Author:
Gao Lichao,Wang Wei,Wang Huafeng,Xu Zhufei,Zhou Shulai,Geng Zhimin,Fu Songling,Xie Chunhong,Zhang Yiying,Wang Yujia,Gong Fangqi
Abstract
AbstractKawasaki disease can be combined with liver injury. As a mainstay treatment for Kawasaki disease, aspirin may cause liver injury. This study aimed to compare the safety and effectiveness of clopidogrel versus aspirin in Kawasaki disease with mild-to-moderate liver injury. This study retrospectively analysed 166 children with Kawasaki disease combined with mild-to-moderate liver injury. The children treated with clopidogrel were less likely to have aggravated liver injury than those treated with aspirin (n = 2/100 vs. n = 13/66, P < 0.001). The initial alanine aminotransferase value of the clopidogrel group was higher (131.5 [98.5, 167.5] vs. 96 [72, 133], P < 0.001), while the time of alanine aminotransferase recovery to normal was similar (5 [4, 7] vs. 4 [3, 7], P = 0.179). No significant fever differences observed between groups: 7.5 [6, 9] for aspirin vs. 7 [6, 8] for clopidogrel group, P = 0.064. The probability of nonresponse to intravenous immunoglobulin (n = 29/100 vs. n = 30/66, P = 0.030) and the days of hospitalization (n = 6 [4, 9] vs. n = 7 [5, 10], P = 0.007) in the clopidogrel group were less than those in the aspirin group. In conclusion, the application of clopidogrel is potentially superior to aspirin in Kawasaki disease combined with mild-to-moderate liver injury.
Funder
The National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Rife, E. & Gedalia, A. Kawasaki disease: An update. Curr. Rheumatol. Rep. 22, 75 (2020).
2. Subspecialty Group of Cardiology t. S. o. P. C. M. A., Subspecialty Group of Rheumatology t. S. o. P. C. M. A., Subspecialty Group of Immunology t. S. o. P. C. M. A., Editorial Board C. J. o. P. [The expert consensus on diagnosis and acute-phase treatment of Kawasaki disease]. Zhonghua Er Ke Za Zhi 60, 6–13 (2022).
3. Fukazawa, R. et al. JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease. Circ. J. 84, 1348–1407 (2020).
4. Mammadov, G. et al. Hepatic dysfunction secondary to Kawasaki disease: Characteristics, etiology and predictive role in coronary artery abnormalities. Clin. Exp. Med. 20, 21–30 (2020).
5. Tremoulet, A. H. et al. Evolution of laboratory values in patients with Kawasaki disease. Pediatr. Infect. Dis. J. 30, 1022–1026 (2011).