Zhou Xue, Peng Yue, Yi Qijian
Department of Cardiovascular Medicine, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
J Inflamm Res. 2025 Jan 3;18:105-114. doi: 10.2147/JIR.S473511. eCollection 2025.
Coronary thrombosis is a serious cardiovascular complication of Kawasaki disease (KD), and recurrence of coronary thrombosis increases the short-term risk of myocardial infarction and the long-term risk of coronary artery disease. However, there are currently no studies predicting the recurrence of coronary thrombosis, so the aim of this study was to develop and validate a nomogram to predict recurrent coronary thrombosis in KD patients.
This was a retrospective study of data from 149 KD patients who had a history of previous coronary disease at the Children's Hospital of Chongqing Medical University from 2013 to 2020. Independent risk factors were identified using univariate and multivariate logistic regression analyses, and a nomogram was constructed to predict recurrent coronary thrombosis.
Multivariate analysis showed that large coronary artery aneurysm(CAA) (Odds Ratio [OR] 4.28; 95% Confidence Interval [CI] 1.39-13.12), saccular CAA (OR 5.03; 95% CI 1.55-16.29), first left anterior descending (LAD) thrombosis (OR 3.90; 95% CI 1.20-12.63), and persistent CAA (OR 43.27; 95% CI 12.23-153.12) were independent risk factors for recurrent coronary thrombosis. Based on these variables, a nomogram was constructed. The Area Under the Curve (AUC) of the nomogram was 0.943, and tenfold cross-validation (200 replicates) showed an average AUC of 0.929. Furthermore, the nomogram not only presented a favorable calibration curve but also demonstrated practical clinical utility.
Large CAA, saccular CAA, first LAD thrombosis and persistent CAA were independent risk factors for recurrent coronary thrombosis. The nomogram can visually show these independent risk factors and predict probabilities.
冠状动脉血栓形成是川崎病（KD）严重的心血管并发症，冠状动脉血栓复发会增加心肌梗死的短期风险和冠状动脉疾病的长期风险。然而，目前尚无预测冠状动脉血栓复发的研究，因此本研究旨在建立并验证一种列线图，以预测KD患者冠状动脉血栓的复发。
这是一项对2013年至2020年重庆医科大学附属儿童医院149例既往有冠状动脉疾病史的KD患者的数据进行的回顾性研究。采用单因素和多因素逻辑回归分析确定独立危险因素，并构建列线图以预测冠状动脉血栓复发。
多因素分析显示，大型冠状动脉瘤（CAA）（比值比[OR]4.28；95%置信区间[CI]1.39 - 13.12）、囊状CAA（OR 5.03；95% CI 1.55 - 16.29）、首次左前降支（LAD）血栓形成（OR 3.90；95% CI 1.20 - 12.63）和持续性CAA（OR 43.27；95% CI 12.23 - 153.12）是冠状动脉血栓复发的独立危险因素。基于这些变量，构建了列线图。列线图的曲线下面积（AUC）为0.943，十折交叉验证（200次重复）显示平均AUC为0.929。此外，列线图不仅呈现出良好的校准曲线，还具有实际临床应用价值。
大型CAA、囊状CAA、首次LAD血栓形成和持续性CAA是冠状动脉血栓复发的独立危险因素。列线图可以直观地显示这些独立危险因素并预测概率。
