PMID- 34504878 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210911 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 8 DP - 2021 TI - Predictive Value of the Systemic Immune-Inflammation Index for Intravenous Immunoglobulin Resistance and Cardiovascular Complications in Kawasaki Disease. PG - 711007 LID - 10.3389/fcvm.2021.711007 [doi] LID - 711007 AB - Background: The prediction of intravenous immunoglobulin (IVIG) resistance and cardiovascular complications are critically clinical issues in Kawasaki disease (KD). This prospective study firstly aimed to determine the predictive ability of the systemic immune inflammation index (SII) for IVIG resistance and cardiovascular complications and compare the prognostic accuracy of SII with that of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR). Methods: Patients with KD were divided into different groups according to the presence of IVIG resistance or cardiovascular complications (coronary artery lesions, valve regurgitation, myocarditis, pericardial effusion, and Kawasaki disease shock syndrome [KDSS]). The clinical and laboratory parameters were compared. Further analysis stratified by platelet level was performed. Multivariate logistic regression analysis was used to identify predictors for IVIG resistance and cardiovascular complications. The receiver operating characteristic (ROC) curve was applied to assess and compare the ability of SII, NLR, and PLR for predicting IVIG resistance and cardiovascular complications. Results: SII was significantly higher in KD patients with IVIG-resistance, myocarditis, valve regurgitation, and KDSS. It was identified as an independent risk factor for IVIG resistance, myocarditis, and valve regurgitation. For KD patients with thrombocytopenia, there were no significant differences in SII between KD patients with IVIG resistance/cardiovascular complications and those without. The best cutoff values of SII for IVIG resistance, myocarditis, valve regurgitation, and KDSS prediction in the whole cohort were 1331.4 x 10(9), 1368.6 x 10(9), 1002.4 x 10(9), and 1485.4 x 10(9), with a corresponding sensitivity of 0.525, 0.614, 0.754, and 0.670, a specificity of 0.711, 0.723, 0.584, and 0.730, respectively. The predictive value of SII for both IVIG resistance and cardiovascular complications were not superior to that of NLR. Conclusion: Although the parameter of SII may predict IVIG resistance, myocarditis, valve regurgitation, and KDSS in KD as a single parameter, its predictive ability was not good enough and not superior to NLR. SII might not be applicable in patients with KD having thrombocytopenia. CI - Copyright (c) 2021 Liu, Shao, Wang, Zhang, Wu, Liu, Zhao, Hua, Zhou, Luo, Deng and Wang. FAU - Liu, Xiaoliang AU - Liu X AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Shao, Shuran AU - Shao S AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Wang, Lin AU - Wang L AD - Longquanyi District of Chengdu Maternity & Child Health Care Hospital, Chengdu, China. FAU - Zhang, Nanjun AU - Zhang N AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Wu, Mei AU - Wu M AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Liu, Lei AU - Liu L AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Zhao, Li AU - Zhao L AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Hua, Yimin AU - Hua Y AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, 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, China. FAU - Zhou, Kaiyu AU - Zhou K AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, 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, China. FAU - Luo, Chunyan AU - Luo C AD - Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. FAU - Deng, Yuxin AU - Deng Y AD - Department of Biology, College of Science and Technology, Wenzhou-Kean University, Wenzhou, China. FAU - Wang, Chuan AU - Wang C AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, 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, China. LA - eng PT - Journal Article DEP - 20210824 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC8421732 OTO - NOTNLM OT - Kawasaki disease OT - cardiovascular complications OT - intravenous immunoglobulin resistance OT - neutrophil-to-lymphocyte ratio OT - platelet-to-lymphocyte ratio OT - systemic immune-inflammation index COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/09/11 06:00 MHDA- 2021/09/11 06:01 PMCR- 2021/01/01 CRDT- 2021/09/10 07:03 PHST- 2021/05/17 00:00 [received] PHST- 2021/07/26 00:00 [accepted] PHST- 2021/09/10 07:03 [entrez] PHST- 2021/09/11 06:00 [pubmed] PHST- 2021/09/11 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2021.711007 [doi] PST - epublish SO - Front Cardiovasc Med. 2021 Aug 24;8:711007. doi: 10.3389/fcvm.2021.711007. eCollection 2021.