Published Online
on December 20, 2004

A more recent version of this article appeared on January 4, 2005

This Article Full Text (PDF) All Versions of this Article: 111/1/38    most recent 01.CIR.0000151311.38708.29v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mitani, Y. Articles by Komada, Y. Search for Related Content PubMed PubMed Citation Articles by Mitani, Y. Articles by Komada, Y. Related Collections Risk Factors Other arteriosclerosis Chronic ischemic heart disease Oxidant stress

Submitted on April 6, 2004
Revised on September 28, 2004
Accepted on September 30, 2004

Elevated Levels of High-Sensitivity C-Reactive Protein and Serum Amyloid-A Late After Kawasaki Disease. Association Between Inflammation and Late Coronary Sequelae in Kawasaki Disease

Yoshihide Mitani MD, PhD^*, Hirofumi Sawada MD, Hidetoshi Hayakawa MD, PhD, Kenzo Aoki MD, PhD, Hiroyuki Ohashi MD, Masahiko Matsumura MD, PhD, Kenji Kuroe MD, Hideto Shimpo MD, PhD, Masataka Nakano PhD, and Yoshihiro Komada MD, PhD

From the Department of Pediatrics, Mie University School of Medicine, Tsu, Mie (Y.M., H.S., Y.K.); the Department of Pediatrics, Yamada Red Cross Hospital, Watarai, Mie (H.H.); the Department of Pediatrics, Matsusaka City Hospital, Matsusaka, Mie (K.A., H.O.); the Department of Pediatrics, Tenri Hospital, Tenri, Nara (M.M.); the Department of Cardiology, Hyogo Children’s Hospital, Kobe, Hyogo (K.K.); the Department of Thoracic Cardiovascular Surgery, Mie University School of Medicine, Tsu, Mie (H.S.); and the Department of Community Nursing, Mie University School of Nursing, Tsu, Mie (M.N.), Japan.

^* To whom correspondence should be addressed. E-mail: ymitani{at}clin.medic.mie-u.ac.jp.

Background--Coronary sequelae that persist after Kawasaki disease (KD) have been associated with obstructive changes of the lesions and coronary vascular events in adolescents and young adults. However, little is known about the association between sequelae late after KD and inflammatory markers, which are potential mediators and markers for atherogenesis.

Methods and Results--Cross-sectional study was performed to test the hypothesis that coronary sequelae are associated with elevated levels of inflammatory markers in patients late after KD (mean time interval after the onset, 10 years, 10 months). Levels of high-sensitivity C-reactive protein (CRP), serum amyloid-A (SAA), interleukin-6, and soluble intercellular adhesion molecule-1 were measured in the 4 groups (n=80): the referent group (n=15) and KD subgroups with normal coronary arteries from the onset (n=27); with regressed aneurysms (n=18); and with coronary artery lesions, such as persistent aneurysms, stenosis, and occlusion (n=20). CRP levels were significantly elevated in a KD subgroup with coronary artery lesions compared with the referent or other KD subgroups, as analyzed by ANOVA and ANCOVA after adjustment for a confounding factor body mass index. Levels of CRP, SAA, and interleukin-6 were positively correlated. Stepwise regression and logistic regression analyses support the association between the persistence of coronary artery lesions and the levels of CRP and SAA.

Conclusions--Results demonstrate that the persistence of coronary lesions late after KD was independently associated with levels of CRP and SAA, suggesting that inflammation may be a novel functional aspect of coronary artery diseases late after KD.

Key words: atherosclerosis • coronary disease • risk factors • pediatrics • prevention

This article has been cited by other articles:

				Y. Mitani, H. Ohashi, H. Sawada, Y. Ikeyama, H. Hayakawa, S. Takabayashi, K. Maruyama, H. Shimpo, and Y. Komada In Vivo Plaque Composition and Morphology in Coronary Artery Lesions in Adolescents and Young Adults Long After Kawasaki Disease: A Virtual Histology-Intravascular Ultrasound Study Circulation, June 2, 2009; 119(21): 2829 - 2836. [Abstract] [Full Text] [PDF]

				M.-T. Lin, S.-J. Chen, Y.-L. Ho, K.-C. Huang, C.-A. Chen, S.-N. Chiu, L.-C. Sun, W.-J. Lee, H.-C. Chen, J.-K. Wang, et al. Abnormal Matrix Remodeling in Adolescents and Young Adults with Kawasaki Disease Late after Onset Clin. Chem., November 1, 2008; 54(11): 1815 - 1822. [Abstract] [Full Text] [PDF]

				R.-E. W. Kavey, V. Allada, S. R. Daniels, L. L. Hayman, B. W. McCrindle, J. W. Newburger, R. S. Parekh, and J. Steinberger Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics Circulation, December 12, 2006; 114(24): 2710 - 2738. [Abstract] [Full Text] [PDF]

				M. E. Rosenkranz, D. J. Schulte, L. M.A. Agle, M. H. Wong, W. Zhang, L. Ivashkiv, T. M. Doherty, M. C. Fishbein, T. J.A. Lehman, K. S. Michelsen, et al. TLR2 and MyD88 Contribute to Lactobacillus casei Extract-Induced Focal Coronary Arteritis in a Mouse Model of Kawasaki Disease Circulation, November 8, 2005; 112(19): 2966 - 2973. [Abstract] [Full Text] [PDF]