The Systemic Immune-Inflammation Index (SII) and coronary artery lesions in Kawasaki disease

Area of Science:

• Pediatric Cardiology
• Inflammatory Diseases
• Biomarker Discovery

Background:

• Coronary artery lesions (CALs) are a major complication of Kawasaki disease (KD), impacting long-term prognosis.
• Early identification of children at risk for CALs is crucial for timely intervention and management.
• The Systemic Immune-Inflammation Index (SII) has emerged as a potential indicator of systemic inflammation.

Purpose of the Study:

• To investigate the association between the Systemic Immune-Inflammation Index (SII) and the presence of coronary artery lesions (CALs) in pediatric patients diagnosed with Kawasaki disease (KD).
• To evaluate the predictive value of SII for the development of CALs at the time of admission in KD patients.

Main Methods:

• Retrospective analysis of medical records from 364 KD patients treated between January 2017 and January 2023.
• Statistical analyses included single-variable tests, binary logistic regression, ROC curve analysis, and restricted cubic spline tests.
• Evaluation of the relationship between SII levels and the occurrence of CALs at admission.

Main Results:

• Of the 364 patients, 63 (17.3%) had CALs upon admission.
• Binary logistic regression confirmed SII as a significant risk factor for CALs, both unadjusted and adjusted for confounders.
• ROC curve analysis showed an AUC of 0.789 for SII in predicting CALs at admission (P < 0.001).
• A positive linear relationship was observed between SII and the risk of CALs.

Conclusions:

• The Systemic Immune-Inflammation Index (SII) is a significant risk factor for coronary artery lesions (CALs) in patients with Kawasaki disease (KD).
• SII demonstrates utility as an auxiliary laboratory biomarker for the early prediction of CALs in KD.
• These findings support the integration of SII assessment in the initial evaluation of KD patients to identify those at higher risk for coronary complications.