ISSN : 2146-3123
E-ISSN : 2146-3131

Prognosis and Risk Factors of Coronary Artery Lesions before Treatment Among Patients with Kawasaki Disease
Huixian Qiu1, Jia Chang1, Zhenquan Wang1, Yuee He1, Xing Rong1, Rongzhou Wu1, Maoping Chu1, Hongying Shi2
1Children’s heart center, the second affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, WenZhou Medical University, Wenzhou, Zhejiang, China
2Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Zhejiang Province, China
DOI : 10.4274/balkanmedj.galenos.2020.2020.1.56

Background: Many children with Kawasaki disease (KD) had already developed coronary artery lesions (CAL) before intravenous immunoglobulin (IVIG) treatment. However, little data are available on the prognosis of KD children who developed CAL before IVIG treatment.
Aims: To explore the outcomes of CAL before IVIG treatment in children with Kawasaki disease (KD) and analyze the factors that influence the duration of CALs.
Study design: Retrospective cross-sectional study.
Methods: All patients with KD who had developed CAL before IVIG treatment in our hospital from January 2009 to December 2014 were reviewed. A Cox proportional risk model was used to determine the factors influencing the prognosis of CAL.
Results: Among 182 patients included, 28.6% were male and 83.50% were <36 months old, 181 exhibited resolution of CAL 2 years after disease onset. The median duration of CALs was 31 days, and the proportion of CAL was 52% at 1 month, 35% at 2 months, 33% at 3 months, 25% at 6 months, 14% at 1 year, and 0.5% at 2 years. The univariate analysis showed that an overweight status, higher platelet count, lower albumin level, and receiving treatment later than 10 days after disease onset were the factors possibly affecting the duration of CAL in children. The multivariate Cox regression analysis showed that female sex [adjusted HR, 1.661; 95% CI, 1.117–2.470] was an independent protective factor and that an overweight status (adjusted HR, 0.469; 95% CI, 0.298–0.737), higher platelet count (adjusted HR, 0.649; 95% CI, 0.443–0.950), and treatment later than 10 days after disease onset (adjusted HR, 0.392; 95% CI, 0.215–0.716) were independent risk factors for a longer duration of CAL.
Conclusion: The median duration of CAL before IVIG treatment in children with KD was 31 days. Male sex, an overweight status, a higher platelet count, and treatment later than 10 days after onset were independent risk factors for a longer duration of CAL.

Keywords : Kawasaki disease, coronary artery lesions, survival analysis, prognosis study
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