Coronary Arteries Lesions in Kawasaki Disease: Risk Factors in an Italian Cohort

Area of Science:

• Pediatrics
• Cardiology
• Rheumatology

Background:

• Kawasaki disease (KD) is a critical systemic vasculitis affecting medium arteries, especially coronary arteries.
• Coronary artery lesions (CALs) are the most severe acute complication, risking ischemic cardiomyopathy, myocardial infarction, and sudden death.
• Individual susceptibility to CALs is influenced by environmental and genetic factors.

Purpose of the Study:

• To identify and define independent risk factors for developing coronary artery lesions (CALs) in Kawasaki disease patients within an Italian cohort.
• To analyze demographic, clinical, and laboratory data to pinpoint specific predictors of CALs.
• To enhance understanding of KD pathophysiology and CALs development in a European population.

Main Methods:

• A multicenter retrospective study involving 517 Kawasaki disease patients from 10 Italian sites.
• Data collection included demographics, clinical presentation, laboratory findings, and coronary status, recorded in a REDCap database.
• Multiple logistic regression analysis was employed to determine independent risk factors for CALs.

Main Results:

• Coronary artery lesions (CALs) were observed in 26.31% of the enrolled patients.
• Independent risk factors identified for CALs included male gender, age under 18 months, Asian ethnicity, incomplete KD presentation, and fever duration exceeding 10 days.
• Factors such as seasonality did not show a significant association with CALs.

Conclusions:

• Age younger than 18 months, incomplete KD presentation, and prolonged fever (>10 days) are significant risk factors for CALs.
• Asian ethnicity was identified as a notable risk factor for CALs in this Italian cohort, suggesting potential genetic or environmental interactions.
• These findings aid in identifying high-risk KD patients requiring closer monitoring for CALs.