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Shuai S, Zhang H, Zhang R, Tang M, Luo E, Yang Y, Gao Y, Yue S, Liang H, Cai J. Prediction of coronary artery lesions based on C-reactive protein levels in children with Kawasaki Disease: a retrospective cohort study. J Pediatr (Rio J) 2023; 99:406-412. [PMID: 36977496 PMCID: PMC10373155 DOI: 10.1016/j.jped.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE Since coronary artery lesions (CALs) are the most severe complication of Kawasaki disease (KD), clinically speaking, early prediction of CALs is crucial. The authors aimed to investigate the predictive value of C-reactive protein (CRP) in predicting CALs in KD patients. METHODS KD patients were divided into the CALs group and the non-CALs group. The clinical and laboratory parameters were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors of CALs. The receiver operating characteristic curve was applied to determine the optimal cut-off value. RESULTS 851 KD patients who met the inclusion criteria were studied, including 206 in the CALs group and 645 in the non-CALs group. Children in the CALs group had significantly higher CRP levels than the non-CALs group (p < 0.05). Multivariable logistic regression analysis showed that incomplete KD, male, lower hemoglobin, and higher CRP were independent risk factors for predicting CAL (all p < 0.05). The optimal cut-off value of initial serum CRP for predicting CALs was 105.5 mg/L, with a sensitivity of 47.57% and a specificity of 69.61%. In addition, KD patients with high CRP (≥105.5 mg/L) had a higher occurrence of CALs than those with low CRP (<105.5 mg/L) (33% vs 19%, p < 0.001). CONCLUSION The incidence of CALs was significantly higher in patients with high CRP. CRP is an independent risk factor for CALs formation and may be useful for predicting CALs in KD patients.
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Affiliation(s)
- ShuPing Shuai
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - HongXi Zhang
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - Rui Zhang
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - Mi Tang
- University of Electronic Science and Technology of China, School of Medicine, Chengdu, China; University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Office of Good Clinical Practice, Chengdu, China
| | - ErDan Luo
- University of Electronic Science and Technology of China, School of Medicine, Chengdu, China; University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Office of Good Clinical Practice, Chengdu, China
| | - YanFeng Yang
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pediatric Cardiology, Chengdu, China
| | - Yu Gao
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - ShanLan Yue
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - Hua Liang
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China
| | - JiangHui Cai
- University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China.
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Relationship between mean platelet volume-to-lymphocyte ratio and coronary artery abnormalities in Kawasaki disease. Cardiol Young 2018; 28:832-836. [PMID: 29656728 DOI: 10.1017/s1047951118000422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Recently, mean platelet volume-to-lymphocyte ratio has emerged as a novel parameter of inflammation. No study has investigated the role of mean platelet volume-to-lymphocyte ratio in children with Kawasaki disease. We aimed to evaluate the relationship between mean platelet volume-to-lymphocyte ratio and coronary artery abnormalities in Kawasaki disease. METHODS Between January 2008 and January 2017, a total of 58 children with Kawasaki disease and 42 healthy subjects matched for sex and age were enrolled. Before the treatment, transthoracic echocardiography for all children was performed. Clinical and laboratory results including mean platelet volume, platelet distribution width, red blood cell distribution width, and counts of platelets, neutrophils, lymphocytes, and white blood cells, erythrocyte sedimentation rate, and C-reactive protein levels were measured. Mean platelet volume-to-lymphocyte ratio was calculated as mean platelet volume divided by lymphocyte count. RESULTS Compared with healthy controls, mean platelet volume-to-lymphocyte ratio was significantly lower in the children with Kawasaki disease (p<0.01). A total of 14 patients (24.1%) had incomplete Kawasaki disease and 15 (25.8%) children with Kawasaki disease had coronary involvement. Mean platelet volume-to-lymphocyte ratio was significantly lower in patients with coronary artery abnormalities (p<0.01). According to receiver operating characteristic curve analysis performed for the prediction of coronary artery abnormalities, the best cut-off point for mean platelet volume-to-lymphocyte ratio was 2.5 (area under curve=0.593, sensitivity 53.3%, specificity 51.1%). CONCLUSION It was first shown that the children with Kawasaki disease have lower mean platelet volume-to-lymphocyte ratio compared with control subjects. Mean platelet volume-to-lymphocyte ratio may be helpful in predicting coronary artery lesions in patients with Kawasaki disease.
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Garg J, Shah N, Krishnamoorthy P, Mehta K, Bozorgnia B, Boyle NG, Freudenberger R, Natale A. Catheter ablation of accessory pathway: 14-year trends in utilization and complications in adults in the United States. Int J Cardiol 2017; 248:196-200. [PMID: 28712558 DOI: 10.1016/j.ijcard.2017.06.115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 06/02/2017] [Accepted: 06/28/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to determine the temporal trends in utilization of catheter ablation of accessory pathways in the United States. METHODS All patients from the Nationwide Inpatient Sample (NIS) ≥18years of age with a primary diagnosis of anomalous atrioventricular excitation syndrome (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] code 426.7) were included in the study. Patients who underwent catheter ablation were identified using ICD-9-CM procedure code 37.34. Patients with a concomitant diagnosis of atrial fibrillation, atrial flutter, atrial tachycardia or ventricular arrhythmias were excluded from the analysis. Annual hospital volume was identified using unique hospital identification number and was divided into tertiles for further analysis. RESULTS A total of 11,601 catheter ablations for anomalous atrioventricular excitation syndrome were studied from 1998 to 2011. The mean length of stay was 1.8days (median 1day). The utilization trends of accessory pathway ablation have steadily declined from 3.9 ablation procedures/million US population in 1998-1999 to 2.5 ablation procedures/million US population in 2010-2011. The second tertile (adjusted OR 0.41; 95% CI 0.20-0.83, p=0.01) and third tertile (adjusted OR 0.39; 95% CI 0.18-0.85, p=0.02) of hospital volume were associated with reduction in cardiac complications as compared to first tertile of hospital volume. Advanced age (OR 1.02, 95% CI 1.01-1.04, p=0.002) was independent predictor of cardiac complications. There were no in-hospital deaths. CONCLUSION Despite decline in ablation trends, it still remains a relatively safe procedure associated with low morbidity and no mortality.
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Affiliation(s)
- Jalaj Garg
- Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States.
| | - Neeraj Shah
- Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States
| | | | - Kathan Mehta
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Babak Bozorgnia
- Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States
| | - Noel G Boyle
- UCLA Cardiac Arrhythmia Center, University of California, Los Angeles, CA, United States
| | - Ronald Freudenberger
- Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX, United States
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