Garg Jalaj, Krishnamoorthy Parasuram, Palaniswamy Chandrasekar, Paudel Rajiv, Chatterjee Saurav, Ahmad Hasan, Snyder Christopher
1Department of Internal Medicine,Division of Cardiology,Westchester Medical Center,New York Medical College,Valhalla,New York,United States of America.
2Department of Internal Medicine,Mount Sinai Englewood Hospital and Medical Center,Englewood,New Jersey,United States of America.
Cardiol Young. 2015 Aug;25(6):1124-9. doi: 10.1017/S1047951114001759. Epub 2014 Oct 23.
Accelerated coronary atherosclerosis in patients with Kawasaki disease, in conjunction with coronary artery aneurysm and stenosis that characterise this disease, are potential risk factors for developing coronary artery disease in young adults. We aimed to determine the prevalence and predictors of coronary artery disease in adult patients with Kawasaki disease.
All patients aged 18-55 years of age diagnosed with Kawasaki disease were sampled from Nationwide Inpatient Sample database using International Classification of Diseases 9th revision (ICD 9 code 446.1) from 2009 to 2010. Demographics, prevalence of coronary artery disease, and other traditional risk factors in adult patients with Kawasaki disease were analysed using ICD 9 codes.
The prevalence of Kawasaki disease among adults was 0.0005% (n=215) of all in-hospital admissions in United States. The mean age was 27.3 years with women (27.6 years) older than men (27.1 years). Traditional risk factors were hypertension (21%), hyperlipidaemia (15.6%), diabetes (11.5%), tobacco use (8.8%), and obesity (8.8%), with no significant difference between men and women. Coronary artery disease (32.4%), however, was more prevalent in men (44.7%) than in women (12.1%; p=0.03). In multivariate regression analysis, after adjusting for demographics and traditional risk factors, hypertension (OR=13.2, p=0.03) was an independent risk factor of coronary artery disease.
There was increased preponderance of coronary artery disease in men with Kawasaki disease. On multivariate analysis, hypertension was found to be the only independent predictor of coronary artery disease in this population after adjusting for other risk factors.
川崎病患者冠状动脉粥样硬化加速，以及该疾病所特有的冠状动脉瘤和狭窄，是年轻成年人发生冠状动脉疾病的潜在危险因素。我们旨在确定成年川崎病患者冠状动脉疾病的患病率及预测因素。
使用国际疾病分类第九版（ICD-9编码446.1），从2009年至2010年的全国住院患者样本数据库中抽取所有年龄在18 - 55岁且诊断为川崎病的患者。使用ICD-9编码分析成年川崎病患者的人口统计学特征、冠状动脉疾病患病率及其他传统危险因素。
在美国，成年患者中川崎病的患病率占所有住院患者的0.0005%（n = 215）。平均年龄为27.3岁，女性（27.6岁）比男性（27.1岁）年龄稍大。传统危险因素包括高血压（21%）、高脂血症（15.6%）、糖尿病（11.5%）、吸烟（8.8%）和肥胖（8.8%），男女之间无显著差异。然而，冠状动脉疾病（32.4%）在男性（44.7%）中的患病率高于女性（12.1%；p = 0.03）。在多因素回归分析中，在调整人口统计学特征和传统危险因素后，高血压（OR = 13.2，p = 0.03）是冠状动脉疾病的独立危险因素。
川崎病男性患者中冠状动脉疾病的患病率更高。多因素分析显示，在调整其他危险因素后，高血压是该人群中冠状动脉疾病唯一的独立预测因素。
