Analysis of risk factors for medium–giant coronary artery aneurysms in children with Kawasaki disease

Abstract Background: Our study aimed to explore risk factors for medium–giant coronary artery aneurysms in children with Kawasaki disease. Methods: 6,540 eligible children with Kawasaki disease who were diagnosed in Wuhan Children’s Hospital from January 2011 to December 2023 were retrospectively analysed. The clinical and laboratory data were compared between medium–giant group and non–medium–giant group. Results: A total of 6,540 patients with Kawasaki disease were included, and 162 (2.5%) developed medium–giant coronary artery aneurysms, of whom 56 (0.9%) were giant. Univariate analysis showed a statistically significant difference between the two groups in 22 variables ( P < 0.05). The least absolute shrinkage and selection operator regression analysis revealed that intravenous immunoglobulin resistance, haemoglobin, platelet count, and albumin were the most significant risk factors for medium–giant coronary artery aneurysms. The result of binary logistic regression analysis showed that intravenous immunoglobulin resistance (OR = 6.474, 95%CI = 4.399 ∼ 9.528, P < 0.001), platelet count elevation (OR = 1.003, 95%CI = 1.002 ∼ 1.004, P < 0.001), and albumin reduction (OR = 0.912, 95%CI = 0.879 ∼ 0.946, P < 0.001) were independent risk factors affecting the occurrence of medium–giant coronary artery aneurysms, and the area under the curve of the regression model was 0.75, with a sensitivity of 62.3% and a specificity of 79.2%. Conclusions: Intravenous immunoglobulin resistance, platelet counts elevation, and albumin levels reduction may be significant predictors of medium–giant coronary artery aneurysms and can serve as a reference for early diagnosis of medium–giant coronary artery aneurysms.