Prognosis and Risk Factors of Coronary Artery Lesions before Treatment Among Patients with Kawasaki Disease

Qiu, Huixian; Jia, Chang; Wang, Zhenquan; He, Yuee; Rong, Xing; Wu, Rongzhou; Chu, Maoping; Shi, Honglian

doi:10.4274/balkanmedj.galenos.2020.2020.1.56

Cited by 7 publications

(11 citation statements)

References 27 publications

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“…Coronary artery injury is mainly attributed to KD, accompanied by thrombosis and distal embolism, for which ASA, an antithrombotic drug, shows some certain preventive effect [ 19 ]. Finally, we confirmed through univariate and multivariate logistic regression analyses that gender, onset-to-treatment time, overweight, PLT, and treatment methods were independent risk factors for poor short-term prognosis of children with KD, similar to the results of Qiu et al [ 20 ]. The report of Huang et al [ 21 ] confirmed that PLT, CRP, neutrophil percentage, serum albumin, serum sodium, etc.…”

Section: Discussionsupporting

confidence: 89%

Efficacy of Gamma Globulins in Children with Kawasaki Disease and Factors Influencing Children’s Short-Term Prognosis

Sun¹,

Lu²,

Wu³

2022

Computational and Mathematical Methods in Medicine

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Purpose. To explore and analyze the therapeutic effect of gamma globulins (GG) on Kawasaki disease (KD) in children and the influencing factors of short-term prognosis. Methods. First, 90 pediatric KD patients admitted between January 2019 and January 2021 were selected and divided into a control group ( n = 40 ) and a research group ( n = 50 ) according to the difference in treatment. In addition to routine treatment and nursing given to both groups, control group was given aspirin (ASA), based on which research group was supplemented with GG therapy. The treatment outcome and adverse events (AEs) of the two cohorts of patients were analyzed and compared, and the influencing factors of children’s short-term prognosis were analyzed by logistics multivariate analysis. Results. Research group had a statistical higher overall response rate than control group, with significantly fewer cases suffering from AEs such as nausea and vomiting, diarrhea, rash, dizziness and headache, and coronary artery injury. On the other hand, logistics multivariate analysis identified that gender, body mass index (BMI), onset time, platelet (PLT), and treatment mode all independently influence the short-term prognosis of children with KD. Conclusions. GG therapy is effective in treating pediatric KD patients and can effectively prevent AEs. In addition, gender, BMI, onset-to-treatment time, PLT, C-reactive protein (CRP), and treatment methods are independent risk factors for short-term prognosis of children with KD.

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Section: Discussionsupporting

confidence: 89%

Efficacy of Gamma Globulins in Children with Kawasaki Disease and Factors Influencing Children’s Short-Term Prognosis

Sun¹,

Lu²,

Wu³

2022

Computational and Mathematical Methods in Medicine

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“…Due to lack of height data, no mean body surface area (BSA)-adjusted Z-score was available. CALs were defined according to an internal lumen diameter of > 2.5 mm in patients < 3 years of age, > 3 mm in patients aged 3–9 years, and > 3.5 mm in patients aged 9–14 years; an internal segment diameter ≥ 1.5 times that of an adjacent segment; and an irregular lumen [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Red Blood Cell Distribution Width as a Predictive Marker for Coronary Artery Lesions in Patients with Kawasaki Disease

Cao

et al. 2021

Pediatr Cardiol

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This study aimed to investigate the association between red blood cell distribution width (RDW) and the risk of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). A total of 1355 patients who met the diagnostic criteria for KD were reviewed between January 2018 and December 2019, including 636 patients with CALs and 719 patients without CALs. Blood samples for RDW were obtained at admission (before intravenous immunoglobulin treatment). A logistic regression analysis was performed, and a receiver operating characteristic curve was constructed to determine the prognostic value of RDW standard deviation (RDW-SD) and RDW coefficient of variation (RDW-CV). The study was registered at www.chictr.org.cn, No.: ChiCTR 2000040980. The results showed that RDW-SD increased in patients with complete KD and CALs compared with patients with complete KD without CALs (39 fL vs. 38 fL, respectively; p = 0.000). RDW-CV in patients with complete KD and CALs was significantly higher compared with patients with completed KD without CALs (p = 0.000). Further multivariate logistic regression analysis revealed that RDW-SD was an independent marker of CALs in patients with complete KD (p = 0.001), but no association was found between RDW-CV and CALs. The area under the curve of RDW-SD for predicting CALs in patients with complete KD was 0.606 (95% confidence interval 0.572–0.640; p = 0.000) with a sensitivity and specificity of 61% and 55%, respectively, when the optimal cut-off value of RDW-SD was 38.5 fL. RDW-CV increased in patients with incomplete KD and CALs compared with patients without CALs (13.55% vs 13.3%, respectively; p = 0.004), and multivariate logistic regression analysis revealed that RDW-CV was an independent marker of CALs in patients with incomplete KD (p = 0.021). The area under the curve of RDW-CV for predicting CALs in patients with incomplete KD was 0.597 (95% confidence interval 0.532–0.661; p = 0.004) with a sensitivity and specificity of 40% and 77%, respectively, when the optimal cut-off value of RDW-SD was 13.85%. Conclusion: RDW can be used as an independent predictive marker of CALs in patients with KD, but the type of KD should be considered. RDW-SD was an independent marker of CALs in patients with complete KD, while RDW-CV was a predictor of incomplete KD.

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“…In contrast, Kobayashi system was invalid in identifying CALs in our Chinese cohort with the AUC below 0.5. Notably, previous studies reported that the infusion of IVIG after 10 days of the illness course was an independent risk factor for CALs ( 43 , 44 ), yet our corresponsive data was 6 days. The reasons might be due to renewal of the diagnostic criteria and the suggestion of IVIG infusion as soon as the diagnosis can be established ( 1 ).…”

Section: Discussionmentioning

confidence: 54%

Tenascin-C predicts IVIG non-responsiveness and coronary artery lesions in kawasaki disease in a Chinese cohort

et al. 2022

Front. Pediatr.

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ObjectivesTo assess the predictive value of tenascin-C (TN-C) for intravenous immunoglobulin (IVIG) non-responsiveness and coronary artery lesions (CALs) development at the acute stage of Kawasaki disease, and to build novel scoring systems for identifying IVIG non-responsiveness and CALs.MethodsA total of 261 patients in acute-stage Kawasaki disease were included. Serum samples before IVIG initiation were collected and TN-C expression levels were measured using an enzyme-linked immunosorbent assay. In addition to TN-C, another fifteen clinical and laboratory parameters collected before treatment were compared between IVIG responsive and non-responsive groups, and between groups with and without CALs. Multiple logistic regression analyses were performed to construct new scoring systems for the prediction of IVIG non-responsiveness and CALs development.ResultsIVIG non-responsive group (n = 51) had significantly higher TN-C level compared to IVIG responsive group (n = 210) (15.44 vs. 12.38 IU/L, P < 0.001). A novel scoring system composed of TN-C, total bilirubin, serum sodium and albumin was established to predict IVIG non-responsiveness. Patients with a total score ≥ 2 points were classified as high-risk cases. With the sensitivity of 78.4% and specificity of 73.8%, the efficiency of our scoring system for predicting IVIG non-responsiveness was comparable to the Kobayashi system. Consistently, the group developing CALs at the acute stage (n = 42) had significantly higher TN-C level compared to the group without CALs (n = 219) (19.76 vs. 12.10 IU/L, P < 0.001). A new scoring system showed that patients with elevated TN-C, platelet count ≥ 450 × 109/L, and delayed initial infusion of IVIG had a higher risk of developing CALs. Individuals with a total score ≥ 3 points were classified as high-risk cases. The sensitivity and specificity of the novel simple system for predicting CALs development were 83.3% and 74.0%, respectively, yielding a better efficiency than the Harada score.ConclusionElevated TN-C appeared to be an independent risk factor for both IVIG non-responsiveness and CALs in Chinese children with KD. Our scoring systems containing TN-C is simple and efficient in the early identification of high-risk KD cases that could benefit from more individualized medications.

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Prognosis and Risk Factors of Coronary Artery Lesions before Treatment Among Patients with Kawasaki Disease

Cited by 7 publications

References 27 publications

Efficacy of Gamma Globulins in Children with Kawasaki Disease and Factors Influencing Children’s Short-Term Prognosis

Efficacy of Gamma Globulins in Children with Kawasaki Disease and Factors Influencing Children’s Short-Term Prognosis

Red Blood Cell Distribution Width as a Predictive Marker for Coronary Artery Lesions in Patients with Kawasaki Disease

Tenascin-C predicts IVIG non-responsiveness and coronary artery lesions in kawasaki disease in a Chinese cohort

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