PDF(Sci-hub)
Abstract：
The diagnosis of coronary artery abnormalities (CAA), including dilation and aneurysm, in patients with Kawasaki disease is paramount to treatment planning. CAA are defined using various standards, which makes diagnosis difficult. The aims of this study were to determine the variability of CAA prevalence according to existing guidelines and Z score formulas and to examine the discrepancies in widely used Z score formulas.
Using data from a Korean national survey on Kawasaki disease, 6,889 patients were included and analyzed. The overall prevalence of CAA and the prevalence for subgroups were compared on the basis of aneurysm severity, age, and body surface area. Finally, discrepancies among five Z score formulas were evaluated by comparing two of the formulas in pairs.
According to the Japanese criteria, the prevalence of CAA was 18%. According to the American Heart Association criteria, the prevalence of dilation or aneurysm was about 21% to 42%, and that of aneurysm of the left anterior descending artery or right coronary artery was about 8% to 27%. The prevalence of CAA and that of left anterior descending or right coronary artery aneurysm was significantly different, with discrepancies between the Japanese and AHA Z score criteria, as well as among the five Z score formulas. Additionally, misclassification of aneurysm severity was observed for each criterion or Z score formula. There was significant variation among calculated Z scores. The more extreme the Z score values, the more discrepancy was observed.
Different guidelines and Z score formulas yield significantly different prevalence rates and classifications of CAA. In addition, more discrepancies were observed with higher Z score values. As CAA or aneurysm severity could be changed by guidelines or Z score formulas, they should be chosen carefully, and when a particular formula is chosen, consistency is needed.
Using data from a Korean national survey on Kawasaki disease, 6,889 patients were included and analyzed. The overall prevalence of CAA and the prevalence for subgroups were compared on the basis of aneurysm severity, age, and body surface area. Finally, discrepancies among five Z score formulas were evaluated by comparing two of the formulas in pairs.
According to the Japanese criteria, the prevalence of CAA was 18%. According to the American Heart Association criteria, the prevalence of dilation or aneurysm was about 21% to 42%, and that of aneurysm of the left anterior descending artery or right coronary artery was about 8% to 27%. The prevalence of CAA and that of left anterior descending or right coronary artery aneurysm was significantly different, with discrepancies between the Japanese and AHA Z score criteria, as well as among the five Z score formulas. Additionally, misclassification of aneurysm severity was observed for each criterion or Z score formula. There was significant variation among calculated Z scores. The more extreme the Z score values, the more discrepancy was observed.
Different guidelines and Z score formulas yield significantly different prevalence rates and classifications of CAA. In addition, more discrepancies were observed with higher Z score values. As CAA or aneurysm severity could be changed by guidelines or Z score formulas, they should be chosen carefully, and when a particular formula is chosen, consistency is needed.
摘要：
冠状动脉异常（CAA）的诊断，包括扩张和动脉瘤，川崎病患者的治疗计划至关重要。CAA使用各种标准定义，这使得诊断变得困难。这项研究的目的是根据现有指南和Z评分公式确定CAA患病率的变异性，并检查广泛使用的Z评分公式中的差异。
使用韩国全国川崎病调查的数据，纳入并分析了6,889例患者。根据动脉瘤严重程度比较CAA的总体患病率和亚组的患病率，年龄,和体表面积。最后,通过对两个公式进行比较，评估了五个Z评分公式之间的差异。
按照日本的标准,CAA的患病率为18%。根据美国心脏协会的标准,扩张或动脉瘤的患病率约为21％至42％，左前降支或右冠状动脉的动脉瘤约为8％至27％。CAA的患病率与左前降支或右冠状动脉瘤的患病率有显著差异，日本人和AHAZ评分标准之间存在差异，以及五个Z得分公式中。此外,对于每个标准或Z评分公式,观察到动脉瘤严重程度的错误分类.计算的Z得分之间存在显着差异。Z得分值越极端,观察到的差异越多。
不同的指南和Z评分公式产生显著不同的CAA患病率和分类。此外,Z评分越高,差异越大.由于CAA或动脉瘤严重程度可以通过指南或Z评分公式来改变，他们应该谨慎选择，当选择一个特定的公式时，需要一致性。
使用韩国全国川崎病调查的数据，纳入并分析了6,889例患者。根据动脉瘤严重程度比较CAA的总体患病率和亚组的患病率，年龄,和体表面积。最后,通过对两个公式进行比较，评估了五个Z评分公式之间的差异。
按照日本的标准,CAA的患病率为18%。根据美国心脏协会的标准,扩张或动脉瘤的患病率约为21％至42％，左前降支或右冠状动脉的动脉瘤约为8％至27％。CAA的患病率与左前降支或右冠状动脉瘤的患病率有显著差异，日本人和AHAZ评分标准之间存在差异，以及五个Z得分公式中。此外,对于每个标准或Z评分公式,观察到动脉瘤严重程度的错误分类.计算的Z得分之间存在显着差异。Z得分值越极端,观察到的差异越多。
不同的指南和Z评分公式产生显著不同的CAA患病率和分类。此外,Z评分越高,差异越大.由于CAA或动脉瘤严重程度可以通过指南或Z评分公式来改变，他们应该谨慎选择，当选择一个特定的公式时，需要一致性。
