Key result
In children with Kawasaki disease treated with intravenous immunoglobulin, an eosinophil count ≥ 0.24 × 10^9/L was independently associated with a increased risk of cardiovascular death.
Why the study?
Coronary artery dilation causes poor prognosis in Kawasaki disease, but whether eosinophils can predict coronary artery dilation and long-term prognosis after IVIG therapy was unknown.
Does an eosinophil count ≥ 0.24 predict coronary artery dilatation and cardiovascular death in children with Kawasaki disease after IVIG treatment?
Cohort (n=664)
Single-blind
No
Does an eosinophil count ≥ 0.24 predict coronary artery dilatation and cardiovascular death in children with Kawasaki disease after IVIG treatment?
An elevated eosinophil count (≥ 0.24 × 10^9/L) is an independent predictor of coronary artery dilatation and cardiovascular death in children with Kawasaki disease following IVIG therapy.
Answers are grounded in this paper and cite their sources.
Eosinophil count may aid post-IVIG risk stratification for coronary dilation in KD; leaves open whether monitoring improves outcomes or warrants routine use.
Background: Coronary artery dilation is the main cause of poor prognosis in children with Kawasaki disease. Whether eosinophils can predict coronary artery dilation and long-term prognosis in children after intravenous immunoglobulin (IVIG) treatment for Kawasaki disease (KD). Methods: From January 2018 to December 2020, a total of 664 children with Kawasaki disease were continuously enrolled. Results: With a sensitivity of 77.78% and a specificity of 74.38%, the optimal cut-off value for predicting coronary artery dilatation is eosinophils ≥ 0.24. According to the cut-off value, the children were separated into two groups: eosinophils<0.24 group (n = 461) and eosinophils ≥ 0.24 group (n = 203). Eosinophils ≥ 0.24 as the ideal cut-off value for predicting cardiovascular death with an area under the curve (AUC) of 0.772 [95% confidence interval (CI): 0.720 ~ 0.823, P < 0.001], a sensitivity of 72.88%, and a specificity of 78.57%. The incidence of cardiovascular death, heart failure and multiple organ dysfunction was greater in the eosinophils ≥ 0.24 group, although there was no significant difference in the incidence of pericarditis procedures following IVIG between the two groups. Eosinophils ≥ 0.24 was also an independent predictor of cardiovascular death (hazard ratio = 4.95, 95% confidence interval (CI):2.98 ~ 8.23, P < 0.001). However, eosinophils have a lower sensitivity (23.08%) for predicting the recurrence of Kawasaki disease. Conclusion: eosinophils ≥ 0.24 was independently associated with coronary artery dilatation and poor clinical outcomes for children in Kawasaki disease after IVIG treatment.
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Sun et al. (2023) conducted a cohort in Kawasaki disease (n=664). Eosinophils ≥ 0.24 × 10^9/L vs. Eosinophils < 0.24 × 10^9/L was evaluated on Cardiovascular death (HR 4.95, 95% CI 2.98-8.23, p=<0.001). In children with Kawasaki disease treated with intravenous immunoglobulin, an eosinophil count ≥ 0.24 × 10^9/L was independently associated with a increased risk of cardiovascular death.
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