Are patients after Kawasaki disease at increased risk for accelerated atherosclerosis?

作者：Mccrindle Brian W^*; Mcintyre Susan; Kim Christopher; Lin Tammy; Adeli Khosrow

来源：Journal of Pediatrics, 2007, 151(3): 244-248.

DOI：10.1016/j.jpeds.2007.03.056

Objective To assess whether patients after Kawasaki disease (KD) have increased risk factors and abnormalities suggestive of early atherosclerosis in systemic arteries.
Study design. In a case-control study, we compared 52 patients after typical Kawasaki disease with varying coronary artery involvement (67% males; mean time from illness episode 11.2 +/- 3.7 years) studied between 10 and 20 years of age with 60 healthy control subjects (50% males). Brachial artery reactivity (BAR) was assessed using vascular ultrasonography, mid atherosclerosis risk assessment was performed. Differences between cases and controls and factors associated with endothelial OF function in cases were determined.
Results Case patients had lower resting systolic blood pressure (P < .001), lower apolipoprotein AI levels (P < .05), and higher levels of glycosylated hemoglobin (P = .007). There were no significant differences in BAR between case patients and control subjects in response to increased flow (P = .60) and nitroglycerine (P = .93). For case patients, significant factors in multivariable analysis for lower flow-mediated BAR included higher fasting triglyceride levels (P = .04) and lower free fatty acid levels (P < .001). No significant relationship was noted with past or current coronary artery involvement.
Conclusion Patients with KD have some abnormalities for risk factors for atherosclerosis, but systemic arterial endothelial dysfunction is not present in the long term.

• 出版日期2007-9