Development of a prediction model for progression of coronary artery lesions in Kawasaki disease

Xu, Dan; Chen, Ye-Shi; Feng, Chen-Hui; Cao, Ai-Mei; Li, Xiao-Hui

doi:10.1038/s41390-023-02931-5

Pediatr Res

2023

DOI: 10.1038/s41390-023-02931-5

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Development of a prediction model for progression of coronary artery lesions in Kawasaki disease

Dan Xu,

Ye-Shi Chen,

Chen-Hui Feng

et al.

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2024

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Cited by 4 publications

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Nutrition‐Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta‐Analysis

Liu,

Chen,

Wang

et al. 2024

Food Science & Nutrition

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Several studies explored the associations of pre‐albumin (PA)/albumin (ALB) and ALB‐combined indicators (prognostic nutrition index [PNI], albumin‐to‐globulin ratio [AGR], bilirubin‐to‐albumin [BAR], and C‐reactive protein/albumin ratio [CAR]) with intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in Kawasaki disease (KD) patients. However, the results were controversial. A meta‐analysis was conducted to reconfirm their associations and predictive performance. Databases of PubMed, EMBASE, and the Cochrane library were searched. The pooled standardized mean difference (SMD) or odds ratios (ORs) assessed the association, while the pooled area under the receiver operating characteristic curve (AUC) evaluated the predictive power. Ninety‐four studies were included. Overall and subgroup meta‐analyses demonstrated lower ALB and higher CAR were associated with IVIG resistance (ALB: SMD = −0.61; OR = 0.83; CAR: SMD = 1.47; OR = 1.69) and CALs (ALB: SMD = −0.56; OR = 0.92; CAR: SMD = 0.52). PNI was reduced in IVIG‐resistant (SMD = −0.82) and coronary artery aneurysm (SMD = −0.18) patients in subgroup analysis and high PNI predicted the decreased risk of CALs in overall analysis (OR = 0.82). ALB, CAR, and PNI were a good or fair biomarker for differentiating IVIG‐resistant (CALs) from IVIG‐sensitive (non‐CALs) patients (AUC > 0.6 or > 0.7). PA (SMD = −0.72) and BAR (SMD = 1.10) were differential in IVIG‐resistant, but not in CAL patients compared with controls. AGR was not associated with CALs (p > 0.05). In conclusion, ALB, CAR, PNI, PA, and BAR may represent promising biomarkers for the prediction of IVIG resistance and CALs in KD patients.

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Nutrition‐Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta‐Analysis

Liu,

Chen,

Wang

et al. 2024

Food Science & Nutrition

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An Update on Kawasaki Disease

Goel,

Yalcindag

2024

Curr Rheumatol Rep

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A novel scoring system based on sIL-2R for predicting IVIG resistance in Chinese children with KD

Zeng,

Zhu,

et al. 2024

Pediatr Rheumatol

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Objective This study aimed to develop a novel scoring system utilizing circulating interleukin (IL) levels to predict resistance to intravenous immunoglobulin (IVIG) in Chinese patients with Kawasaki disease (KD). We further compared this scoring system against six previously established scoring methods to evaluate its predictive performance. Methods A retrospective analysis was conducted on KD patients who were treated at the cardiovascular medical ward of our institution from January 2020 to December 2022. Six scoring systems (Egami, Formosa, Harada, Kobayashi, Lan and Yang) were analyzed, and a new scoring system was developed based on our data. Results In our study, 521 KD patients were recruited, 42 of whom (8.06%) were identified as resistant to IVIG. Our study indicated that IVIG-resistant KD patients were at an increased risk for the development of coronary arterial lesions (CALs) ( P = 0.001). The evaluation of IVIG resistance using various scoring systems revealed differing levels of sensitivity and specificity, as follows: Egami (38.10% and 88.52%), Formosa (95.24% and 41.13%), Harada (78.57% and 43.22%), Kobayashi (66.67% and 74.95%), Lan (66.67% and 73.49%), and Yang (69.05% and 77.24%). Our novel scoring system utilizing sIL-2R demonstrated the highest sensitivity and specificity of 69.29% and 83.91%, respectively, and calibration curves indicated a favorable predictive accuracy of the model. Conclusion Our newly developed scoring system utilizing sIL-2R demonstrated superior predictive performance in identifying IVIG resistance among Chinese patients with KD.

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Development of a prediction model for progression of coronary artery lesions in Kawasaki disease

Cited by 4 publications

References 47 publications

Nutrition‐Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta‐Analysis

Nutrition‐Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta‐Analysis

An Update on Kawasaki Disease

A novel scoring system based on sIL-2R for predicting IVIG resistance in Chinese children with KD

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