AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease.

The aim of this study was to explore the associations between the aspartate aminotransferase-to-alanine aminotransferase ratio (AST/ALT) and coronary artery lesions (CALs) among patients with Kawasaki disease (KD). Medical records of KD patients presenting to a single center between January 2019 and December 2020 were retrospectively collected and analyzed. Univariate, multivariable-adjusted analyses, subgroup analyses, restricted cubic spline test, and fitted curves were used to evaluate the associations between AST/ALT and CALs. A total of 831 patients were enrolled, of which 201 (24.2%) had CALs on admission and 21 (2.5%) developed CALs de novo after intravenous immunoglobulin (IVIG). Multivariable-adjusted analyses models revealed that a lower AST/ALT was associated with an increased risk of CALs on admission when AST/ALT was a continuous variable (P = 0.007) and when it was a categorical variable (P for trend = 0.004). Each unit increase in AST/ALT was associated with a 22% lower risk of CALs on admission (odds ratio = 0.78, 95% confidence interval 0.65-0.94). A negative linear relationship was noted between AST/ALT and the risk of CALs on admission in both observed and fitted models. However, such associations were not observed in AST/ALT and CALs de novo after IVIG. None of the variables significantly modified the association between AST/ALT and CALs on admission and CALs de novo after IVIG (P > 0.05). Our findings suggested that AST/ALT was a risk factor of CALs, but was not associated with progressive CALs. © 2021. Children's Hospital, Zhejiang University School of Medicine.

Citation

Lei Cao, Yun-Jia Tang, Miao Gang, Jin Ma, Wei-Guo Qian, Qiu-Qin Xu, Hai-Tao Lv. AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease. World journal of pediatrics : WJP. 2021 Dec;17(6):659-668

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PMID: 34792780

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