Background KD is a leading cause of acquired heart disease in children in developed countries mostly because of its coronary artery complications. Patient age has been mentioned among other risk factors for coronary artery lesions (CALs) such as male gender, recurrent cases, late IVIG treatment, and refractoriness to initial IVIG treatment. Still there is no consensus about influence of the patient age on the complications of KD.
Objectives The medical records of 168 KD patients in the age of 1 month 13 days-13 years 6 months treated in the University Children's Clinical Hospital from 2003 to 2014 were reviewed. 24 (14,29%) of them were <6 months, 31 (18,45%) - 6-<12 months, 94 (55,95%) - 12 months-<5 years, 19 (11,31%) - ≥5 years. To evaluate the contribution of patient age to the development of CALs clinical, laboratory data and IVIG treatment were analyzed.
Methods The presence of CALs was measured using 2-DE performed at 8 weeks after disease onset. The patients' data were compared between two groups: patients with or without CALs at 8 weeks after disease onset. Differences were tested using the Mann-Whitney test, Fisher's exact test, chi-square, Student's t-test. The odds ratios (ORs) with 95% confidence intervals (CIs) for the presence of CALs were determined by multiple logistic regression models.
Results The age group, natural logarithm of patient age, the total duration of fever, pre-IVIG fever duration, anemia in a acute phase, leukocytosis more than 17x109/l in acute phase, thrombocytosis, elevated ESR, more than 5 times elevated CRP, diagnostics terms, the day of IVIG introduction were significant separately and in joint models. The effect of interaction was noted in the analysis of influence of fever duration in different age groups. For example, chances to have CALs with each day of high temperature increased in different degree for patients of different age groups: for children <6 months – by 1,32 times, for children of 5 years and older – by 1,02 times (1,3 times less).
Conclusions Patient age is an important independent risk factor for CALs. It can also modify the action of the other factors.
Disclosure of Interest None declared