Retrospective Analysis of Risk Factors Impacting the Severity of Coronary Artery Lesions in Kawasaki Disease.

Abstract

Aims/Background Kawasaki disease (KD) is a systemic vasculitis primarily affecting children under five. Coronary artery lesions (CAL), a severe complication associated with KD, can lead to long-term cardiovascular problems and even life-threatening conditions. However, the pathological mechanisms underlying CAL in KD patients remain unexplored. Therefore, this study aims to investigate the risk factors affecting the severity of CAL in KD patients, providing valuable insights for early identification and clinical intervention of KD. Methods This single-center retrospective study included 326 KD patients treated at the pediatric clinic of The Second People's Hospital of Changzhou between January 2016 and December 2023. Baseline data, clinical characteristics, cardiac function-related indicators, and CAL severity-related information were retrieved from the hospital's electronic record system. Furthermore, risk factors affecting CAL severity were identified using logistic regression analysis. Results Among the 326 patients, 51 (15.64%) developed varying degrees of CAL, with 3.07% exhibiting severe CAL. KD patients were presented with clinical symptoms, such as fever, rash, oral mucosal changes, lymphadenopathy, and swelling of the hands and feet. Univariate analysis revealed younger age, longer fever duration, higher platelet count (PLT), elevated C-reactive protein (CRP) levels, faster erythrocyte sedimentation rate (ESR), increased white blood cell (WBC) count, elevated lactate dehydrogenase (LDH) levels, lower left ventricular ejection fraction (LVEF), and lower cardiac indices as significant risk factors for CAL development (p < 0.05). Furthermore, multivariate logistic regression analysis identified longer fever duration, higher PLT levels, increased CRP levels, and lower LVEF as independent risk factors for CAL development (p < 0.05). Conclusion Evaluating CAL development in KD patients requires a comprehensive assessment of clinical characteristics, inflammatory indicators, and cardiac function indices.