Predictive value of clinical indices for intravenous immunoglobulin resistance and coronary artery lesion in Kawasaki disease
Wang, Chuan et al. (2021), Predictive value of clinical indices for intravenous immunoglobulin resistance and coronary artery lesion in Kawasaki disease, Dryad, Dataset, https://doi.org/10.5061/dryad.w0vt4b8qg
Context: Intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) prediction are pivotal topic of interests in Kawasaki disease (KD). However, data on the predictive value of lipid profile for both IVIG resistance and CALs are limited.
Purpose: To investigate the predictive validity of lipid profile for IVIG resistance and CALs in KD.
Design: Prospective cohort study.
Setting: West China Second University Hospital.
Patients: A total of 363 KD patients were divided into either the initial IVIG-resistant group (n=56) and initial IVIG-responsive group (n=307), or CAL+ group (n=61) and CAL- group (n=302). Patients suffering initial IVIG resistance were further categorized into the repeated IVIG-resistant group (n=33) and the repeated IVIG-responsive group (n=23).
Main Outcome Measures: Validity of serum lipid profile in predicting IVIG resistance and CALs.
Results: Serum TG was significantly higher (p=0.047) and TC (p=0.025), HDL-C (p<0.001), LDL-C (p=0.021) as well as Apo A (p<0.001) were significantly lower in initial IVIG-resistant subjects, with best cut-off values of 1.625 mmol/L, 3.255 mmol/L, 0.475 mmol/L, and 1.965 mmol/L and0.665 g/L, yielding sensitivities of 52%, 70%, 52%, 61%, 50%, and specificities of 68%, 53%, 78%, 71%, 81% for initial IVIG resistance prediction, respectively. TC (p=0.012), LDL-C (p=0.017), and Apo A (p=0.048) levels were significantly lower in repeated IVIG-resistant subjects, with best cut-off values of 3.20 mmol/L, 1.78 mmol/L, 0.605 g/L, producing sensitivities of 91%, 70%, 57% and specificities of 55%, 67%, 70% for repeated IVIG resistance prediction, respectively. Serum Apo-A level (p=0.036) was significantly lower in the CAL group, with best cut-off value of 0.805g/L, yielding a sensitivity of 66% and a specificity of 54% for CAL prediction.
Conclusions: Serum lipid profiles were significantly dysregulated in KD patients suffering IVIG resistance and CALs. Some of them, such as LDL-c and Apo-A, could serve as complementary laboratory markers for the prediction of both IVIG resistance and CALs in KD.