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Are patients recovering from Kawasaki disease at increased risk for accelerated atherosclerosis? A meta-analysis
Yuan-Yuan Zeng1, Feng Chen1, Yong Zhang1
1Department of Pharmacy, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing 210008, China.
Insights
Patients with a history of Kawasaki disease (KD) show signs of endothelial dysfunction and inflammation, increasing their risk for atherosclerosis. This meta-analysis confirms KD as a potential risk factor for accelerated atherosclerosis development.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Inflammatory Diseases
Background:
- Kawasaki disease (KD) is linked to potential endothelial dysfunction and atherosclerosis.
- A clear consensus on the KD-atherosclerosis relationship is lacking.
- This study investigates KD history and accelerated atherosclerosis risk.
Purpose of the Study:
- To determine if patients with a history of Kawasaki disease (KD) face an increased risk of accelerated atherosclerosis.
- To synthesize existing evidence through a meta-analysis.
Main Methods:
- Systematic literature search of PubMed, Embase, and SpringerLink databases.
- Inclusion of studies focusing on atherosclerosis risk factors.
- Meta-analysis of case-control studies using RevMan 5.3 software.
Main Results:
- Analysis of 20 studies with 1684 participants (990 KD patients, 694 controls).
- Significantly higher carotid intima-media thickness (cIMT) and hsCRP levels in KD patients.
- Significantly lower flow-mediated dilatation (FMD) in KD patients, indicating endothelial dysfunction.
Conclusions:
- Patients with a history of KD exhibit endothelial dysfunction and inflammation.
- These factors are identified as significant risk factors for atherosclerosis development.
- KD history may predispose individuals to accelerated atherosclerosis.
Background:
Recent studies have suggested that Kawasaki disease (KD) may cause endothelial dysfunction, which can potentially induce atherosclerosis. However, there is still no consensus on the relationship between KD and atherosclerosis. This article aimed to determine whether patients with a history of KD may be at increased risk for accelerated atherosclerosis via a meta-analysis.
Methods:
The PubMed, Embase, and SpringerLink databases were systematically searched. Studies on risk factors for atherosclerosis were included. A meta-analysis of case-control studies was performed using RevMan 5.3 software.
Results:
Twenty studies were included with a total of 1684 subjects (990 patients after KD and 694 controls). The meta-analysis showed that the level of carotid intima-media thickness (cIMT) (95% CI: 0.01, 0.03; P = 0.005) and high-sensitivity C-reactive protein (hsCRP) (95% CI: 0.00, 0.10; P = 0.03) were significantly higher in patients after KD than controls, whereas flow-mediated dilatation (FMD) (95% CI: - 5.14, - 1.26; P = 0.001) in patients after KD was significantly lower. There were no significant differences in total cholesterol (TC) (95% CI: - 0.13, 5.92; P = 0.06), low-density lipoprotein cholesterol (LDL) (95% CI: - 0.65, 2.08; P = 0.31), or triglycerides (TG) (95% CI: - 1.94, 8.03; P = 0.23).
Conclusion:
Endothelial dysfunction and inflammatory processes may exist in patients with a history of KD, which are risk factors for the development of atherosclerosis.
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