Analysis On High Risk Factors Of Giant Coronary Artery Aneurysms Complicated With Kawasaki Disease In36Cases

Objective To investigate the high risk factors of giant coronary arteryaneurysms (GCAA) complicated with Kawasaki disease (KD) and toprovide references for prevention and follow up of GCAA.Methods Totally3726patients with KD from September2003toNovember2012in our hospital were enrolled including36patientscomplicated with GCAA (GCAA group),90patients complicated withsmall or medium coronary artery aneurysms(CAA,76patients wereselected randomly as small or medium CAA group),1231patientscomplicated with coronary artery dilation(CAD,304patients were selectedrandomly as CAD group) and2369patients with non coronary arterylesion (NCAL,216patients were selected randomly as NCAL group).Statistical description of epidemiological data and cardiac involvement ofpatients in the four groups was made. Chi-square test was used to analyzethe possible risk factors of GCAA. Multiple Logistic regression analysiswas performed to estimate the OR and95%CI for the risk factors. Results In the GCAA, small or medium CAA, CAD, NCAL group,the numbers of male, female cases were28and8,54and22,212and92,113and103, respectively; their average age were (4.4±3.8)Years,(2.8±2.6)Years,(2.4±1.9)Years,(3.0±2.2)Years, respectively. Chi-square testshowed that the factors of age <1Year or≥5Years, febrile days>14d,white blood cell counts≥20.00×109/L, platelet counts≥800×109/L,hemoglobin <90g/L, lower hematokrit, C-reactive peptide(CRP)>100mg/L, erythrocyte sedimentation rate (ESR)>100mm/h,accepting the first intravenous immunoglobulin (IVIG) until the11d afterfinishing the disease course, insensitivity to initial treatment with IVIGwere associated with CAA. Multiple Logistic regression analysis showedthat febrile days>14d [OR=3.981,95%CI(1.571，10.087), P=0.004]，ESR>100mm/h [OR=3.206,95%CI(1.271，8.088), P=0.014], were theindependent risk factors of GCAA.Conclusions Febrile days>14d, ESR>100mm/h are the independentrisk factors of GCAA.