Risk Factors For Coronary Artery Aneurysms In Children With Kawasaki Disease And A Follow-up Study With Echocardiography

Objective:We analyzed risk factors for coronary artery aneurysms (CAA) in children with Kawasaki disease(KD); we also used echocardiography to detect concurrent coronary distension during the long-term follow-up for early intervention and treatment, therefor reducing the rate of serious sequelae of cardiovascular diseases.Methods:All the patients were diagnosed as KD in our hospital from January2009to January2014; a total of679cases were included, and42with concurrent CAA,181with concurrent coronary artery expansion (CAD), and456without coronary artery damage cases (Non-coronary artery lesion, NCAL). Coronary artery damage was related to factors such as gender, age, fever, white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), alanine aminotransferase, serum potassium, plasma amino terminal brain natriuretic peptide precursor (NT-proBNP), acrylic ball resistance. We used SPSS18.0software package for risk factor analysis. Quantitative data using t test, the data with mean±standard deviation (x±s); Qualitative date using chi-square test, was used to analyze the high risk factors of CAA group, and logistic multivariate regression analysis was also used. Echocardiography of concurrent coronary distension with long-term follow-up.Results:Chi-square test showed that male, with febrile days>14d, NT-proBNP≥1000ng/L, immunoglobulin resistance were more likely to have KD concurrent CAA (P<0.05); Multiple Logistic regression analysis showed that male [OR=4.092,95%CI (1.514,11.060), P=0.004]; febrile days>14d [OR=12.436,95%CI (4.599,33.631), P=0.000]; NT-proBNP≥1000ng/L [OR=3.305,95%CI(1.401,7.794),P=0.005], immunoglobulin resistance [OR=3.842,95%CI(1.562,9.453), P=0.000] four are KD concurrent CAA were independent risk factors; Coronary artery aneurysms most prone in the right coronary artery trunk(39.5%), followed by the left anterior descending branch (36.8%).One case with echocardiography follow-up found in the left coronary artery thrombosis size was1.21cm×0.74cm, right coronary artery thrombus within1.26cm×0.25cm, also found in the coronary sinus with thrombosis (1.45cm×0.35cm).Conclusions:1、Male children, febrile days>14d, NT-proBNP≥1000ng/L, immunoglobulin resistance are independent risk factors of CAA;2、Coronary artery aneurysms most prone in the right coronary artery trunk, followed by the left anterior descending branch;3、KD may be complicated with giant coronary aneurysm coronary artery thrombosis, may also be complicated with coronary sinus thrombosis.