title: Cardiovascular status after Kawasaki disease in the UK.
abstract: OBJECTIVE
  Kawasaki disease (KD) is an acute vasculitis that causes coronary artery aneurysms (CAA) in young children. Previous studies have emphasised poor long-term outcomes for those with severe CAA. Little is known about the fate of those without CAA or patients with regressed CAA. We aimed to study long-term cardiovascular status after KD by examining the relationship between coronary artery (CA) status, endothelial injury, systemic inflammatory markers, cardiovascular risk factors (CRF), pulse-wave velocity (PWV) and carotid intima media thickness (cIMT) after KD.
  
  
  METHODS
  Circulating endothelial cells (CECs), endothelial microparticles (EMPs), soluble cell-adhesion molecules cytokines, CRF, PWV and cIMT were compared between patients with KD and healthy controls (HC). CA status of the patients with KD was classified as CAA present (CAA+) or absent (CAA-) according to their worst-ever CA status. Data are median (range).
  
  
  RESULTS
  Ninety-two KD subjects were studied, aged 11.9 years (4.3-32.2), 8.3 years (1.0-30.7) from KD diagnosis. 54 (59%) were CAA-, and 38 (41%) were CAA+. There were 51 demographically similar HC. Patients with KD had higher CECs than HC (p=0.00003), most evident in the CAA+ group (p=0.00009), but also higher in the CAA- group than HC (p=0.0010). Patients with persistent CAA had the highest CECs, but even those with regressed CAA had higher CECs than HC (p=0.011). CD105 EMPs were also higher in the KD group versus HC (p=0.04), particularly in the CAA+ group (p=0.02), with similar findings for soluble vascular cell adhesion molecule 1 and soluble intercellular adhesion molecule 1. There was no difference in PWV, cIMT, CRF or in markers of systemic inflammation in the patients with KD (CAA+ or CAA-) compared with HC.
  
  
  CONCLUSIONS
  Markers of endothelial injury persist for years after KD, including in a subset of patients without CAA.
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: V
authors: V
authors: Shah
authors: Department of Paediatric Cardiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors: G
authors: G
authors: Christov
authors: Department of Paediatric Cardiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors: T
authors: T
authors: Mukasa
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: K S
authors: KS
authors: Brogan
authors: Department of Clinical Epidemiology, Nutrition and Biostatistics Section, UCL Institute of Child Health, London, UK.
authors: A
authors: A
authors: Wade
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: D
authors: D
authors: Eleftheriou
authors: Paediatric Infectious diseases group, Division of Medicine, Imperial College London, London, UK.
authors: M
authors: M
authors: Levin
authors: Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, UK.
authors: R M
authors: RM
authors: Tulloh
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: B
authors: B
authors: Almeida
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: M J
authors: MJ
authors: Dillon
authors: Department of Paediatric Cardiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
authors: J
authors: J
authors: Marek
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: N
authors: N
authors: Klein
authors: Infection, Inflammation and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: P A
authors: PA
authors: Brogan
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D063177:Pulse Wave Analysis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers