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Background <p>A previous study reported that among patients with complete Kawasaki Disease (KD), those exhibiting all six principal clinical features were more likely to develop coronary artery (CA) sequelae than those exhibiting only five features. We aimed to determine which specific features are associated with CA sequelae.</p> Methods <p>This retrospective cohort study analyzed 14,732 patients diagnosed with complete KD across Japan from January 2019 to March 2020. Separate multivariable conditional logistic regression analyses were performed to evaluate relative risk for CA sequelae in patients with all six principal clinical features, compared individually to those lacking each specific feature.</p> Results <p>7234 (49.1%) exhibited all six principal clinical features, while 7498 (50.9%) presented with five features. CA sequelae occurred in 2.1% of those with six features versus 1.7% with five. Multivariable conditional logistic regression analysis determined that patients with conjunctival injection were significantly more likely to develop CA sequelae compared with those lacking it (adjusted odds ratio [95% confidence interval], 3.6 [1.3–10.1]).</p> Conclusions <p>Among patients with complete KD, the absence of conjunctival injection—a relatively rare presentation—was associated with a lower cumulative incidence of CA sequelae. This finding may help identify distinct low-risk phenotypes of KD and support risk stratification.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>This study emphasizes the importance of feature-specific risk for coronary artery (CA) sequelae among patients with complete Kawasaki Disease (KD).</p> </ItemContent> <ItemContent> <p>We found that among patients with complete KD, those with conjunctival injection were more likely to develop CA sequelae than were those lacking it.</p> </ItemContent> <ItemContent> <p>The absence of conjunctival injection—a relatively rare presentation in KD—is associated with a markedly lower cumulative incidence of CA sequelae.</p> </ItemContent> <ItemContent> <p>This finding may help identify a distinct low-risk phenotype of KD and aid risk stratification.</p> </ItemContent> </UnorderedList></p>

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Association between the absence of individual principal clinical features and coronary artery abnormalities in complete Kawasaki disease

  • 期刊论文

  • 发表日期：

    2026年2月4日

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  • Naoto Kato,
  • Jun Matsubayashi,
  • Shinsuke Hoshino,
  • Tohru Kobayashi,
  • Masanari Kuwabara,
  • Hiroya Masuda,
  • Ryusuke Ae

摘要

Background

A previous study reported that among patients with complete Kawasaki Disease (KD), those exhibiting all six principal clinical features were more likely to develop coronary artery (CA) sequelae than those exhibiting only five features. We aimed to determine which specific features are associated with CA sequelae.

Methods

This retrospective cohort study analyzed 14,732 patients diagnosed with complete KD across Japan from January 2019 to March 2020. Separate multivariable conditional logistic regression analyses were performed to evaluate relative risk for CA sequelae in patients with all six principal clinical features, compared individually to those lacking each specific feature.

Results

7234 (49.1%) exhibited all six principal clinical features, while 7498 (50.9%) presented with five features. CA sequelae occurred in 2.1% of those with six features versus 1.7% with five. Multivariable conditional logistic regression analysis determined that patients with conjunctival injection were significantly more likely to develop CA sequelae compared with those lacking it (adjusted odds ratio [95% confidence interval], 3.6 [1.3–10.1]).

Conclusions

Among patients with complete KD, the absence of conjunctival injection—a relatively rare presentation—was associated with a lower cumulative incidence of CA sequelae. This finding may help identify distinct low-risk phenotypes of KD and support risk stratification.

Impact

This study emphasizes the importance of feature-specific risk for coronary artery (CA) sequelae among patients with complete Kawasaki Disease (KD).

We found that among patients with complete KD, those with conjunctival injection were more likely to develop CA sequelae than were those lacking it.

The absence of conjunctival injection—a relatively rare presentation in KD—is associated with a markedly lower cumulative incidence of CA sequelae.

This finding may help identify a distinct low-risk phenotype of KD and aid risk stratification.