Abstract:

Objective To investigate the risk factors of coronary artery aneurysm (CAA) occurrence in children with Kawasaki disease (KD). Methods The clinical data of children with KD hospitalized from January 2020 to December 2021 were retrospectively analyzed. According to the presence or absence of CAA, the children were divided into CAA group and non-CAA group, and the clinical characteristics between the two groups were compared. The risk factors affecting the occurrence of CAA and the predictive value of related indicators for KD complicated with CAA were analyzed. Results A total of 557 children with KD (346 boys and 211 girls) were included, and the median age was 25.0 (13.0-45.2) months. CAA was found in 75 patients (13.5%) and intravenous immunoglobulin (IVIG) resistance was observed in 39 (7.0%) patients. Multivariate logistic regression analysis showed that age ≤1 year, IVIG resistance and elevated platelet count (PLT) were independent risk factors for KD complicated with CAA, and elevated albumin (ALB) was a protective factor for KD complicated with CAA (P<0.05). ROC curve analysis showed that the area under ROC curve (AUC) of PLT and ALB predicting KD with CAA was 0.64 (0.57-0.73) and 0.65 (0.58-0.72), respectively. The sensitivity and specificity of PLT>551×10⁹/L for predicting KD with CAA were 63.0% and 67.0%, and the sensitivity and specificity of ALB<36.5U/L for predicting KD with CAA were 68.0% and 56.0%. Conclusions Age≤1 year, IVIG resistance, PLT>551×10⁹/L and ALB<36.5U/L had certain predictive effects on the occurrence of CAA in children with Kawasaki disease.

Key words: Kawasaki disease, coronary artery aneurysm, risk factor