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Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions

Abstract: Kawasaki disease (KD) is one of the most common forms of systemic vasculitis in children. Pathological features include extensive inflammation of small and medium blood vessels throughout the body. The primary complication of KD is coronary artery lesions (CALs). A total of 640 children wi...

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Autores principales: Hu, Jinling, Ren, Weidong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688820/
https://www.ncbi.nlm.nih.gov/pubmed/34950620
http://dx.doi.org/10.3389/fped.2021.798148
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author Hu, Jinling
Ren, Weidong
author_facet Hu, Jinling
Ren, Weidong
author_sort Hu, Jinling
collection PubMed
description Abstract: Kawasaki disease (KD) is one of the most common forms of systemic vasculitis in children. Pathological features include extensive inflammation of small and medium blood vessels throughout the body. The primary complication of KD is coronary artery lesions (CALs). A total of 640 children with KD were admitted to the Department of Pediatric Cardiology at Shengjing Hospital of China Medical University from January 2017 to December 2019. These patients comprised 52 coronary artery aneurysm (CAA) cases and 47 coronary artery dilation (CAD) cases. Echocardiography was performed during the acute KD phase and then at 1, 3, 6, 12, and 24 months after KD onset. Patients were divided into a poor prognosis group (n = 30) and a normal group (n = 69) based on CALs prognosis. Differences in laboratory data, clinical manifestations and coronary artery damage rates were compared between the two groups. Univariate analysis was performed on these data, and an ROC curve was used to analyze the efficacy of each risk factor. Univariate analysis revealed that age (months), number of coronary arteries involved (NACI), IgM, IgA and brain natriuretic peptide (ProBNP) levels were higher in the poor prognosis group compared with the normal group, procalcitonin (PCT) levels in the poor prognosis group were lower than in the normal group (P < 0.05). Conclusion: Age ≥ 18 months, IgM ≥ 1.07g/L, IgA ≥ 0.728g/L and NCAI ≥ 3 were poor prognostic factors of KD children with CALs. These parameters can be used as a reference indicator of early prediction where combined detection might improve the accuracy and sensitivity of prediction. Follow-up should be maintained to monitor changes in the coronary artery by echocardiography.
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spelling pubmed-86888202021-12-22 Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions Hu, Jinling Ren, Weidong Front Pediatr Pediatrics Abstract: Kawasaki disease (KD) is one of the most common forms of systemic vasculitis in children. Pathological features include extensive inflammation of small and medium blood vessels throughout the body. The primary complication of KD is coronary artery lesions (CALs). A total of 640 children with KD were admitted to the Department of Pediatric Cardiology at Shengjing Hospital of China Medical University from January 2017 to December 2019. These patients comprised 52 coronary artery aneurysm (CAA) cases and 47 coronary artery dilation (CAD) cases. Echocardiography was performed during the acute KD phase and then at 1, 3, 6, 12, and 24 months after KD onset. Patients were divided into a poor prognosis group (n = 30) and a normal group (n = 69) based on CALs prognosis. Differences in laboratory data, clinical manifestations and coronary artery damage rates were compared between the two groups. Univariate analysis was performed on these data, and an ROC curve was used to analyze the efficacy of each risk factor. Univariate analysis revealed that age (months), number of coronary arteries involved (NACI), IgM, IgA and brain natriuretic peptide (ProBNP) levels were higher in the poor prognosis group compared with the normal group, procalcitonin (PCT) levels in the poor prognosis group were lower than in the normal group (P < 0.05). Conclusion: Age ≥ 18 months, IgM ≥ 1.07g/L, IgA ≥ 0.728g/L and NCAI ≥ 3 were poor prognostic factors of KD children with CALs. These parameters can be used as a reference indicator of early prediction where combined detection might improve the accuracy and sensitivity of prediction. Follow-up should be maintained to monitor changes in the coronary artery by echocardiography. Frontiers Media S.A. 2021-12-07 /pmc/articles/PMC8688820/ /pubmed/34950620 http://dx.doi.org/10.3389/fped.2021.798148 Text en Copyright © 2021 Hu and Ren. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Hu, Jinling
Ren, Weidong
Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title_full Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title_fullStr Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title_full_unstemmed Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title_short Analysis of the Risk Factors in Prognosis of Kawasaki Disease With Coronary Artery Lesions
title_sort analysis of the risk factors in prognosis of kawasaki disease with coronary artery lesions
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688820/
https://www.ncbi.nlm.nih.gov/pubmed/34950620
http://dx.doi.org/10.3389/fped.2021.798148
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