Nomogram model based on serum chitotriosidase activity to predict coronary artery aneurysm in Kawasaki disease

Objective: Kawasaki disease (KD) is a common children's disease with unknown etiology, which easily involves coronary artery and causes serious cardiovascular sequelae. The purpose was to investigate the relationship between chitotriosidase activity and coronary artery aneurysm (CAA) and develop and validate a nomogram to predict CAA in KD patients.

Methods: A total of 338 KD patients were included in this study. Differences analysis compared baseline characteristics and multivariate logistic regression analysis to determine independent risk factors for CAA in KD patients. Based on this independent risk factor, the nomogram was constructed and validated.

Results: Of 338 KD patients, 107 patients developed CAA. Multivariate logistic regression analysis identified that low-density lipoprotein (LDL) [odds ratio (OR):1.456, 95% confidence interval (CI): 1.062-1.996], age (OR: 0.986, 95% CI: 0.974-0.998), neutrophil-to-lymphocyte ratio (NLR) (OR: 1.098, 95% CI: 1.020-1.182), and chitotriosidase activity (OR: 1.115, 95% CI: 1.111-1.192) were independent predictors for CAA. The nomogram was established based on serum chitotriosidase activity and clinical characteristics, and this nomogram has demonstrated to be of potential value in clinical practice using the receiver operating characteristic curve, calibration curve, and decision curve analysis.

Conclusion: LDL, age, NLR, and chitotriosidase activity were independent risk factors for CAA. Based on this independent risk factor, the nomogram was constructed to guide clinicians to effectively predict CAA and adopt appropriate interventions such as more aggressive anti-inflammatory and more frequent follow-up.