Department of Pediatrics Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Korea.
Department of Pediatrics Kangnam Sacred Heart HospitalHallym University College of Medicine Seoul Korea.
J Am Heart Assoc. 2022 Jun 21;11(12):e023840. doi: 10.1161/JAHA.121.023840. Epub 2022 Jun 14.
Background There are few studies on the association with Kawasaki disease in children and the family's history of cardiovascular disease (CVD). The aim of this study was to identify the association of increased risks for Kawasaki disease in children with a family history of CVD. Methods and Results Clinical data of children born in 2008 and 2009 (n=917 707) were obtained from the National Health Insurance Service and the National Health Screening Program for Infants and Children for this study. The cohort consisted of 495 215 participants (53.8%) who completed the family history questionnaire for children 54 to 60 months old. Family history of CVD included 5 medical conditions: hypertension, dyslipidemia, myocardial infarction, stroke, and diabetes. Kawasaki disease was defined using the disease code, intravenous immunoglobulin prescription, and use of antipyretics for more than 25 days. Severe Kawasaki disease was defined as diagnosis of accompanied cardiac/coronary artery complications or intravenous immunoglobulin use ≥2 times. The incidence rate of Kawasaki disease was 124/100 000 person-years (95% CI, 117.5-131.5) for children <2 years old, 95/100 000 person-years (95% CI, 90.5-100.4) in children 2 to 5 years old, and 14/100 000 person-years (95% CI, 12.6-15.6) in children >5 years old. After propensity-score matching, 829 participants with a family history of CVD were diagnosed as having Kawasaki disease (0.68% [95% CI, 0.63-0.72]), and 690 patients with Kawasaki disease (0.56% [95% CI, 0.52-0.61]) had no family history of CVD. The family history of CVD was associated with increased risk for Kawasaki disease (risk ratio, 1.20 [95% CI, 1.08-1.32]) but not for severe Kawasaki disease (risk ratio, 1.23 [95% CI, 0.92-1.65]). Conclusions In this nationwide propensity-score matched study, those with a family history of CVD had a significantly greater risk of Kawasaki disease compared with those who had no family history of CVD.
目前关于儿童川崎病与心血管疾病（CVD）家族史之间的关联研究较少。本研究旨在确定 CVD 家族史与儿童川崎病风险增加之间的关联。
本研究从国家健康保险服务和国家婴幼儿健康筛查计划中获取了 2008 年和 2009 年出生的儿童的临床数据（n=917707）。该队列包括 495215 名参与者（53.8%），他们完成了 54-60 个月大儿童的家族史问卷。CVD 家族史包括 5 种疾病：高血压、血脂异常、心肌梗死、卒中和糖尿病。川崎病使用疾病代码、静脉注射免疫球蛋白处方和使用超过 25 天的退烧药进行定义。严重川崎病的定义为伴有心脏/冠状动脉并发症或静脉注射免疫球蛋白使用≥2 次的诊断。年龄<2 岁、2-5 岁和>5 岁的儿童川崎病发病率分别为 124/100000 人年（95%CI，117.5-131.5）、95/100000 人年（95%CI，90.5-100.4）和 14/100000 人年（95%CI，12.6-15.6）。在倾向评分匹配后，829 名 CVD 家族史患者被诊断为川崎病（0.68%[95%CI，0.63-0.72%]），690 名川崎病患者（0.56%[95%CI，0.52-0.61%]）无 CVD 家族史。CVD 家族史与川崎病风险增加相关（风险比，1.20[95%CI，1.08-1.32]），但与严重川崎病无关（风险比，1.23[95%CI，0.92-1.65]）。
在这项全国范围内的倾向评分匹配研究中，与无 CVD 家族史的患者相比，有 CVD 家族史的患者川崎病的风险显著增加。
