythrocyte sedimentation rate, white blood cell counts, time of platelet increase, the maximum value of platelet, albumin, and immunoglobulin G level was associated with coronary artery lesion. In multivariable logistic analysis, those younger and mainly males were associated with all three outcomes of coronary artery lesion, lower serum albumin levels, and later initial use of intravenous immunoglobulin were linked to a higher risk of coronary dilation and coronary aneurysm.

Conclusions:

The potential risk factors that could be used to estimate the occurrence of coronary artery lesion in Kawasaki disease patients are young age, male, lower serum albumin lever, and later initial use of intravenous immunoglobulin. However, long-term follow-up and multi-centre studies are required to verify our findings in the future.

Keywords

Kawasaki diseasecoronary artery lesionspaediatricrisk factors
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 9 , September 2024 , pp. 1854 - 1862
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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