1. Cardiovascular status after Kawasaki disease in the UK
- Author
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Shah, V, Christov, G, Mukasa, T, Brogan, KS, Wade, A, Eleftheriou, D, Levin, M, Tulloh, RM, Almeida, B, Dillon, MJ, Marek, J, Klein, N, and Brogan, PA
- Subjects
EXPRESSION ,Adult ,Male ,Cardiac & Cardiovascular Systems ,CIRCULATING ENDOTHELIAL-CELLS ,SURFACE ,Adolescent ,SYSTEMIC VASCULITIS ,CHILDREN ,Coronary Artery Disease ,Mucocutaneous Lymph Node Syndrome ,Pulse Wave Analysis ,1102 Cardiovascular Medicine And Haematology ,Carotid Intima-Media Thickness ,Risk Assessment ,Young Adult ,Risk Factors ,mental disorders ,Humans ,cardiovascular diseases ,Child ,Retrospective Studies ,Science & Technology ,Incidence ,Great Britain ,nutritional and metabolic diseases ,DYSFUNCTION ,United Kingdom ,Cardiovascular System & Hematology ,GIANT CORONARY ANEURYSMS ,Cardiovascular Diseases ,Child, Preschool ,YOUNG ,Cardiovascular System & Cardiology ,RISK-FACTORS ,cardiovascular system ,Female ,HEALTH ,Endothelium, Vascular ,Life Sciences & Biomedicine ,Biomarkers ,Follow-Up Studies - Abstract
Objective Kawasaki disease (KD) is an acute vasculitis that causes coronary artery aneurysms (CAA) in young children. Previous studies have emphasised poor long-term outcomes for those with severe CAA. Little is known about the fate of those without CAA or patients with regressed CAA. We aimed to study long-term cardiovascular status after KD by examining the relationship between coronary artery (CA) status, endothelial injury, systemic inflammatory markers, cardiovascular risk factors (CRF), pulse-wave velocity (PWV) and carotid intima media thickness (cIMT) after KD. Methods Circulating endothelial cells (CECs), endothelial microparticles (EMPs), soluble cell-adhesion molecules cytokines, CRF, PWV and cIMT were compared between patients with KD and healthy controls (HC). CA status of the patients with KD was classified as CAA present (CAA+) or absent (CAA−) according to their worst-ever CA status. Data are median (range). Results Ninety-two KD subjects were studied, aged 11.9 years (4.3–32.2), 8.3 years (1.0–30.7) from KD diagnosis. 54 (59%) were CAA−, and 38 (41%) were CAA+. There were 51 demographically similar HC. Patients with KD had higher CECs than HC (p=0.00003), most evident in the CAA+ group (p=0.00009), but also higher in the CAA− group than HC (p=0.0010). Patients with persistent CAA had the highest CECs, but even those with regressed CAA had higher CECs than HC (p=0.011). CD105 EMPs were also higher in the KD group versus HC (p=0.04), particularly in the CAA+ group (p=0.02), with similar findings for soluble vascular cell adhesion molecule 1 and soluble intercellular adhesion molecule 1. There was no difference in PWV, cIMT, CRF or in markers of systemic inflammation in the patients with KD (CAA+ or CAA−) compared with HC. Conclusions Markers of endothelial injury persist for years after KD, including in a subset of patients without CAA.
- Published
- 2015