Risk Factors for Coronary Artery Aneurysm in Children with Kawasaki Disease: A Case-control Study

Abstract

Coronary artery aneurysms (CAA) are common in children with Kawasaki disease (KD) who have delayed diagnosis. This can increase the high cardiovascular burden and cause acquired heart defects in adulthood. This study aims to investigate the risk factors for CAA in children with KD. An observational retrospective case-control study was carried out in Surabaya Tertiary Hospital. We collected the medical records in the child care installation, Pediatrics ward, from 2016 to 2019. The research participants were pediatric patients who were treated with KD. The exclusion criteria were incomplete medical record data regarding the risk factors studied. The risk factors studied included age, sex, duration of fever, haemoglobin, leukocytes levels, platelets levels, C-reactive protein (CRP), and albumin levels. Twenty-eight medical records of children with KD were collected in this study; only 17 eligible patients were observed. The confirmed CAA was found in 8 patients, while 9 patients were non-CAA aged ranging from 3-124 months. Almost 60% of patients had fever duration > 7 days, and 47.1% of patients had hemoglobin <10 g/dL. Platelets were the only risk factor that had a significant correlation for developing CAA in children with KD, with a p-value of 0.015 at a 95% confidence interval (CI), odds ratio (OR) of 24 (1.785 – 336.227). Almost half of KD patients in this study were at risk for developing CAA; platelet value was a risk factor that we could consider in the administration of aspirin and IVIG therapy, providing the follow-up results and evaluating aneurysm progression or regression after IVIG administration is needed to prevent poor long-term outcomes.