Albumin level and progression of coronary artery lesions in Kawasaki disease: A retrospective cohort study

Abstract

BackgroundAlbumin (ALB) level is closely associated with the occurrence of intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in Kawasaki disease (KD). The association between ALB level and CALs progression, is critical to the prognosis of KD patients. But little is known about it. This study aims to investigate the effect of the ALB level on CALs progression in KD patients.MethodsA total of 3,479 KD patients from 1 January 2005 to 30 November 2020, in Wenzhou, China were recruited. A total of 319 KD patients who had CALs and ALB data, and finish the follow-up as requested were enrolled in this study. They were classified into the low ALB group and the normal ALB group, divided by 30 g/L. CALs outcomes were classified into two categories according to the CALs changes from the time that CALs were detected within 48 h before or after IVIG treatment to 1 month after disease onset: progressed and no progressed. Multiple logistic regression models were used to assess the independent effect of ALB level on CALs progression among KD patients. Stratified analysis was performed to verify the ALB level on CALs progression among patients in different subgroups.ResultsHigher proportion of IVIG resistance (P < 0.001), receiving non-standard therapy (P < 0.001), and receiving delayed IVIG treatment (P = 0.020) were detected in patients with lower ALB level. Patients with lower ALB level had higher C-reactive protein (CRP) level (P = 0.097) and white blood cell count (WBC) (P = 0.036). After adjustment for confounders, patients with lower ALB level had higher odds of CALs progression; the adjusted odds ratio (OR) was 3.89 (95% CI: 1.68, 9.02). Similar results were found using stratification analysis and sensitivity analysis. Male gender and age over 36 months, as covariates in multiple logistic regression models, were also associated with CALs progression.ConclusionLow ALB level is identified as an independent risk factor for CALs progression in KD patients. Male gender and age over 36 months are also proved to be risk factors for CALs progression. Further investments are required to explore its mechanisms.

Multiresistant Kawasaki Disease in a Young Infant with Giant Aneurysms Growing Fast

“…At admission, our patient presented with risk factors for IVIg resistance and, consequently, coronary aneurysms, such as an age of <12 months, hypoalbuminemia, elevated liver enzymes, decreasing hemoglobin levels, and elevated CRP [24]. Hypoalbuminemia has been shown to be an independent risk factor for the occurrence and progression of CAAs [25].…”

Study on network pharmacology of Ginkgo biloba extract against ischaemic stroke mechanism and establishment of UPLC‐MS/MS methods for simultaneous determination of 19 main active components

“…Recent research has shown that ALB level in patients with cerebral infarction or coronary heart disease is significantly lower than in normal people, which has important predictive significance for the clinical treatment of IS and other cardiovascular and cerebrovascular diseases. 63,64 ALB can also effectively protect cerebral nerve cells. It not only improves blood flow but also protects brain cells, thereby promoting nerve regeneration.…”

“…It can be clearly seen that ALB, AKT1, TNF, CASP3, EGFR, PTGS2, and MMP9 are important targets in the treatment of IS. Recent research has shown that ALB level in patients with cerebral infarction or coronary heart disease is significantly lower than in normal people, which has important predictive significance for the clinical treatment of IS and other cardiovascular and cerebrovascular diseases 63,64 . ALB can also effectively protect cerebral nerve cells.…”

Association of Triglyceride-Glucose Index and Liver Function Parameters Among Healthy Obese Civil Servants: A Center-Based Study

“…The primary protein in plasma, albumin is primarily produced by hepatic parenchymal cells and serves as the clotting factor, substance binding, and colloid osmotic pressure regulator. 21 Albumin contains a sulfhydryl group that can control how inflammatory cells signal, limiting the release of inflammatory chemicals and functioning inadvertently as an antiinflammatory agent. This study discovered comparatively high albumin levels in persons with high TyG indices, which may be linked to increased synthesis as a result of higher TyG indices being associated with bigger waist circumference.…”