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Is There a Role for Laboratory Parameters in Predicting Coronary Artery Involvement in Kawasaki Disease?
Rumeysa Yalcinkaya1, Fatma Nur Öz1, Sevgi Yaşar Durmuş2,1
1Pediatric Infectious Diseases, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
Insights
Lower prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) levels, along with male sex, are linked to coronary artery lesions in children with Kawasaki disease (KD). These findings aid in predicting KD complications.
Area of Science:
- Pediatric Cardiology
- Immunology
- Hematology
Background:
- Kawasaki disease (KD) can lead to serious cardiac and coronary artery complications.
- Predictive markers for coronary involvement in KD are currently lacking.
- Hematological indices and inflammatory markers may offer predictive value.
Purpose of the Study:
- To investigate the role of neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), mean platelet volume-to lymphocyte ratio (MPVLR), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) in predicting coronary artery lesions (CALs) in KD patients.
- To identify key indicators for coronary involvement in pediatric KD cases.
Main Methods:
- Retrospective analysis of medical records from 134 KD patients and 268 healthy controls.
- KD patients were categorized into groups with and without coronary artery lesions (CALs).
- Logistic regression analysis was employed to identify predictive parameters for coronary involvement.
Main Results:
- Patients with KD exhibited significantly altered levels of various hematological indices, including higher NLR, PLR, MPVLR, and SII, and lower lymphocyte counts, PNI, and LMR compared to healthy controls.
- The group with CALs showed significantly lower SII, PLR, and PNI values compared to the group without CALs.
- Multivariable regression identified male sex, lower PNI, and lower SII as independent predictors of CALs in KD.
Conclusions:
- Male sex, reduced prognostic nutritional index (PNI), and lower systemic immune-inflammation index (SII) levels are independently associated with the presence of coronary artery lesions in children with Kawasaki disease.
- These findings provide valuable insights for early identification and management of KD patients at higher risk for cardiac complications.
Background:
Kawasaki disease (KD) may cause cardiac and coronary complications. Since definite markers to accurately predict coronary involvement is not present, we aimed to analyze the role of hematological indices [neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), and mean platelet volume (MPV)-to lymphocyte ratio (MPVLR)], prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in predicting coronary involvement of KD. Patients The medical records of 134 KD patients admitted between January 2008 and December 2019 were investigated. Also, 268 age-matched healthy controls (HCs) were included in the study.
Methods:
KD patients were divided into two groups: KD with coronary artery lesions (KD-CALs) and KD without CALs. Logistic regression analysis was performed to determine parameters that may predict coronary involvement in children with KD.
Results:
Among KD patients, 39 (29.1%) had CALs. When compared with HCs, the median levels of WBC, neutrophils, monocytes, eosinophils, platelets, MPV and, the values of NLR, PLR, MPVLR, SII were significantly higher; whereas lymphocyte count, PNI, platelet distribution width (PDW), LMR were markedly lower in the KD group (p˂0.001 for all, except for p=0.010 for eosinophil count). The CALs group's SII, PLR, and PNI values were significantly lower than those without (p=0.030, p=0.032, and p ˂0.001; respectively). Multivariable regression analysis revealed that PNI, SII, and gender (male) were associated with CALs in KD.
Conclusion:
Our analysis revealed that male sex, lower PNI, and lower SII levels were independently associated with CALs in children with KD.
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