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Objective <p>The objective of this research was to explore the predictive value of the combination of the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase level for coronary artery lesions (CAL) in patients with acute Kawasaki disease (aKD).</p> Methods <p>We retrospectively reviewed a total of 215 patients diagnosed with aKD. Patients were divided into two groups according to their CAL: aKD patients without CAL (<i>n</i> = 134) and those with CAL (<i>n</i> = 81). We compared the differences in age at diagnosis, sex, and laboratory and echocardiography data between the two groups. Multivariate logistic regression analysis was performed to evaluate the risk factors for predicting CALs in patients with aKD. Receiver operating characteristic (ROC) curve analysis was performed to detect the sensitivity and specificity of the NLR, LDH, and the combination of the two values in patients with CAL with aKD.</p> Results <p>PLT, ALB, LDH, CK, and CK-MB in aKD patients without CAL were significantly greater than those in patients with CAL, whereas hs-CRP and TBIL were significantly lower than those in patients with CAL (<i>P</i> &lt; 0.05). Echocardiography data showed that LCAd, RCAd, LVDd, IVSd, and LVPWd were significantly greater in aKD patients with CAL than in those without CAL (<i>P</i> &lt; 0.05). After adjusting for age at diagnosis, sex, LDH, CK, IVSd, LVPWd, LVDd, and LVEF, NLH remained an independent risk indicator related to CAL (OR: 1.210, 95% CI: 1.0221.432, <i>P</i> = 0.027). ROC analysis revealed that LDH demonstrated excellent sensitivity (90.28%), whereas the NLR showed excellent specificity (91.79%). The combined evaluation exhibited good sensitivity (52.78%), specificity (80.30%), and AUC (0.727, 95% CI: 0.660 to 0.787); these findings indicate that the combined assessment is superior to the single-index assessment using the NLR (<i>P</i> <sub>Combination vs. NLR</sub> = 0.007).</p> Conclusion <p>The present research concluded that NLH is an independent risk indicator related to CAL in aKD patients. When the NLR is &gt; 4.06 and/or LDH is &lt; 370.4 U/L, aKD patients are more likely to develop CAL. The combination of NLR and LDH level has good predictive value for CAL in aKD patients.</p> Clinical trial number <p>Not applicable.</p>

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Predictive value of the combined evaluation of the neutrophil-to-lymphocyte ratio and lactate dehydrogenase level for coronary artery lesions in patients with acute Kawasaki disease

  • 期刊论文

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  • 发表日期：

    2025年11月29日

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  • Li Li,
  • Yu Wan,
  • Guang-an Li,
  • Shuang-shuang Tao

摘要

Objective

The objective of this research was to explore the predictive value of the combination of the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase level for coronary artery lesions (CAL) in patients with acute Kawasaki disease (aKD).

Methods

We retrospectively reviewed a total of 215 patients diagnosed with aKD. Patients were divided into two groups according to their CAL: aKD patients without CAL (n = 134) and those with CAL (n = 81). We compared the differences in age at diagnosis, sex, and laboratory and echocardiography data between the two groups. Multivariate logistic regression analysis was performed to evaluate the risk factors for predicting CALs in patients with aKD. Receiver operating characteristic (ROC) curve analysis was performed to detect the sensitivity and specificity of the NLR, LDH, and the combination of the two values in patients with CAL with aKD.

Results

PLT, ALB, LDH, CK, and CK-MB in aKD patients without CAL were significantly greater than those in patients with CAL, whereas hs-CRP and TBIL were significantly lower than those in patients with CAL (P < 0.05). Echocardiography data showed that LCAd, RCAd, LVDd, IVSd, and LVPWd were significantly greater in aKD patients with CAL than in those without CAL (P < 0.05). After adjusting for age at diagnosis, sex, LDH, CK, IVSd, LVPWd, LVDd, and LVEF, NLH remained an independent risk indicator related to CAL (OR: 1.210, 95% CI: 1.0221.432, P = 0.027). ROC analysis revealed that LDH demonstrated excellent sensitivity (90.28%), whereas the NLR showed excellent specificity (91.79%). The combined evaluation exhibited good sensitivity (52.78%), specificity (80.30%), and AUC (0.727, 95% CI: 0.660 to 0.787); these findings indicate that the combined assessment is superior to the single-index assessment using the NLR (P Combination vs. NLR = 0.007).

Conclusion

The present research concluded that NLH is an independent risk indicator related to CAL in aKD patients. When the NLR is > 4.06 and/or LDH is < 370.4 U/L, aKD patients are more likely to develop CAL. The combination of NLR and LDH level has good predictive value for CAL in aKD patients.

Clinical trial number

Not applicable.