PS-C05-8: ERYTHROCYTE SEDIMENTATION RATE LEVELS AND ITS ASSOCIATION WITH CORONARY ARTERY INVOLVEMENT IN KAWASAKI DISEASE

Abstract

Objectives: The general objective of this study is to determine association of ESR with cardiovascular involvement in Kawasaki Disease (KD) patients. Specific Objectives: Design and method: This is a cross sectional study conducted at National Childrens Hospital (NCH), a tertiary pediatric hospital. Data was gathered using charts from the medical records of patients diagnosed with KD. Study population included patients diagnosed with KD with classical presentation from year 2013–2018. The diagnostic criteria for KD require presence of fever for five days or more and at least four of five of the following: bilateral conjunctival infection without exudates, polymorphous exanthema, strawberry tongue, desquamation of palms and soles, and cervical lymphadenopathy. ESR levels were recorded both as a numerical variable and categorical variable based on the level (below 80 mm/hr, more than 80 mm/hr). Patients with coronary artery involvement included perivascular brightness, coronary artery dilatation, or coronary aneurysm on two-dimensional echocardiography done during admission for KD. Descriptive statistics was done using frequency and percentages for categorical variables, and standard deviations for continuous variables was calculated to describe the profile of the respondents. Determination of the association between ESR and CAD among KD patients was analyzed using Chi square test and stratified analysis. Odds ratio and the 95% confidence interval was also calculated. Significance was set at p value of < 0.05. Results: Of the 116 patients, 72.4% of the population were noted to have cardiac involvement and 50% had coronary artery involvement. The most common coronary artery involvement was on the proximal right coronary artery. Moreover, pericardial effusion and valvular regurgitation mostly involving the mitral valve were the most common cardiac involvement. In the population, 61 (52.6%) were male, and 26 (42.6%) of which developed CAD however no correlation between sex and CAD was revealed. Conclusion: This study showed no correlation between the level of ESR and the development of CAD. It is not recommended to obtain ESR in patients who qualify as complete KD. Hence the study does not support the practice of obtaining ESR upon admission of KD patients. Further studies on the association of ESR with CAD with higher sample size and adjusting for other confounding variables are needed.