[II-JCKAP2-2] Predicting coronary artery abnormalities development using coronary Z-score and clinical parameters before the treatment for Kawasaki disease
キーワード：Kawasaki Disease, coronary artery aneurysms, coronary artery Z-score
Objective: We aimed to construct a predictive score for the development of coronary artery aneurysms (CAA) using indicators before IVIG treatment for Kawasaki disease(KD).
Methods: We retrospectively reviewed 1,230 patients who developed KD between April 2009 and March 2020 and were treated at 8 hospitals in the Clinical Research Network of the Wakayama KD Study Group using the same protocol as our hospital. The medical records of all enrolled patients were retrospectively reviewed, including demographics, echocardiographic findings before treatment, and laboratory tests on admission. Echocardiography data were reviewed retrospectively before treatment (Pre) and around 4 weeks after onset (Post), and the maximum Z-score of each of the 3 coronary artery branches (excluding LMCA) was defined as Zmax, respectively. CAA was defined as Post-Zmax >= 2.5, and risk factors for developing CAA were statistically examined. From April 2020 to September 2023, an additional 321 patients were treated at same 8 hospitals and reviewed retrospectively to test accuracy of prediction.
Results: We identified independent three risk factors associated with the development of CAA: Pre-Zmax, low albumin, and infants younger than 1 year of age. Our predictive model (CAA risk score >= 2 points) are classified into a high-risk group for developing CAA (sensitivity 84%, specificity 61%).
Conclusion: Our results suggest that initial intensive treatment might be considered based on not only the risk scores of IVIG resistance but also CAA risk scores.
Methods: We retrospectively reviewed 1,230 patients who developed KD between April 2009 and March 2020 and were treated at 8 hospitals in the Clinical Research Network of the Wakayama KD Study Group using the same protocol as our hospital. The medical records of all enrolled patients were retrospectively reviewed, including demographics, echocardiographic findings before treatment, and laboratory tests on admission. Echocardiography data were reviewed retrospectively before treatment (Pre) and around 4 weeks after onset (Post), and the maximum Z-score of each of the 3 coronary artery branches (excluding LMCA) was defined as Zmax, respectively. CAA was defined as Post-Zmax >= 2.5, and risk factors for developing CAA were statistically examined. From April 2020 to September 2023, an additional 321 patients were treated at same 8 hospitals and reviewed retrospectively to test accuracy of prediction.
Results: We identified independent three risk factors associated with the development of CAA: Pre-Zmax, low albumin, and infants younger than 1 year of age. Our predictive model (CAA risk score >= 2 points) are classified into a high-risk group for developing CAA (sensitivity 84%, specificity 61%).
Conclusion: Our results suggest that initial intensive treatment might be considered based on not only the risk scores of IVIG resistance but also CAA risk scores.