Morana Elisabetta, Guida Fiorentina, Andreozzi Laura, Frazzoni Leonardo, Baselli Lucia Augusta, Lami Francesca, Corinaldesi Elena, Cicero Cristina, Mambelli Lorenzo, Bigucci Barbara, Taddio Andrea, Ghizzi Chiara, Cappella Michela, Fernicola Paola, Lanari Marcello, Zagari Rocco Maurizio, Fabi Marianna
Specialty School of Paediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Biomedicines. 2024 Sep 3;12(9):2010. doi: 10.3390/biomedicines12092010.
: Kawasaki disease (KD) is a systemic vasculitis of medium arteries, particularly involving coronary arteries. Coronary artery lesions (CALs) is the most serious complication in the acute stage, potentially leading to ischemic cardiomyopathy, myocardial infarction and sudden death. Environmental factors and genetic background contribute to individual susceptibility to develop CALs. The aim of this study was to define the risk factors for CALs in an Italian cohort. : Data of KD patients from 10 Italian sites were registered into a REDCap database where demographic and clinical data, laboratory findings and coronary status were recorded. KD was diagnosed according to AHA definition. We used multiple logistic regression analysis to identify independent risk factors for CALs. : A total of 517 patients were enrolled, mainly Caucasians (83.6%). Presentation was complete in 321 patients (62.8%) and IVIG responsiveness in 360 (70%). CALs developed in 136/517 (26.31%). Gender, age, ethnicity, clinical presentation, fever duration, non-coronary cardiac events, Hb, albumin and CRP were significantly different between patients with and without CALs, while seasonality was not. Male gender, age < 18 months, Asian ethnicity, incomplete presentation and fever > 10 days were independent risk factors for CALs. : Age younger than 18 months, incomplete KD and longer fever duration are risk factors for CALs. Asian ethnicity also represents a risk factor in our Italian Cohort.
川崎病（KD）是一种累及中等动脉的全身性血管炎，尤其易侵犯冠状动脉。冠状动脉病变（CALs）是急性期最严重的并发症，可能导致缺血性心肌病、心肌梗死和猝死。环境因素和遗传背景导致个体易患CALs。本研究旨在确定意大利队列中CALs的危险因素。：来自意大利10个地点的KD患者数据被录入一个REDCap数据库，其中记录了人口统计学和临床数据、实验室检查结果以及冠状动脉状况。KD根据美国心脏协会（AHA）的定义进行诊断。我们使用多因素逻辑回归分析来确定CALs的独立危险因素。：共纳入517例患者，主要为白种人（83.6%）。321例患者（62.8%）表现完整，360例（70%）对静脉注射免疫球蛋白（IVIG）有反应。136/517例（26.31%）发生了CALs。有和没有CALs的患者在性别、年龄、种族、临床表现、发热持续时间、非冠状动脉心脏事件、血红蛋白（Hb）、白蛋白和C反应蛋白（CRP）方面存在显著差异，而季节性无差异。男性、年龄<18个月、亚洲种族、表现不完整和发热>10天是CALs的独立危险因素。：年龄小于18个月、KD表现不完整和发热持续时间较长是CALs的危险因素。在我们的意大利队列中，亚洲种族也是一个危险因素。
