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Predictive value of red blood cell distribution width for coronary artery lesions in patients with Kawasaki disease

Published online by Cambridge University Press:  05 October 2015

Haiyan Xu
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Songling Fu
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Wei Wang
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Qing Zhang
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Jian Hu
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Lichao Gao
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Weihua Zhu
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Fangqi Gong*
Affiliation:
Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
*
Correspondence to: Dr F. Gong, PhD, MD Children’s Hospital, Zhejiang University School of Medicine, No.57, Zhugan Lane, Hangzhou 310003, PR China. Tel: +86-571-87073271, Fax: +86-571-87033296, E-mail: gongfangqi@zju.edu.cn

Abstract

Recent studies have shown that elevated red blood cell distribution width is associated with poor outcome in cardiovascular diseases. In order to assess the predictive value of red blood cell distribution width, before treatment with intravenous immunoglobulins, for coronary artery lesions in patient with Kawasaki disease, we compared 83 patients with coronary artery lesions and 339 patients without coronary artery lesions before treatment with intravenous immunoglobulin. Clinical, echocardiographic, and biochemical values were evaluated along with red blood cell distribution width. A total of 422 consecutive patients with Kawasaki disease were enrolled into our study. According to receiver operating characteristic curve analysis, the optimal red blood cell distribution width cut-off value for predicting coronary artery lesions was 14.55% (area under the curve was 0.721; p=0.000); eighty-three patients (19.7%) had coronary artery lesions, and 70% of the patients with coronary artery lesions had red blood cell distribution width level >14.55%. Logistic regression analysis revealed that fever duration >14 days (odds ratio was 3.42, 95% confidence interval was 1.27–9.22; p=0.015), intravenous immunoglobulin resistance (odds ratio was 2.33, 95% confidence interval was 1.02–5.29; p=0.04), and red blood cell distribution width >14.55% (odds ratio was 3.49, 95% confidence interval was 2.01–6.05; p=0.000) were independent predictors of coronary artery lesions in patients with Kawasaki disease. In Conclusion, red blood cell distribution width may be helpful for predicting coronary artery lesions in patients with Kawasaki disease.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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Footnotes

*

Xu H and Fu S contributed equally to this paper.

References

1. Kawasaki, T. Acute febrile mucocutaneous lymph node syndrome: clinical observations of 50 cases. Jpn J Allergy 1967; 16: 178222.Google Scholar
2. Kawasaki, T, Kosai, F, Okawa, S, Shigematsu, I, Yanagawa, H. A new infantile acute febrile mucocutaneous lymph node syndrome (MCLS) prevailing in Japan. Pediatrics 1974; 54: 271276.CrossRefGoogle ScholarPubMed
3. Kuo, HC, Wang, CL, Liang, CD, et al. Association of lower eosinophil-related T helper2(Th2) cytokines with coronary artery lesions in Kawasaki disease. Pediatr Allergy Immunol 2009; 20: 266272.Google Scholar
4. Wang, Y, Wang, W, Gong, F, et al. Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis Rheum 2013; 65: 805814.CrossRefGoogle ScholarPubMed
5. Qi, Y, Gong, F, Zhang, Q, Xie, C, Wang, W, Fu, S. Reverse regulation of soluble receptor for advanced glycation end products and proinflammatory factory resistin and S100A12 in Kawasaki disease. Arthritis Res Ther 2012; 14: R251.Google Scholar
6. Gong, F, Zhang, Y, Xie, C, et al. The expression of receptor for advanced glycation end products on circulating endothelial cells surface is upregulated in Kawasaki Disease. Pediatr Res 2012; 71: 720724.Google Scholar
7. Fu, S, Gong, F, Xie, C, et al. S100A12 on circulating endothelial cells surface in children with Kawasaki Disease. Pediatr Res 2010; 68: 165168.Google Scholar
8. Kobayashi, T, Inoue, Y, Takeuchi, K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation 2006; 113: 26062612.CrossRefGoogle ScholarPubMed
9. Aung, N, Ling, HZ, Cheng, AS, et al. Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure. Int J Cardiol 2013; 168: 19972002.CrossRefGoogle ScholarPubMed
10. Seyhan, EC, Özgül, MA, Tutar, N, Ömür, I, Uysal, A, Altın, S. Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD 2013; 10: 416424.CrossRefGoogle ScholarPubMed
11. Veeranna, V, Zalawadiya, SK, Panaich, S, Patel, KV, Afonso, L. Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: findings from the 1999-2004 NHANES. Int J Cardiol 2013; 168: 51565161.CrossRefGoogle ScholarPubMed
12. Zorlu, A, Bektasoglu, G, Guven, FMK, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol 2012; 109: 128134.CrossRefGoogle ScholarPubMed
13. Ayusawa, M, Sonobe, T, Uemura, S, et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int 2005; 7: 232234.CrossRefGoogle Scholar
14. Rhodes, CJ, Wharton, J, Howard, LS, Gibbs, JSR, Wilkins, MR. Red cell distribution width outperforms other potential circulating biomarkers in predicting survival in idiopathic pulmonary arterial hypertension. Heart 2011; 97: 10541060.CrossRefGoogle ScholarPubMed
15. Wang, YL, Hua, Q, Bai, CR, Tang, Q. Relationship between red cell distribution width and short-term outcomes in acute coronary syndrome in a Chinese population. Intern Med 2011; 50: 29412945.CrossRefGoogle ScholarPubMed
16. Núňez, J, Núňez, E, Rizopoulos, D, et al. Red blood cell distribution width is longitudinally associated with mortality and anemia in heart failure patients. Circ J 2014; 78: 410418.Google Scholar
17. Felker, GM, Allen, LA, Pocock, SJ, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007; 50: 4047.Google Scholar
18. Semba, RD, Patel, KV, Ferrucci, L, et al. Serum antioxidants and inflammation predict red cell distribution width in older women: the Women’s Health and Aging Study I. Clin Nutr 2010; 29: 600604.CrossRefGoogle ScholarPubMed
19. Friedman, JS, Lopez, MF, Fleming, MD, et al. SOD2-deficiency anemia: protein oxidation and altered protein expression reveal targets of damage, stress response, and antioxidant responsiveness. Blood 2004; 104: 25652573.CrossRefGoogle ScholarPubMed
20. Lippi, G, Targher, G, Montagnana, M, Salvagno, GL, Zoppini, G, Guidi, GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009; 133: 628632.CrossRefGoogle Scholar
21. Tsuboi, S, Miyauchi, K, Kasai, T, et al. Impact of red blood cell distribution width on long-term mortality in diabetic patients after percutaneous coronary intervention. Circ J 2013; 77: 456461.Google Scholar
22. Ye, Z, Smith, C, Kullo, IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol 2011; 107: 12411245.CrossRefGoogle ScholarPubMed
23. Zalawadiya, SK, Veeranna, V, Panaich, SS, Afonso, L. Red cell distribution width and risk of peripheral artery disease: analysis of National Health and Nutrition Examination Survey 1999–2004. Vasc Med 2012; 17: 155163.Google Scholar
24. Akyel, A, Çelik, İE, Öksüz, F, et al. Red blood cell distribution width in saphenous vein graft disease. Can J Cardiol 2013; 29: 448451.CrossRefGoogle ScholarPubMed
25. Weiss, G, Goodnough, LT. Anemia of chronic disease. N Engl J Med 2005; 52: 10111023.CrossRefGoogle Scholar
26. Park, KI, Kim, KY. Clinical evaluation of red cell volume distribution width (RDW). Yonsei Med J 1987; 28: 282290.CrossRefGoogle ScholarPubMed
27. Patel, KV, Mohanty, JG, Kanapuru, B, Hesdorffer, C, Ershler, WB, Rifkind, JM. Association of the red cell distribution width with red blood cell deformability. Adv Exp Med Biol 2013; 765: 211216.CrossRefGoogle ScholarPubMed
28. Minetti, M, Agati, L, Malorni, W. The microenvironment can shift erythrocytes from a friendly to a harmful behavior: pathogenetic implications for vascular diseases. Cardiovasc Res 2007; 75: 2128.Google Scholar
29. Patel, KV, Semba, RD, Ferrucci, L, et al. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A-Biol 2009; 65: 258265.Google ScholarPubMed
30. Perlstein, TS, Weuve, J, Pfeffer, MA, Beckman, JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009; 169: 588594.CrossRefGoogle Scholar
31. Patel, KV, Ferrucci, L, Ershler, WB, Longo, DL, Guralnik, JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009; 169: 515523.CrossRefGoogle ScholarPubMed