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Can Coronary Artery Involvement in Kawasaki Disease be Predicted?
Sunil J Ghelani1, Neha S Kwatra2, Christopher F Spurney3
1Division of Cardiology, Children's National Medical Center, Washington, DC 20010, USA. sunil.ghelani@cardio.chboston.org.
Insights
Predicting coronary artery involvement in Kawasaki disease is challenging. High erythrocyte sedimentation rate and refractory disease are key predictors, aiding in risk assessment for affected children.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease affects coronary arteries in 15-20% of children.
- Existing literature on predictive factors for coronary artery involvement is conflicting.
Purpose of the Study:
- Identify predictive factors for coronary artery involvement in Kawasaki disease.
- Review existing literature on clinical and laboratory associations.
Main Methods:
- Retrospective study of 203 patients diagnosed with Kawasaki disease.
- Analysis of clinical data and laboratory markers.
Main Results:
- 16.3% of patients had coronary artery involvement.
- High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin, and refractory disease were associated with coronary involvement.
- High erythrocyte sedimentation rate and refractory disease independently predicted coronary artery involvement.
Conclusions:
- Accurate risk determination for coronary artery involvement remains difficult.
- Laboratory markers like ESR can aid in parental counseling and follow-up.
- Further research into biomarkers and host predispositions is needed for personalized therapy.
Background:
Coronary artery involvement is seen in approximately 15-20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature.
Methods And Results:
A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High erythrocyte sedimentation rate and refractory Kawasaki disease were found to be independent predictors of coronary artery involvement. Review of literature suggested a wide range of coronary involvement (<5% to >60%), and highly conflicting clinical and laboratory associations.
Conclusion:
It remains difficult to accurately determine risk of coronary artery involvement, although some laboratory markers may provide information that is helpful for parental counseling and clinical follow up. Future identification of novel biomarkers and host predispositions may further our understanding of coronary artery risks and help personalize therapy for Kawasaki disease.
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