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Cardiovascular status after Kawasaki disease in the UK.
- Source :
-
Heart . Oct2015, Vol. 101 Issue 20, p1646-1655. 10p. 5 Charts, 3 Graphs. - Publication Year :
- 2015
-
Abstract
- <bold>Objective: </bold>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.<bold>Methods: </bold>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).<bold>Results: </bold>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.<bold>Conclusions: </bold>Markers of endothelial injury persist for years after KD, including in a subset of patients without CAA. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CARDIOVASCULAR disease diagnosis
*BIOMARKERS
*CARDIOVASCULAR diseases
*COMPARATIVE studies
*ENDOTHELIUM
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*MUCOCUTANEOUS lymph node syndrome
*RESEARCH
*RESEARCH funding
*RISK assessment
*EVALUATION research
*DISEASE incidence
*RETROSPECTIVE studies
*CAROTID intima-media thickness
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 13556037
- Volume :
- 101
- Issue :
- 20
- Database :
- Academic Search Index
- Journal :
- Heart
- Publication Type :
- Academic Journal
- Accession number :
- 110258890
- Full Text :
- https://doi.org/10.1136/heartjnl-2015-307734