Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease

RONG, Xing; CHU, Maoping; QIU, Huixian; WANG, Zhenquan; JIA, Chang; WU, Rongzhou; SHI, Hongying; HE, YUEE

doi:10.4274/balkanmedj.galenos.2020.2020.1.56

Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease

Huixian QIU, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Chang JIA, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Zhenquan WANG, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

YUEE HE, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Xing RONG, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Rongzhou WU, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Maoping CHU, (Wenzhou Medical University, Children’s Heart Center, The Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Zhejiang, China)

Hongying SHI (Wenzhou Medical University, Department of Preventive Medicine, School of Public Health and Management, Zhejiang, China)

Balkan Medical Journal

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Yıl: 2020 Cilt: 37 Sayı: 6 Sayfa Aralığı: 324 - 329 Metin Dili: İngilizce DOI: 10.4274/balkanmedj.galenos.2020.2020.1.56 İndeks Tarihi: 07-06-2021

Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease

Öz:

Background:ManychildrenwithKawasakidiseasedevelopcoronary artery lesions before intravenous immunoglobulin treatment. However, little data are available on the prognosis of children with Kawasaki disease who developed coronary artery lesions before intravenous immunoglobulin treatment.Aims: To explore the outcomes of coronary artery lesions before intravenous immunoglobulin treatment in children with Kawasaki disease and analyze the factors that influence the duration of coronary artery lesions.Study Design: Retrospective cohort study.Methods:AllpatientswithKawasakidiseasewhodevelopedcoronary artery lesions before intravenous immunoglobulin treatment in our hospital from January 2009 to December 2014 were reviewed. A Cox proportional hazards model was used to determine the factors influencing the prognosis of coronary artery lesions.Results: Among 182 patients included, 28.6% were male, 83.50% were younger than 36 months, and 181 exhibited resolution of coronary artery lesions 2 years after disease onset. The median duration of coronary artery lesions was 31 days, and the proportion of coronary artery lesions 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 overweight status, higher platelet count, lower albumin level, and starting treatment more than 10 days after disease onset were factors that possibly affect the duration of coronary artery lesions in children. The multivariate Cox regression analysis showed that female sex (adjusted hazard ratio, 1.661; 95% confidence interval, 1.117-2.470) was an independent protective factor, and overweight status (adjusted hazard ratio, 0.469; 95% confidence interval, 0.298-0.737), higher platelet count (adjusted hazard ratio, 0.649; 95% confidence interval, 0.443-0.950), and starting treatment more than 10 days after disease onset (adjusted hazard ratio, 0.392; 95% confidence interval, 0.215-0.716) were independent risk factors for a longer duration of coronary artery lesions.Conclusion: The average duration of coronary artery lesions before intravenous immunoglobulin therapy in children with Kawasaki disease is approximately 1 month. Male gender, overweight status, higher platelet count, and initiation of treatment more than 10 days after the onset of the disease are independent risk factors for longer-lasting coronary artery lesions.

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APA	QIU H, JIA C, WANG Z, HE Y, RONG X, WU R, CHU M, SHI H (2020). Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. , 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
Chicago	QIU Huixian,JIA Chang,WANG Zhenquan,HE YUEE,RONG Xing,WU Rongzhou,CHU Maoping,SHI Hongying Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. (2020): 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
MLA	QIU Huixian,JIA Chang,WANG Zhenquan,HE YUEE,RONG Xing,WU Rongzhou,CHU Maoping,SHI Hongying Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. , 2020, ss.324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
AMA	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. . 2020; 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
Vancouver	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. . 2020; 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
IEEE	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H "Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease." , ss.324 - 329, 2020. 10.4274/balkanmedj.galenos.2020.2020.1.56
ISNAD	QIU, Huixian vd. "Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease". (2020), 324-329. https://doi.org/10.4274/balkanmedj.galenos.2020.2020.1.56

APA	QIU H, JIA C, WANG Z, HE Y, RONG X, WU R, CHU M, SHI H (2020). Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. Balkan Medical Journal, 37(6), 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
Chicago	QIU Huixian,JIA Chang,WANG Zhenquan,HE YUEE,RONG Xing,WU Rongzhou,CHU Maoping,SHI Hongying Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. Balkan Medical Journal 37, no.6 (2020): 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
MLA	QIU Huixian,JIA Chang,WANG Zhenquan,HE YUEE,RONG Xing,WU Rongzhou,CHU Maoping,SHI Hongying Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. Balkan Medical Journal, vol.37, no.6, 2020, ss.324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
AMA	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. Balkan Medical Journal. 2020; 37(6): 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
Vancouver	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease. Balkan Medical Journal. 2020; 37(6): 324 - 329. 10.4274/balkanmedj.galenos.2020.2020.1.56
IEEE	QIU H,JIA C,WANG Z,HE Y,RONG X,WU R,CHU M,SHI H "Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease." Balkan Medical Journal, 37, ss.324 - 329, 2020. 10.4274/balkanmedj.galenos.2020.2020.1.56
ISNAD	QIU, Huixian vd. "Prognosis and Risk Factors of Coronary Artery Lesions before Immunoglobulin Therapy in Children with Kawasaki Disease". Balkan Medical Journal 37/6 (2020), 324-329. https://doi.org/10.4274/balkanmedj.galenos.2020.2020.1.56