PMID- 33712036 OWN - NLM STAT- MEDLINE DCOM- 20211103 LR - 20211103 IS - 1546-0096 (Electronic) IS - 1546-0096 (Linking) VI - 19 IP - 1 DP - 2021 Mar 12 TI - Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study. PG - 24 LID - 10.1186/s12969-021-00517-1 [doi] LID - 24 AB - BACKGROUND: Intravenous immunoglobulin (IVIG) resistance prediction is one pivotal topic of interests in Kawasaki disease (KD). This study aimed to prospectively investigated the value of C-reactive protein-to-albumin (CAR) in predicting both initial and repeated IVIG resistance in patients with KD, and to test the hypothesis that CAR was more valuable or accurate than either C-reactive protein (CRP) or albumin (ALB) alone in IVIG resistance prediction. METHOD: A prospective cohort study involving 550 patients with KD was conducted. The clinical and laboratory data were compared between IVIG-response group and IVIG-resistance group. Multivariate logistic regression analysis was performed to identify the independent risk factors of initial/repeated IVIG resistance. Receiver operating characteristic (ROC) curves analysis was applied to assess the validity of CAR, CRP and ALB in predicting both initial and repeated IVIG resistance. RESULTS: CAR was significantly higher in IVIG non-responders and was identified as independent risk factor for both initial and repeated IVIG resistance in KD. The best cut-off value of CAR for initial and repeated IVIG resistance prediction was 2.07 and 3.34, with a corresponding sensitivity of 0.610 and 0.548, a specificity of 0.552 and 0.813, respectively. The value of CAR was not better than either CRP or ALB alone for both initial and repeated IVIG resistance prediction. CONCLUSION: A higher CAR was an independent risk factor for both initial and repeated IVIG resistance. However, similar with that of CRP or ALB, the predictive value of CAR was not good enough for both initial and repeated IVIG resistance prediction in KD. FAU - Liu, Xiaoliang AU - Liu X AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Wang, Lin AU - Wang L AD - Longquanyi District of Chengdu Maternity & Child Health Care Hospital, Chengdu, Sichuan, China. FAU - Zhou, Kaiyu AU - Zhou K AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Shao, Shuran AU - Shao S AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - West China Medical School of Sichuan University, Chengdu, Sichuan, China. FAU - Hua, Yimin AU - Hua Y AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Wu, Mei AU - Wu M AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - West China Medical School of Sichuan University, Chengdu, Sichuan, China. FAU - Liu, Lei AU - Liu L AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. AD - West China Medical School of Sichuan University, Chengdu, Sichuan, China. FAU - Wang, Chuan AU - Wang C AUID- ORCID: 0000-0001-5165-8273 AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, China. 805101396@qq.com. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. 805101396@qq.com. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. 805101396@qq.com. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. 805101396@qq.com. LA - eng GR - 2018YFC1002301/National Key R&D Program of China/ GR - 81800288/National Natural Science Foundation of China/ GR - 2019YFS0243/Science-technology Support Plan Projects in Sichuan province/ GR - 2017SZ0117/Science-technology Support Plan Projects in Sichuan province/ PT - Journal Article DEP - 20210312 PL - England TA - Pediatr Rheumatol Online J JT - Pediatric rheumatology online journal JID - 101248897 RN - 0 (Biomarkers) RN - 0 (Immunoglobulins, Intravenous) RN - 0 (Serum Albumin) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - Int Immunopharmacol. 2021 Jun;95:107631. PMID: 33896753 MH - Adolescent MH - Adult MH - Biomarkers/blood MH - C-Reactive Protein/*analysis MH - Cohort Studies MH - Drug Resistance MH - Female MH - Humans MH - Immunoglobulins, Intravenous/*therapeutic use MH - Male MH - Middle Aged MH - Mucocutaneous Lymph Node Syndrome/*blood/*drug therapy MH - Predictive Value of Tests MH - Prospective Studies MH - Serum Albumin/*analysis MH - Young Adult PMC - PMC7953655 OTO - NOTNLM OT - C-reactive protein to albumin ratio OT - Intravenous immunoglobulin resistance OT - Kawasaki disease COIS- None of authors declared any conflict of interests. EDAT- 2021/03/14 06:00 MHDA- 2021/11/04 06:00 PMCR- 2021/03/12 CRDT- 2021/03/13 05:31 PHST- 2020/05/27 00:00 [received] PHST- 2021/03/04 00:00 [accepted] PHST- 2021/03/13 05:31 [entrez] PHST- 2021/03/14 06:00 [pubmed] PHST- 2021/11/04 06:00 [medline] PHST- 2021/03/12 00:00 [pmc-release] AID - 10.1186/s12969-021-00517-1 [pii] AID - 517 [pii] AID - 10.1186/s12969-021-00517-1 [doi] PST - epublish SO - Pediatr Rheumatol Online J. 2021 Mar 12;19(1):24. doi: 10.1186/s12969-021-00517-1.