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Comprehensive Assessment of the Risk of Developing Coronary Artery Aneurysm in Kawasaki Disease: A KawaCOR Score

Stasa Krasic1,2, Srdjan Pasic2,3, Sanela Nikolic Tepic4

  • 1Cardiology Department, Mother and Child Health Institute of Serbia, 11070 Belgrade, Serbia.

Life (Basel, Switzerland)
|May 4, 2026
PubMed

Insights

A new scoring system, KawaCOR, helps identify children at high risk for Kawasaki disease coronary artery aneurysms. A score of 5 or higher significantly increases the risk of developing these dangerous aneurysms.

Area of Science:

  • Pediatrics
  • Cardiology
  • Rheumatology

Background:

  • Early identification of high-risk patients is crucial for Kawasaki disease (KD) treatment.
  • Kawasaki disease can lead to coronary artery aneurysms (CAA), necessitating risk stratification.
  • Developing a predictive scoring system for CAA and persistent giant CAA is essential.

Purpose of the Study:

  • To develop and validate a novel scoring system, the KawaCOR score, for predicting CAA development in KD patients.
  • To assess the score's ability to predict the persistence of giant CAA during follow-up.
  • To aid in stratifying treatment algorithms for Kawasaki disease.

Main Methods:

  • A retrospective cohort study of 151 patients with KD treated between 2011 and 2025.
  • Development of a scoring system based on univariate analysis of clinical and laboratory parameters.
  • Validation of the score using ROC curve analysis for sensitivity and specificity.

Main Results:

  • 25 patients (16.5%) developed CAA; 9 had persistent aneurysms.
  • The KawaCOR score incorporates age, IVIG duration, KD refractoriness, and laboratory markers (leukocytosis, neutrophilia, thrombocytosis, anemia, hypoproteinemia, hypoalbuminemia).
  • A score ≥5 predicted CAA development (OR 8.7), and a score ≥8 predicted chronic giant CAA (OR 71.5). Score ≥5 showed 99% sensitivity and 70% specificity for CAA (AUC=0.87).

Conclusions:

  • The KawaCOR score is the first regional system designed to predict CAA development in Kawasaki disease.
  • The score effectively identifies patients at high risk for acute and chronic giant coronary artery aneurysms.
  • Implementation of the KawaCOR score can improve risk stratification and management of KD patients.

Keywords:
KawaCOR scorecoronary artery aneurysmkawasaki diseasepredictive score

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