Indicators of Oxidative Stress in the Prediction of Coronary Artery Lesions in Patients With Kawasaki Disease

Abstract

Objectives:The aim of this study was to examine the clinical significance of oxidative stress (OS)-related indices, including inflammatory markers and lipid and platelet (PLT) parameter, in coronary artery lesions (CALs) in Kawasaki disease (KD).Methods: Clinical data of 952 KD patients diagnosed between January 2019 and March 2022 were collected and divided into CAL and NCAL groups. All the KD patients were randomly divided into training set and verification set. The univariate analysis and multivariate logistic regression analysis of training set were used to identify the OS-related independent risk factors of CALs, which were then used to construct a predictive nomogram. Calibration curve and receiver operating characteristic curve were used to evaluate the performance of the model. The predictive nomogram was further validated on verification set. Results:In the training set, 137 KD patients (18.0%) showed CALs.C-reactive protein, serum amyloid A, PLT count, monocyte-to-high-density lipoprotein (HDL) ratio, and PLT-to-lymphocyte ratio were significantly higher, whereas HDL was lower in the CAL group than the NCAL group. Increased C-reactive protein, serum amyloid A, PLT, and decreased HDL were identified as independent risk factors. The nomogram constructed using these factors showed satisfactory calibration degree and discriminatory power (the area under the curve, 0.887). In the verification set, the area under the curve was 0.795. Conclusion:The predictive nomogram constructed using 4 OS-related risk factors associated with CALs in patients with KD could be a useful tool for early diagnosis of CALs in KD.

A Nomogram for Predicting Coronary Artery Lesions in Patients with Kawasaki Disease

“…Shuai et al (27) found that KD patients with a high CRP level (≥ 105.5 mg/L) had a higher incidence of CAL than those with a low level. Other research has discovered that CRP rises in the early stage of KD, particularly in individuals with CAL (28,29). The present study revealed similar results, implying in ammatory process may involve in the formation of CAL in KD.…”

Predictive Value of monocyte to HCL-C ratio for Coronary Artery Lesion and Intravenous Immunoglobulin Resistance in Kawasaki Disease

“…So far, few previous studies have focused on the relationship between MHR and KD. Wu R et al [24] found that MHR levels in the CAL + group were higher than those in the CAL-group. What's more, it was shown that the nomogram model constructed in combination with the MHR has satisfactory predictive performance for CALs [25].…”

Expression of oxidative stress and inflammatory indicators for coronary artery disease in Kawasaki disease

“…Additionally, this study confirms that PLR was elevated in the KD combined with the CAL group. 39 However, NLR is meaningless and may be the cause of the disease course. ESR is a widely used indicator for assessing inflammation levels.…”

“…In our study, we observed that HDL and SOD levels were memorably abated, and Ox-HDL and MDA levels were memorably augmented in KD with CALs; moreover, the decrease in HDL and SOD or increase in MDA and Ox-HDL was a factor for CALs, which is consistent with previous studies. 39 , 46 …”