646 - Red blood cell distribution width and iron dysregulation as predictors of coronary artery lesions in Japanese Kawasaki disease patients

Publication Number: 646.6364

Yamato Hanawa, The Jikei University School of medicine, Tokyo, Tokyo, Japan; Kimihiko Oishi, The Jikei University School of Medicine, Tokyo, Tokyo, Japan

Background: Kawasaki disease (KD) is an acute vasculitis that leads to coronary artery lesions (CAL). It is important to identify reliable risk factors for the early prediction of CAL in patients with KD. However, such biomarkers are currently unavailable. Recent studies suggest that iron metabolism biomarkers, such as red blood cell distribution width (RDW), may be associated with CAL risk in some Asian populations other than Japanese.

Objective: To evaluate RDW and its relationship with iron metabolism markers as potential predictors of CAL in Japanese KD patients.

Design/Methods: We conducted a retrospective analysis of 175 Japanese children diagnosed with KD between January 2019 and March 2024. Patients were categorized into CAL and non-CAL groups based on echocardiographic findings. Univariate and multivariate logistic regression analyses were performed to identify predictors of CAL, and the diagnosis of performance of various indicators was assessed using receiver operating characteristic (ROC) curves. Correlations between RDW and iron-related anemia biomarkers were also assessed.

Results: Of the 175 patients, 77 (44%) developed CAL. Compared to the non-CAL group, the CAL group had younger patients and significantly lower hemoglobin (Hb), total protein, albumin, uric acid, and urea nitrogen, with higher RDW coefficient of variation (RDW-CV). Logistic regression analysis identified RDW-CV as an independent predictor of CAL. ROC curve analysis demonstrated moderate predictive performance for RDW-CV (AUC 0.636, sensitivity 55.8%; specificity 70.4%). Significant correlations were observed between RDW-CV and anemia biomarkers in the CAL group, suggesting the role of iron dysregulation in CAL development.

Conclusion(s): Our findings also indicated that RDW-CV and iron dysregulation may play a crucial role in the development of CAL in Japanese KD patients. This highlights the significance of these values as predictors across ethnic groups. Further research is needed to validate these findings and elucidate the underlying mechanisms.