Clinical characteristics and risk factors of coronary artery lesions in Chinese pediatric Takayasu arteritis patients: a retrospective study

Abstract

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.