Are patients recovering from Kawasaki disease at increased risk for accelerated atherosclerosis? A meta-analysis

Background Recent studies have suggested that Kawasaki disease(KD)may cause endothelial dysfunction,which can potentially induce atherosclerosis.However,there is still no consensus on the relationship between KD and atherosclerosis.This article aimed to determine whether patients with a history of KD may be at increased risk for accelerated atherosclerosis via a meta-analysis.Methods The PubMed,Embase,and SpringerLink databases were systematically searched.Studies on risk factors for ath-erosclerosis were included.A meta-analysis of case-control studies was performed using RevMan 5.3 software.Results Twenty studies were included with a total of 1684 subjects(990 patients after KD and 694 controls).The meta-analysis showed that the level of carotid intima media thickness(cIMT)(95%CI:0.01,0.03;P=0.005)and high-sensitivity C-reactive protein(hsCRP)(95%CI:0.00,0.10;P=0.03)were significantly higher in patients after KD than controls,whereas flow-mediated dilatation(FMD)(95%CI:-5.14,-1.26;P=0.001)in patients after KD was significantly lower.There were no significant differences in total cholesterol(TC)(95%CI:-0.13,5.92;P=0.06),low-density lipoprotein cholesterol(LDL)(95%CI:-0.65,2.08;P=0.31),or triglycerides(TG)(95%CI:-1.94,8.03;P=0.23).Conclusion Endothelial dysfunction and infammatory processes may exist in patients with a history of KD,which are risk factors for the development of atherosclerosis.