{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T21:21:07Z","timestamp":1769721667420,"version":"3.49.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The prognostic nutritional index (PNI) is a purported predictor of intravenous immunoglobulin (IVIG) resistance and coronary artery aneurysm (CAA) development in patients with Kawasaki disease (KD). However, limited data exist on CAA regression. This study aimed to confirm whether the PNI is a predictor for CAA persistency in patients with KD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study grouped 341 patients with KD based on the coronary artery status and time of aneurysm persistence. The clinical and laboratory parameters were compared, and multivariate logistic regression analysis was performed to identify the independent risk factors for persistent CAA. The receiver operating characteristic (ROC) curve was further used to assess the predictive values of the PNI in persistent CAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the study patients, 80 (23.5%) presented with CAA, including CAA persisting for 2\u2009years in 17 patients (5.0%). Patients with CAA were more frequently treated with corticosteroids (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.016). No statistically significant differences were found in the nutritional status and PNI among patients with or without coronary artery lesions, regardless of injury severity. Patients in the persistent CAA group presented with higher rates of overnutrition and showed lower PNI values and a higher incidence of thrombosis than those in the normal group (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). The PNI and the maximum <jats:italic>Z<\/jats:italic>-score at 1\u2009month of onset were significantly associated with CAA persisting for 2\u2009years and may be used as predictors of persistent CAA. The area under the ROC curve was 0.708 (95% confidence interval, 0.569\u20130.847), and a 40.2 PNI cutoff yielded a sensitivity and specificity of 41 and 92%, respectively, for predicting CAA persisting for 2\u2009years. Kaplan\u2013Meier survival analysis revealed that the estimated median time of aneurysm persistence was significantly higher in patients with PNI values of \u226440 than in those with PNI values of &amp;gt;40 (hazard ratio, 2.958; 95% confidence interval, 1.601\u20135.464; <jats:italic>p\u2009=<\/jats:italic> 0.007). After sampling-time stratification, the PNI differed significantly between patients with and without persistent CAA when sampled on the second (<jats:italic>p<\/jats:italic>\u2009=\u20090.040), third (<jats:italic>p<\/jats:italic>\u2009=\u20090.028), and fourth days (<jats:italic>p<\/jats:italic>\u2009=\u20090.041) following disease onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A lower PNI value is an independent risk factor for CAA persisting for 2\u2009years in patients with KD, besides the maximum <jats:italic>Z<\/jats:italic>-score at 1\u2009month after onset. Furthermore, the PNI obtained within 4\u2009days from fever onset may possess greater predictive power for patients with persistent CAA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2023.1075619","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T07:25:47Z","timestamp":1675236347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic nutritional index value in the prognosis of Kawasaki disease with coronary artery lesions"],"prefix":"10.3389","volume":"10","author":[{"given":"Jie","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danyan","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piaoliu","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingbing","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaizhi","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusheng","family":"Pang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term Management of Kawasaki Disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s10238-019-00596-1","article-title":"Hepatic dysfunction secondary to Kawasaki disease: characteristics, etiology and predictive role in coronary artery abnormalities","volume":"20","author":"Mammadov","year":"2020","journal-title":"Clin Exp Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1056\/NEJM199106063242305","article-title":"A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of a cute Kawasaki syndrome","volume":"324","author":"Newburger","year":"1991","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"275","DOI":"10.3389\/fped.2019.00275","article-title":"Emergence and characterization of acute coronary syndrome in adults after confirmed or missed history of Kawasaki disease in Japan: a Japanese Nationwide survey","volume":"7","author":"Mitani","year":"2019","journal-title":"Front Pediatr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s00246-004-0698-1","article-title":"Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease","volume":"26","author":"Tsuda","year":"2005","journal-title":"Pediatr Cardiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e305","DOI":"10.1542\/peds.2013-1638","article-title":"Long-term cardiovascular outcomes in survivors of Kawasaki disease","volume":"133","author":"Holve","year":"2014","journal-title":"Pediatrics"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1161\/01.cir.75.2.387","article-title":"Regression of coronary aneurysms in patients with Kawasaki syndrome","volume":"75","author":"Takahashi","year":"1987","journal-title":"Circulation"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e003289","DOI":"10.1161\/JAHA.116.003289","article-title":"Coronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population","volume":"5","author":"Friedman","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1161\/01.cir.94.6.1379","article-title":"Long-term consequences of Kawasaki disease. 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