Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease
Soo-Kyeong Jeon1, Geena Kim1, Hoon Ko1
1Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
Insights
Longer fever duration and higher platelet counts predict early coronary aneurysms in Kawasaki disease. Late outcomes require further investigation, as initial coronary severity and white blood cell count were not significant in multivariate analysis.
Area of Science:
- Pediatric Cardiology
- Rheumatology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- Coronary artery aneurysms (CAAs) are a significant complication of KD.
- Identifying prognostic factors for CAAs is crucial for timely management.
Purpose of the Study:
- To identify risk factors for the development of coronary aneurysms in the early phase of Kawasaki disease.
- To determine predictors for the persistence of coronary aneurysms after 1-year follow-up in treated KD patients.
Main Methods:
- Retrospective study of 392 patients diagnosed with KD between January 2012 and December 2015.
- Analysis of early coronary artery outcomes (within 1 month) and late outcomes (1-year follow-up).
- Statistical analysis including univariate and multivariate logistic regression to identify risk factors.
Main Results:
- Coronary aneurysms were detected in 30 of 392 patients (7.7%) within one month.
- Long duration of fever (OR, 1.47) and high platelet count (OR, 1.00) were independent predictors for early CAAs.
- Initial coronary severity (OR, 46.0) and high white blood cell count (OR, 1.17) were significant in univariate analysis for late CAA persistence, but not in multivariate analysis.
Conclusions:
- Longer fever duration and elevated platelet counts are associated with early coronary aneurysm development in Kawasaki disease.
- Predictors for the persistence of coronary aneurysms after treatment require further investigation.
- Additional research is needed to elucidate mechanisms behind CAA resolution in Kawasaki disease.
Purpose:
Prognostic factors of coronary aneurysms in Kawasaki disease have been investigated in many studies. The aim of this study was to identify risk factors associated with early and late coronary artery outcomes in treated patients with Kawasaki disease.
Methods:
A total of 392 patients diagnosed with Kawasaki disease from January 2012 to December 2015 in Pusan National University Children's Hospital were retrospectively selected as subjects of the present study to determine risk factors for coronary aneurysms and persistence of coronary aneurysms after a 1-year follow-up.
Results:
Coronary aneurysms were detected in 30 of 392 patients within 1 month after the occurrence of Kawasaki disease. Coronary aneurysms persisted in 5 of 30 patients after a 1-year follow-up. A long duration of fever (adjusted odds ratio [OR], 1.47; 95% confidence interval [CI], 1.06-2.02; P=0.018) and high platelet count (adjusted OR, 1.00; 95% CI, 1.00-1.01; P=0.009) were found to be independent factors to predict the development of coronary aneurysms in the early phase. Initial coronary severity (adjusted OR, 46.0; 95% CI, 2.01-1047.80; P=0.016) and a high white blood cell count (adjusted OR, 1.17; 95% CI, 1.01-1.36; P=0.028) were found to be significant factors for the persistence of late coronary aneurysms in univariate analysis. However, no significant factors were found in multivariate analysis.
Conclusion:
These data showed early and late follow-up of coronary aneurysms in our unit. Further studies are needed to determine the mechanisms involved in the disappearance of coronary aneurysms and related factors.
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