Assessment of the validity of cardiac biomarkers in the Kawasaki patients

Abstract

Kawasaki is one of the most prevalent acute febrile vasculitis in childhood which is known as the main cause of the acquired heart disease among children. A lot of endeavors have been made for using laboratory tests for diagnosis of heart involvement in this disease but the studies for using biomarkers for this goal is limited. Therefore, the aim of this study is the evaluation of the diagnostic value of serum cardiac troponin I (CTNI) and N-terminal pro-brain natriuretic peptide (Pro-BNP) in heart injuries of children with Kawasaki disease. Methods & Materials: Through a descriptive cross-sectional study, all patients with a diagnosis of Kawasaki disease admitted in the teaching center of Shahid Madani hospital of Tabriz during 2015-2016 were included. Echocardiography was performed for all patients and demographic features and serum CTNI and Pro-BNP levels were recorded. Analysis of the data was done by SPSS version 22.

Results: An overall 32 cases were evaluated which 24 patients (75%) were male and 8 patients (25%) were female. Mean age was 3.38 +/- 1.96. Cardiac involvement was present in 4 patients (12.5%) including 3 patients with perivascular brightness of coronary arteries and one patient with a small aneurysm of coronary arteries. CTNI was normal for all patients but Pro-BNP was increased in all patients and its mean was 1042.722 +/- 1264.96 pg/ml (median= 678.5, range 220 – 5735 pg/ml). Pro-BNP was 660.8 +/- 352.8 in patients without cardiac involvement and 3716 +/- 2114.3 in the group of patients with cardiac involvement (p=0.001). The optimal cutoff point was calculated to be at Pro-BNP of 1354 pg/ml which had both sensitivity and specificity of about 100%.