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Meta-analysis of risk factors associated with atherosclerosis in patients with Kawasaki disease
Han Zhang1, Ming-Guo Xu2, Li-Jian Xie3
1Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China.
Insights
Children with Kawasaki disease (KD) show higher cholesterol and lower artery function, indicating an increased risk for atherosclerosis. This finding highlights the long-term cardiovascular implications of KD in pediatric patients.
Area of Science:
- Cardiovascular Science
- Pediatric Cardiology
- Medical Research
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- This study addresses the potential link between KD and atherosclerosis risk.
Purpose of the Study:
- To investigate whether patients with Kawasaki disease have an increased risk of atherosclerosis.
- To evaluate key atherosclerosis risk factors in KD patients compared to controls.
Main Methods:
- A systematic review and meta-analysis of 16 observational studies.
- Included studies compared KD patients (n=421) with non-KD controls (n=449).
- Assessed risk factors: total cholesterol, LDL, triglycerides, SBP, and FMD.
Main Results:
- KD patients had significantly higher total cholesterol and LDL levels.
- KD patients exhibited significantly lower flow-mediated dilation (FMD).
- No significant differences were found in triglycerides or systolic blood pressure.
Conclusions:
- Kawasaki disease patients may face an elevated risk of developing atherosclerosis.
- Findings suggest potential long-term cardiovascular complications following KD.
Background:
Kawasaki disease (KD) has now become the leading cause of acquired heart disease among children in developed countries. This study investigated whether patients with KD have an increased risk of atherosclerosis.
Methods:
Electronic databases, including PubMed, Embase and Springer link, were searched through June 1, 2015, for eligible studies. Studies were included when they met the following criteria: 1) an observational study focusing on evaluating the risk factors for atherosclerosis in patients with KD; 2) KD was diagnosed clinically according to the Japan Kawasaki Disease Research Committee or American Heart Association's diagnostic criteria; 3) the study subjects were KD patients without coronary heart disease or related cardiovascular disease (KD group) and non-KD patients as control (control group), and 4) investigation of important atherosclerosis risk factors, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), systolic blood pressure (SBP), and flowmediated dilatation (FMD). The methodological quality of the included studies was evaluated using the Newcastle- Ottawa Scale. Mean difference (MD) and relative risk (RR) and corresponding 95% confidence intervals (CI) were used to calculate the pooled results.
Results:
Sixteen studies were included with a total of 870 patients, including 421 KD patients and 449 non-KD controls. Differences in TG and SBP between KD patients and controls were not significant; in contrast, TC and LDL levels were significantly higher in KD patients than the controls, whereas FMD in the KD patients was significantly lower.
Conclusions:
KD patients may have an increased risk of developing atherosclerosis.
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