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Nomogram model based on serum chitotriosidase activity to predict coronary artery aneurysm in Kawasaki disease
Insights
This study identifies low-density lipoprotein (LDL), age, neutrophil-to-lymphocyte ratio (NLR), and chitotriosidase activity as key predictors for coronary artery aneurysm (CAA) in children with Kawasaki disease (KD). A predictive nomogram was developed to aid in early intervention for KD patients at risk of CAA.
Area of Science:
- Pediatrics
- Cardiology
- Biochemistry
Background:
- Kawasaki disease (KD) is a prevalent childhood illness with unknown origins.
- KD can lead to serious cardiovascular complications, notably coronary artery aneurysm (CAA).
- Identifying early predictors of CAA is crucial for timely intervention in KD patients.
Purpose of the Study:
- To investigate the association between chitotriosidase activity and the development of CAA in KD patients.
- To develop and validate a predictive nomogram for CAA in KD patients.
- To identify independent risk factors for CAA in the context of Kawasaki disease.
Main Methods:
- A cohort of 338 patients diagnosed with Kawasaki disease was analyzed.
- Multivariate logistic regression was employed to determine independent risk factors for CAA.
- A nomogram was constructed using identified predictors and validated for clinical utility.
Main Results:
- Low-density lipoprotein (LDL), age, neutrophil-to-lymphocyte ratio (NLR), and chitotriosidase activity were identified as independent predictors of CAA.
- The developed nomogram demonstrated potential clinical value in predicting CAA risk.
- Statistical analysis confirmed the significance of these factors in CAA development.
Conclusions:
- Age, LDL, NLR, and chitotriosidase activity are significant independent risk factors for CAA in KD.
- The established nomogram provides a tool for clinicians to predict CAA risk.
- Early prediction facilitates targeted interventions, including anti-inflammatory therapies and closer monitoring.
Objective:
Kawasaki disease (KD) is a common children's disease with unknown etiology, which easily involves coronary artery and causes serious cardiovascular sequelae. The purpose was to investigate the relationship between chitotriosidase activity and coronary artery aneurysm (CAA) and develop and validate a nomogram to predict CAA in KD patients.
Methods:
A total of 338 KD patients were included in this study. Differences analysis compared baseline characteristics and multivariate logistic regression analysis to determine independent risk factors for CAA in KD patients. Based on this independent risk factor, the nomogram was constructed and validated.
Results:
Of 338 KD patients, 107 patients developed CAA. Multivariate logistic regression analysis identified that low-density lipoprotein (LDL) [odds ratio (OR):1.456, 95% confidence interval (CI): 1.062-1.996], age (OR: 0.986, 95% CI: 0.974-0.998), neutrophil-to-lymphocyte ratio (NLR) (OR: 1.098, 95% CI: 1.020-1.182), and chitotriosidase activity (OR: 1.115, 95% CI: 1.111-1.192) were independent predictors for CAA. The nomogram was established based on serum chitotriosidase activity and clinical characteristics, and this nomogram has demonstrated to be of potential value in clinical practice using the receiver operating characteristic curve, calibration curve, and decision curve analysis.
Conclusion:
LDL, age, NLR, and chitotriosidase activity were independent risk factors for CAA. Based on this independent risk factor, the nomogram was constructed to guide clinicians to effectively predict CAA and adopt appropriate interventions such as more aggressive anti-inflammatory and more frequent follow-up.
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