Oxidative stress in children late after Kawasaki disease: relationship with carotid atherosclerosis and stiffness

BACKGROUND Persistent arterial dysfunction in patients with a history of Kawasaki disease (KD) and an integral role of oxidative stress in the development of cardiovascular disease are increasingly recognized. We sought to test the hypothesis that oxidative stress is increased in KD patients and related to carotid atherosclerotic changes and stiffness. METHODS We compared the serum levels of oxidative stress biomarkers, carotid intima-media thickness (IMT), and carotid stiffness index among KD patients with coronary aneurysms (n = 32), those without coronary complications (n = 19), and controls (n = 32). RESULTS Compared with controls, patients with coronary aneurysms had significantly higher serum levels of malonaldehyde (2.62 +/- 0.12 microM vs 2.22 +/- 0.07 microM, p = 0.014) and hydroperoxides (26.50 +/- 1.13 microM vs 22.50 +/- 0.62 microM, p = 0.008). A linear trend of the magnitude of oxidative stress in relation to inflammatory damage was observed for malonaldehyde (p = 0.018) and hydroperoxides (p = 0.014) levels. Serum malonaldehyde and hydroperoxide levels correlated positively with carotid IMT (p < 0.001 and p = 0.034, respectively) and stiffness index (p = 0.001 and p = 0.021, respectively). Multiple linear regression analysis identified serum malonaldehyde level as a significant determinant of carotid IMT (beta = 0.31, p = 0.006) and stiffness (beta = 0.27, p = 0.008). CONCLUSION Our findings suggest oxidative stress is increased in KD patients with coronary aneurysms and is associated with carotid intima-media thickening and stiffening.