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Am J Emerg Med. 2019 Mar;37(3):468-471. doi: 10.1016/j.ajem.2018.06.021. Epub 2018 Jun 8.

N-terminal pro-brain natriuretic peptide and prediction of coronary artery dilatation in hyperacute phase of Kawasaki disease.

Author information

1
Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea.
2
Department of Emergency Medicine, Seoul Medical Center, Jungang-gu, Seoul, Republic of Korea.
3
Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. Electronic address: jinuking3g@snubh.org.
4
Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
5
Department of Emergency Medicine, Seoul National University Boramae Hospital, Dongjak-gu, Seoul, Republic of Korea.

Abstract

BACKGROUND:

Coronary artery dilatation (CAD) is a great concern with Kawasaki disease (KD). This study aimed to investigate the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and CAD in patients with the hyperacute phase (≤4 days of fever) of KD.

METHODS:

Serum NT-proBNP levels were compared between patients with and those without CAD, who underwent transthoracic echocardiography (TTE) within 24 h of the hyperacute phase of KD in the pediatric emergency department (PED). Electronic medical records of patients aged 1 month to 15 years who visited the PED were retrospectively assessed from January 2010 to December 31, 2014.

RESULTS:

One hundred nine patients were enrolled in the study. Twenty-three of those patients had CAD within 24 h of TTE. Median serum NT-proBNP levels were significantly higher in patients with CAD (824.1 pg/ml; interquartile range [IQR], 515.4-1570.0184.8-767.8 pg/ml) than in patients without CAD (396.4 pg/ml; IQR, 184.8-767.8 pg/ml) (p ≤ 0.001). The cutoff value of serum NT-proBNP, which predicted CAD during the hyperacute phase of KD, was 515.4 pg/ml, which yielded sensitivity of 78.26% and specificity of 61.63%. The area under the curve for NT-proBNP for predicting CAD during hyperacute KD was 0.749 (95% CI, 0.642-0.856).

CONCLUSION:

Serum NT-proBNP might be an additional laboratory marker for detecting early CAD during the hyperacute phase of KD in the PED.

KEYWORDS:

Coronary artery dilatation; Kawasaki disease; N-terminal pro-brain natriuretic peptide

PMID:
29903669
DOI:
10.1016/j.ajem.2018.06.021

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