Key result
Male gender in Kawasaki disease was associated with a significantly higher rate of cardiovascular complications compared to females (38.27% vs 25.26%, p < 0.05) and increased platelet activation.
Why the study?
Kawasaki disease can lead to coronary artery dilations and aneurysms without adequate treatment, prompting the search for new gender-specific biomarkers predictive of cardiovascular complications.
Does male gender predict a higher risk of cardiovascular complications and IVIG resistance in pediatric patients with Kawasaki disease?
Observational (n=257)
No
Does male gender predict a higher risk of cardiovascular complications and IVIG resistance in pediatric patients with Kawasaki disease?
Absolute Event Rate: 38.27% vs 25.26%
p-value: p=<0.05
Male gender in Kawasaki disease is associated with a higher risk of cardiovascular complications, IVIG resistance, and altered platelet apoptosis, suggesting a need for closer monitoring and potentially more aggressive initial therapy in males.
Gender-specific platelet biomarkers may refine KD complication risk assessment; leaves open whether they improve outcomes or warrant prospective validation.
Background: Kawasaki disease (KD) is one of the most common pediatric vasculitis that, in absence of adequate treatment, can be complicated by dilations and aneurysms of the coronary arteries. This study was aimed to identify new gender-specific biomarkers predictive of cardiovascular complications. Methods: We analyzed 257 KD patients (162 males and 95 females) admitted to the Bambino Ges Children's Hospital of Rome (Italy) between January 2005 and September 2018. Flow cytometry analyses were used to evaluate platelet functions, while echocardiography was used to detect cardiovascular complications. Results: Compared to females, we found that males with KD: i) had a higher rate of cardiovascular complications (p < 0.05); ii) were "non-responders" to the first bolus of immunoglobulins and iii) undergo thrombocytosis probably due to a platelet death defect. Conclusions: According to literature, this study confirms gender influence in KD course and therapy response, and proposes platelet functions as new sexassociated predictive biomarkers of cardiovascular disease. Male gender could represent a negative prognostic factor for KD and be associated with a high risk to develop cardiovascular complications. The clinical implications of this investigation could be the improvement of first-line corticosteroid therapy and the need for closer echocardiographic follow-up for male patients.
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Jacobis et al. (2023) conducted an observational in Kawasaki disease (n=257). Male gender vs. Female gender was evaluated on Cardiovascular complications (vascular dilations and coronary artery aneurysms) (p=<0.05). Male gender in Kawasaki disease was associated with a significantly higher rate of cardiovascular complications compared to females (38.27% vs 25.26%, p < 0.05) and increased platelet activation.
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