Key result
NT-proBNP predicts coronary artery lesions in acute Kawasaki disease with ~84% sensitivity.
Why the study?
No single useful marker exists for predicting coronary artery lesions in Kawasaki disease, despite recent reports suggesting NT-proBNP could serve as a predictive biomarker.
Does NT-proBNP measurement predict coronary artery lesions in children with acute Kawasaki disease?
Meta-Analysis (n=861)
Does NT-proBNP measurement predict coronary artery lesions in children with acute Kawasaki disease?
Odds Ratio: 13.52 (95% CI 6.98–26.21)
NT-proBNP demonstrates good diagnostic sensitivity and moderate specificity for predicting coronary artery lesions in the acute phase of Kawasaki disease.
NT-proBNP shows moderate diagnostic accuracy for CAL in acute KD; leaves open standardization and prospective validation before routine use.
Coronary artery lesion (CAL) caused by Kawasaki disease (KD) is currently the most common acquired heart disease in children in many countries. Nevertheless, there is no single useful marker existing for predicting CAL of KD. Recently, many reports have noted that N-terminal pro-brain natriuretic peptide (NT-proBNP) can be utilized as a biomarker to predict CAL. Thus, we perform a meta-analysis to ascertain the diagnostic value of NT-proBNP in detecting CAL of KD in the acute phase. PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, and China National Knowledge Infrastructure were searched to detect relevant publications. Finally, eight eligible studies were included. The overall diagnostic sensitivity and specificity were 0.84 (95% confidence interval [CI]: 0.78-0.89) and 0.71 (95% CI: 0.68-0.75), respectively. The area under the summary receiver operating characteristic curves value (SROC) curve was 0.8582 ± 0.0531. Moreover, the overall sensitivity and specificity across five studies adopted the threshold of approximately 900 ng/L were 0.82 (95% CI: 0.73-0.89) and 0.72 (95% CI: 0.68-0.76), respectively. SROC was 0.8868 ± 0.0486. This meta-analysis would be the first one to describe the role of NT-proBNP in detecting CAL of KD. We register this study with PROSPERO (CRD42019130083).
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Zheng et al. (2020) conducted a meta-analysis in Kawasaki disease with coronary artery lesion (n=861). NT-proBNP vs. Non-CAL patients was evaluated on Diagnostic accuracy of NT-proBNP for detecting coronary artery lesions (DOR 13.52, 95% CI 6.98-26.21). NT-proBNP demonstrated high diagnostic value for predicting coronary artery lesions in acute Kawasaki disease, with an overall sensitivity of 0.84, specificity of 0.71, and a diagnostic OR of 13.52.
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