Predictive Value of Serum N-Terminal Pro-Brain Natriuretic Peptide, D-Dimer, Albumin Combined with T-Cell Subsets in Detecting Coronary Artery Damage in Children with Kawasaki Disease.

Abstract

Aims/Background Kawasaki disease (KD) is the common acute, self-limiting vasculitis in children, often affecting coronary arteries, which may lead to coronary artery dilation, stenosis, or in severe cases, myocardial infarction. This study aimed to identify new approaches for reducing or preventing coronary artery lesions (CAL) in KD patients by analyzing specific serological markers across various paediatric groups. Methods Clinical data were collected from 100 children diagnosed with Kawasaki disease (KD) admitted at First Affiliated Hospital of Hebei North University between May 2023 and June 2024. These children were divided into two groups based on coronary artery injury status: Occurrence group (n = 31) and Non-occurrence group (n = 69). Additionally, data from 100 children with acute upper respiratory tract infections (URTI) and 100 healthy children who underwent routine physical examination during the same period (Healthy group) were included for comparison. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), D-dimer (D-D), albumin (ALB), and T-cell subsets were measured and compared across groups to evaluate their clinical utility in diagnosing coronary artery damage in KD. Results NT-proBNP and D-D levels were highest in KD children with coronary artery injury and lowest in the healthy group, while ALB levels were lowest in KD children with coronary artery injury and highest in the healthy group, with statistically significant differences (p < 0.001). Analysis of T-cell subsets revealed that cluster of differentiation (CD)3⁺, CD4⁺, and CD4⁺/CD8⁺ levels were highest in the Healthy group, while CD8⁺ levels were highest in the Occurrence group, with statistically significant differences (p < 0.001). The combined diagnostic model demonstrated an area under the curve (AUC) value of 0.885 (95% CI: 0.829-0.941), showing higher specificity and AUC value compared to each marker individually. Conclusion The combination of serum NT-proBNP, D-D, ALB, and T-cell subsets offers valuable predictive insights for coronary artery damage in KD children and may serve as an auxiliary diagnostic tool.