Clinical Management
Andréa Azar, MD
Resident doctor
University of Montreal
Laval, Quebec, Canada
Background/
Aim: Kawasaki disease (KD) is an acute vasculitis seen within the pediatric population that can cause serious cardiovascular complications, including coronary artery aneurysm (CAA), which require long terme healthy lifestyle prevention. The objective of this study was to analyze anthropometrics measurements, biochemical data, nutrient intake, and physical activity profile in a cohort of KD patients with CAA (KD-A) according to AHA-2004 definition or without CAA (KD-N).
Methods: We conducted a cross-sectional study of KD patients treated at the CHU Sainte-Justine. Age-adjusted anthropometric measurements, biochemical markers from blood tests, 3-month food frequency (Diet History Questionnaire II (DHQ II) for U.S. & Canada) and physical activity habits (Minnesota Leisure Time Physical Activity Questionnaire and Tecumseh Self-Administered Occupational Physical Activity Questionnaire) were all collected 5-10 years after KD. Our cohort consisted of 8 KD-A patients, 40 KD-N patients and 27 controls (CTL).
Results: The analysis of our data shows that the prevalence of overweight was significantly higher in KD-A patients compared to KD-N (respectively 33% and 15% ; p = 0.0027). KD-A patients had significantly higher CRP compared to KD-N (1.51±1.29 mg/L vs. 0.73±1.10 mg/L; p = 0.047). 22% of KD-A and 42% of KD-N consume an excess of total lipids, 67% of KD-A and 84% of KD-N consume an excess of saturated fatty acids, and 67% of KD-A and 61% of KD-N consume an excess of total sugars. 62% of KD-A and 22% of KD-N spend less then 30 minutes a day doing a physical activity, and only 13% of KD-A but 45% of KD-N spend more than 60 minutes a day doing a physical activity.
Conclusion: The data collected and analyzed in this study highlights a deviation from a healthy lifestyle among our cohort of patients 5 to 10 years following their diagnosis and treatment for KD, making them more at risk of developing significant and irreversible cardiac complications at a young age. Our findings support the importance of allocating resources to strengthen the guidelines with specific recommendations regarding the cardiovascular risks of these young patients and to adapt those recommendations to their socio-economic context.