Novel and traditional cardiovascular risk factors in children after Kawasaki disease: implications for premature atherosclerosis.
OBJECTIVE
We determined the profile of cardiovascular risk factors in children late after Kawasaki disease (KD) and compared it with that of age-matched healthy children.


BACKGROUND
Concerns have been raised regarding the possibility of a predisposition of KD to premature atherosclerosis later in life.


METHODS
A cohort of 102 subjects were studied: 37 KD patients with coronary aneurysms (group I), 29 KD patients with normal coronary arteries (group II), and 36 healthy age-matched children (group III). The fasting total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo) A-I, apoB, and homocysteine levels were compared among the three groups. In addition, blood pressure and brachioradial arterial stiffness, as determined by pulse wave velocity (PWV), were measured and compared.


RESULTS
Group I subjects had lower HDL cholesterol (p = 0.016) and apoA-I levels (p = 0.044) and higher apoB levels (p = 0.029) and PWV (p = 0.001) than group III control subjects. Likewise, the apoB levels (p = 0.007) and PWV (p = 0.042) were higher in group II than in III subjects, although their HDL cholesterol (p = 0.54) and apoA-I (p = 0.52) levels were similar. The LDL cholesterol levels were higher in group I and II patients than in controls, although not statistically significant (p = 0.17). Blood pressure and homocysteine levels did not differ among the groups.


CONCLUSIONS
An adverse cardiovascular risk profile, as characterized by a proatherogenic alteration of the lipid profile and increased arterial stiffness, occurs in children after KD. The profile is worse in those with than in those without coronary aneurysms.
Cheung
Yiu-fai
YF
Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Grantham Hospital, University of Hong Kong, Hong Kong, China. xfcheung@hkucc.hku.hk
Yung
Tak-cheung
TC
Tam
Sidney C F
SC
Ho
Marco H K
MH
Chau
Adolphus K T
AK
D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications*; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL