title: N-terminal pro-brain natriuretic peptide and risk of coronary artery lesions and resistance to intravenous immunoglobulin in Kawasaki disease.
abstract: OBJECTIVE
  To determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) can be a useful marker not only to identify the patients with Kawasaki disease (KD) who are at a higher risk of developing coronary artery lesions (CAL), and predict resistance to intravenous immunoglobulin (IVIG).
  
  
  METHODS
  We enrolled 80 patients with the acute phase of KD at a single center. The demographic, clinical, and laboratory data were prospectively collected.
  
  
  RESULTS
  Nineteen of the 80 patients developed CAL, despite IVIG administration. They had a significantly higher serum NT-proBNP level in comparison with the patients without CAL. The NT-proBNP cut-off value of 1300 pg/mL yielded a sensitivity of 95% and a specificity of 85% for predicting CAL. However, 17 of the 80 patients were IVIG non-responders. They also had a significantly higher serum NT-proBNP level in comparison with the IVIG responders. The NT-proBNP cut-off value of 800 pg/mL yielded a sensitivity of 71% and a specificity of 62% for predicting IVIG non-responders.
  
  
  CONCLUSIONS
  The serum NT-proBNP level is increased in children with KD with CAL and IVIG resistance. It may be useful to predict CAL and IVIG resistance in KD.
authors.affiliation: Department of Pediatrics, Kansai Medical University, Osaka, Japan. yoshimuk@hirakata.kmu.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kimata
authors.forename: Kenji
authors.initials: K
authors.lastname: Mine
authors.forename: Takamichi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsuji
authors.forename: Kazunari
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000150:complications / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain