Increased high sensitivity C reactive protein concentrations and increased arterial stiffness in children with a history of Kawasaki disease.
OBJECTIVE
To test the hypothesis that low grade inflammation persists after the acute phase and affects arterial stiffness in children with a history of Kawasaki disease.


METHODS
A cohort of 106 children was studied, which comprised 43 patients with Kawasaki disease with coronary aneurysms (group I), 28 patients with Kawasaki disease with normal coronary arteries (group II), and 35 healthy age matched children (group III). Their systemic blood pressure, fasting cholesterol concentrations, serum high sensitivity C reactive protein (hs-CRP) concentrations, and carotid artery stiffness index were compared. Significant determinants of serum hs-CRP concentration and carotid artery stiffness were identified and the relation between hs-CRP concentration and arterial stiffness was investigated.


METHODS
Tertiary paediatric cardiac centre.


RESULTS
Serum hs-CRP concentration of group I patients (median 0.39 mg/l, interquartile range 0.28-0.65 mg/l) was significantly greater than that of group II (median 0.24 mg/l, interquartile range 0.17-0.29 mg/l, p < 0.001) and of group III patients (median 0.25 mg/l, interquartile range 0.18-0.40 mg/l, p < 0.01). Likewise, carotid artery stiffness index of group I patients (mean (SD) 5.07 (1.11)) was significantly greater than that of group II (4.27 (0.83), p = 0.002), and of group III patients (4.24 (0.86), p = 0.001). For the entire cohort, the carotid artery stiffness index correlated positively with log serum hs-CRP concentration (r = 0.24, p = 0.013). In multiple linear regression analysis, age (standardised beta = 0.22, p = 0.02), systolic blood pressure (standardised beta = 0.28, p = 0.01), log serum hs-CRP concentration (standardised beta = 0.21, p = 0.017), and patient grouping (standardised beta = -0.36, p < 0.001) were all independently associated with the carotid artery stiffness index.


CONCLUSIONS
These findings support the possibility of ongoing low grade inflammation late after the acute phase of Kawasaki disease in patients with coronary aneurysms. Furthermore, this low grade inflammation may have a role in increasing systemic arterial stiffness.
Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Grantham Hospital, The University of Hong Kong, 125 Wong Chuk Hang Road, Hong Kong, China. xfcheung@hkucc.hku.hk
Y F
YF
Cheung
M H K
MH
Ho
S C F
SC
Tam
T C
TC
Yung
D002097:C-Reactive Protein / Q000378:metabolism*; D002339:Carotid Arteries / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003323:Coronary Aneurysm / Q000097:blood / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology
D002097:C-Reactive Protein; D002784:Cholesterol