Key result
Kawasaki disease was associated with persistent endothelial dysfunction, evidenced by significantly elevated CRP (p=0.0005), cholesterol, triglycerides, and abnormal arterial Doppler indices compared to controls.
Why the study?
Long-term follow-up shows persistent endothelial dysfunction predisposing to atherosclerosis in post-Kawasaki disease patients, prompting study to establish endothelial dysfunction and correlate it with premature atherosclerosis.
Do patients previously diagnosed with Kawasaki disease exhibit persistent endothelial dysfunction and premature atherosclerosis compared to age-matched controls?
Observational
Do patients previously diagnosed with Kawasaki disease exhibit persistent endothelial dysfunction and premature atherosclerosis compared to age-matched controls?
Patients with a history of Kawasaki disease demonstrate persistent endothelial dysfunction and abnormal vascular parameters, highlighting the need for long-term cardiovascular follow-up.
Answers are grounded in this paper and cite their sources.
May warrant endothelial surveillance in Kawasaki survivors; leaves open atherosclerosis causality pending prospective data.
Background: Kawasaki disease, the commonest cause of multisystem vasculitis in children, was believed initially as a one-time disease. Long-term follow-up reveals that endothelial dysfunction persists in post-Kawasaki disease patients with and without coronary lesions and predisposes to atherosclerosis.Aims and Objectives: To establish the endothelial dysfunction and to correlate it with premature atherosclerosis in Kawasaki disease patients.Settings and Design: Prospective comparative study.Materials and Methods: Thirty patients of Kawasaki disease (age, 6 months to 20 years) were compared to the age matched control population and evaluated 2 times (1st F/U and 2nd F/U) at an interval of 6 months. USG Doppler was used to measure intimal thickness of carotid arteries CAD-IT, flow character and Resistive Index of anterior ATA-RI and posterior tibial arteries PTA-RI. Echocardiography was used to detect perivascular hyperintensity, dilatation and aneurysm of coronary arteries. Ongoing inflammation was documented by C- reactive protein (CRP) level. Coronary involvement (dilatation, small, medium, giant CAA) was determined by the z-scores adjusted to patients' body surface area (BSA) (AHA guidelines 2017).Statistical analysis used: Mean, paired t-test, GEE model, Odds ratio.Results: Significantly elevated CRP levels were observed in both the 1st follow up (p=0.0005) and 2nd follow up (p=0.000001) compared to control value. A significant rise (p<0.05) in total cholesterol, triglyceride levels, ATA-RI, PTA-RI and CAD-IT were seen. Seven patients developed coronary aneurysm of which three had persistent lesion.Conclusions: Kawasaki disease is not a one -time disease. Persistent endothelial dysfunction continues. CRP, total cholesterol, triglyceride, and USG doppler of coronary, carotids as well as peripheral arteries were found abnormal in follow up. So, these patients need to be followed up for a long period.
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Maity et al. (2022) conducted an observational in Kawasaki disease. Kawasaki disease vs. Age matched control population was evaluated on Endothelial dysfunction markers including CRP levels, lipid profile, and USG Doppler indices (p=0.0005). Kawasaki disease was associated with persistent endothelial dysfunction, evidenced by significantly elevated CRP (p=0.0005), cholesterol, triglycerides, and abnormal arterial Doppler indices compared to controls.
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