About other Journals and Publications - Changes in platelet count and risk for having coronary artery anomalies in Kawasaki Disease

Abstract

Introduction
The platelet count is considered a biomarker for the development of coronary artery abnormalities in patients with Kawasaki disease (KD). However, previous studies have reported inconsistent results. In this study, researchers address the controversial association of platelet count and coronary artery abnormalities, using a large-scale data set.

Methodology
A retrospective cohort study was conducted, using data from Kawasaki Disease (KD) surveys from Japan (2015–2016; n = 25,448). Patients were classified according to response to treatment with intravenous immunoglobulin (IVIG) and trends in platelet count were described using the lowest and highest values ​​along with specific days of disease. A multivariate logistic regression analysis was performed to assess the association between platelet count and coronary artery abnormalities, adjusting for relevant factors.

Results
Platelet count decreased rapidly since admission, reaching the lowest count between 6 -7 days and peaking after 10 days. The platelet count in IVIG non-responders decreased with a lower trough value than IVIG responders, but subsequently rebounded toward a higher maximum. Compared with patients with normal platelet counts (150–450-109 / L), patients with abnormally high platelet counts (> 450x109 / L) were more likely to have coronary artery abnormalities on admission (ratio of adjusted odds: IVIG responders, 1.50 [95% confidence interval 1.20–1.87] and non-responders, 1.46 [1.01–2.12]). In contrast, IVIG nonresponders whose platelet counts were below normal (150 x 109 / L) after hospitalization were at increased risk of developing coronary artery abnormalities (2.27 [1.44 -3.58]).

Conclusions
The researchers conclude that the platelet count varied widely based on the day of illness and was confused by the responsiveness of IVIG, which may have contributed to the previous inconsistent findings. KD patients with abnormally high platelet counts on admission or with abnormally low counts after hospitalization were at increased risk of coronary abnormalities.