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已发表论文
川崎病合并中大型冠状动脉瘤患者冠状动脉血栓形成的年龄分层危险因素
Received 26 July 2025
Accepted for publication 27 October 2025
Published 4 November 2025 Volume 2025:18 Pages 15349—15355
DOI https://doi.org/10.2147/JIR.S553416
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Qing Lin
Junming Huo,1– 4 Yue Peng,2– 5 Pengfei Guo2– 4,6
1Department of Critical Care Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 5Department of Cardiovascular Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 6Department of Emergency Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
Correspondence: Pengfei Guo, Email gpf1956@163.com
Objective: To identify risk factors for coronary thrombosis in Kawasaki disease (KD) patients with medium-to-large coronary artery aneurysms (CAA) (stratified by age at disease onset).
Methods: This retrospective study analyzed 490 consecutive KD patients with medium-to-large CAA treated at Children’s Hospital of Chongqing Medical University. Demographic characteristics, initial treatment details, and follow-up echocardiographic data were collected. We divided KD patients into three categories according to age at disease onset: age < 12 months, aged 12– 47 months, and age > 47 months. Multivariable logistic regression models were employed to assess coronary thrombosis risk factors in different age groups.
Results: Analysis showed the risk of coronary thrombosis by age after adjustment for confounders. In patients younger than 12 months, multiple coronary artery involvement and the left anterior descending artery (LAD) involvement was associated with coronary thrombosis. In KD patients older than 47 months, large CAA and multiple coronary artery involvement was associated with coronary thrombosis, In KD patients aged 12– 47 months, male, intravenous immunoglobulin (IVIG) resistance, delayed IVIG initiation (> 10 days post-fever onset), multiple coronary artery involvement and LAD involvement was associated with coronary thrombosis.
Conclusion: For KD with medium-to-large CAA, independent risk factors besides multiple coronary artery involvement are stratified by age. These findings underscore the importance of age-specific risk stratification to optimize thromboprophylaxis and long-term management.
Keywords: Kawasaki disease, age, coronary thrombosis, risk factors
1Department of Critical Care Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 5Department of Cardiovascular Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 6Department of Emergency Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
Correspondence: Pengfei Guo, Email gpf1956@163.com
Objective: To identify risk factors for coronary thrombosis in Kawasaki disease (KD) patients with medium-to-large coronary artery aneurysms (CAA) (stratified by age at disease onset).
Methods: This retrospective study analyzed 490 consecutive KD patients with medium-to-large CAA treated at Children’s Hospital of Chongqing Medical University. Demographic characteristics, initial treatment details, and follow-up echocardiographic data were collected. We divided KD patients into three categories according to age at disease onset: age < 12 months, aged 12– 47 months, and age > 47 months. Multivariable logistic regression models were employed to assess coronary thrombosis risk factors in different age groups.
Results: Analysis showed the risk of coronary thrombosis by age after adjustment for confounders. In patients younger than 12 months, multiple coronary artery involvement and the left anterior descending artery (LAD) involvement was associated with coronary thrombosis. In KD patients older than 47 months, large CAA and multiple coronary artery involvement was associated with coronary thrombosis, In KD patients aged 12– 47 months, male, intravenous immunoglobulin (IVIG) resistance, delayed IVIG initiation (> 10 days post-fever onset), multiple coronary artery involvement and LAD involvement was associated with coronary thrombosis.
Conclusion: For KD with medium-to-large CAA, independent risk factors besides multiple coronary artery involvement are stratified by age. These findings underscore the importance of age-specific risk stratification to optimize thromboprophylaxis and long-term management.
Keywords: Kawasaki disease, age, coronary thrombosis, risk factors