Backgroud To summarize the clinical characteristics and identify the risk factors for pediatric Takayasu arteritis (TAK) with coronary artery lesions (CALs). Methods Clinical data of pediatric TAK patients in our center were retrospectively assessed. Independent risk factors for CALs were identified using multivariate logistic regression analysis. Survival analysis was used to compare differences in survival rates between the groups. Results Among the 66 pediatric TAK cases, the incidence of accompanying CALs was 39.4%. In the CAL group, 19 (73.1%) cases started within 36 months. None of the patients had symptoms of angina or ischemia on electrocardiogram (ECG), the CALs were detected using coronary ultrasound. The CALs most commonly were the left main and right coronary arteries. The lesions were mostly small or middle coronary artery aneurysms; some children may have giant coronary aneurysmal dilations, thrombosis and heart failure. The age of onset and symptom onset to diagnosis in TAK patients with CAL were lower than those in TAK patients without CAL(P < 0.005). TAK patients with CAL had significantly higher CRP,WBC, PLT,TNF-α and IL-2R levels (P < 0.05), lower HGB (P = 0.01), lower rate of renal artery stenosis (RAS) (P = 0.009). In multivariate logistic regression, the risk factors for pediatric TAK combined with CAL included the age of TAK onset (OR = 0.9835, 95% CI: 0.9710–0.9946, P = 0.006) and RAS (OR = 0.1901, 95% CI: 0.0386–0.7503, P = 0.03). In addition, there was no significant difference in survival rates between the two groups after regular treatment. Conclusion This study showed that the occurrence of CAL in pediatric TAK patients has a relatively more rapid clinical course, and a stronger inflammatory state at the time of diagnosis. The earlier the age of TAK onset and without RAS are more likely to cause CAL.
Backgroud: To summarize the clinical characteristics and identify the risk factors for pediatric Takayasu arteritis (TAK) with coronary artery lesions (CALs). Methods: Clinical data of pediatric TAK patients in our center were retrospectively assessed. Independent risk factors for CALs were identified using multivariate logistic regression analysis. Survival analysis was used to compare differences in survival rates between the groups. Results: Among the 66 pediatric TAK cases, the incidence of accompanying CALs was 39.4%. The children in the CAL group were all subclinical, and the coronary arteries most commonly involved were the left main and right coronary arteries. The CALs were mostly small or middle coronary artery aneurysms; some children may have giant coronary aneurysmal dilations. Univariate logistic regression analysis showed that age at onset, white blood count, hemoglobin, platelet count, interleukin-2 receptor, and renal artery stenosis (RAS) were associated with pediatric TAK combined with CAL(P < 0.05). In multivariate logistic regression, the age of onset and RAS were predictive factors associated with pediatric TAK combined with CAL (P < 0.05). A cutoff value of 54.75 months maximized the diagnostic efficacy combined with CAL. In addition, there was no significant difference in survival rates between the two groups after regular treatment. Conclusion: This study showed that the occurrence of CAL in pediatric TAK patients has a relatively more rapid clinical course, and a stronger inflammatory state at the time of diagnosis. Early onset is more likely to cause CAL. Pediatric TAK patients with RAS were less likely to develop CAL.
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