Risk factors associated with persistent coronary artery lesions in children with Kawasaki disease in an Italian cohort

被引：0

作者：

Fiorentina Guida ^{[1
]}

Elisabetta Morana ^{[2
]}

Elena Maria Tarì ^{[2
]}

Leonardo Frazzoni ^{[3
]}

Laura Andreozzi ^{[1
]}

Lucia Augusta Baselli ^{[5
]}

Francesca Lami ^{[6
]}

Elena Corinaldesi ^{[7
]}

Cristina Cicero ^{[8
]}

Lorenzo Mambelli ^{[9
]}

Gianluca Vergine ^{[10
]}

Andrea Taddio ^{[11
]}

Michela Cappella ^{[13
]}

Barbara Bigucci ^{[10
]}

Ivana Bruno ^{[9
]}

Paola Fernicola ^{[14
]}

Ilaria Frabboni ^{[6
]}

Matteo Meli ^{[12
]}

Martina Rossano ^{[5
]}

Rocco Maurizio Zagari ^{[4
]}

Marcello Lanari ^{[1
]}

Marianna Fabi ^{[1
]}

机构：

[1] IRCCS Azienda Ospedaliero Universitaria Di Bologna,Pediatric Emergency Unit

[2] University of Bologna,Specialty School of Paediatrics (EM, EMT), Alma Mater Studiorum

[3] AUSL della Romagna,UOC Gastroenterologia ed Endoscopia Digestiva Forlì

[4] University of Bologna,Cesena

[5] Pediatric Intermediate Care Unit,Department of Medical and Surgical Sciences

[6] Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico,Department of Medical and Surgical Sciences for Mothers, Children and Adults

[7] University of Modena and Reggio Emilia,Paediatric Unit

[8] Carpi Hospital,Department of Pediatrics

[9] AUSL,Department of Paediatrics

[10] Guglielmo da Saliceto Hospital,Pediatric Clinic

[11] Santa Maria Delle Croci Hospital,Institute for Maternal and Child Health

[12] AUSL Della Romagna,Paediatrics Unit, Santa Maria Nuova Hospital

[13] Rimini Hospital,Paediatrics Unit, G.B. Morgagni Pierantoni Hospital

[14] AUSL Romagna,undefined

[15] IRCCS “Burlo Garofolo”,undefined

[16] and University of Trieste,undefined

[17] AUSL Bologna,undefined

[18] Azienda Unità Sanitaria Locale (AUSL)-Scientific Institute for Research and Healthcare (IRCCS) of Reggio Emilia,undefined

[19] Azienda Unità Sanitaria Locale (AUSL) Romagna,undefined

来源：

European Journal of Pediatrics | / 184卷 / 6期

关键词：

Kawasaki disease; Persistent coronary artery lesions; Risk score; Coronary artery aneurysms; Risk factors;

D O I：

10.1007/s00431-025-06162-0

中图分类号：

学科分类号：

摘要：

Kawasaki disease (KD) can be complicated—particularly during the acute phase—by coronary artery lesions (CALs). The persistence of CALs (pCALs) beyond the subacute phase increases the risk of long-term cardiovascular morbidity and life-threatening events. While several risk scores, primarily based on Asian and American populations, have been proposed to predict CALs or treatment resistance, few studies have focused on identifying risk factors for pCALs. This study aimed to identify risk factors for pCALs in Italian patients and to evaluate the validity of an existing risk score developed in a North American cohort. Data from KD patients across 11 Italian centers were collected in a centralized RedCap database. pCALs were defined as CALs persisting 8 weeks post-diagnosis. Clinical, demographic, and laboratory features of patients with and without pCALs were compared. Independent risk factors were identified using multiple logistic regression. The predictive performance of Son’s risk score was assessed through ROC analysis. A total of 517 children (87.4% Caucasian) were enrolled; 52 developed pCALs. pCALs were more common in males (12.03%, p = 0.06), patients < 6 months (61.5%, p = 0.05), those with Asian ethnicity (26.9%, p = 0.026), incomplete clinical presentation (p = 0.03), and in those with abnormal abdominal ultrasound findings (p = 0.04). Affected children had higher WBC, elevated CRP (> 13 mg/dL), and lower hemoglobin. Compared to those with acute CALs, patients with pCALs were younger, more often IVIG non-responders (34.6% vs. 29.6%, p < 0.001), and late-treated. Son’s score showed good predictive ability for pCALs.

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