Predictive value of the combined evaluation of the neutrophil-to-lymphocyte ratio and lactate dehydrogenase level for coronary artery lesions in patients with acute Kawasaki disease

Q: What is the study’s main objective regarding NLR and LDH?

To evaluate the predictive value of combining the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) for coronary artery lesions in acute Kawasaki disease patients.

Q: How were patients grouped for analysis?

A total of 215 acute Kawasaki disease patients were divided into two groups based on coronary artery lesions: without CAL (n=134) and with CAL (n=81).

Q: Which markers were reported to be associated with coronary artery lesions?

The study reports differences in several laboratory markers and echocardiography measures between groups, and concludes that NLH is an independent risk indicator for CAL.

Sep 29, 2026

Uploaded by Aldword

Objective explores whether combining neutrophil-to-lymphocyte ratio (NLR) with lactate dehydrogenase (LDH) predicts coronary artery lesions (CAL) in acute Kawasaki disease (aKD). Methods retrospectively analyze 215 aKD patients, comparing demographics, laboratory results, and echocardiography between those with and without CAL. Multivariate logistic regression identifies independent risk factors, while ROC curves evaluate sensitivity and specificity of NLR, LDH, and their combination. Results show distinct blood markers and echocardiographic measurements by CAL status, with NLH remaining an independent CAL indicator after adjustment. ROC outcomes indicate good discriminative performance for the combined assessment, outperforming single-index NLR.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusion

Introduction

Li etal. Italian Journal of Pediatrics (2026) 52:1 Italian Journal of Pediatrics [https://doi.org/10.1186/s13052-025-02165-7](https://doi.org/10.1186/s13052-025-02165-7) RESEARCH Open Access Predictive value of the combined evaluation of the neutrophil-to-lymphocyte ratio and lactate dehydrogenase level for coronary artery lesions in patients with acute Kawasaki disease Li Li 1,2, Yu Wan 1*, Guang-an Li3 and Shuang-shuang Tao4 Abstract Objective The objective of this research was to explore the predictive value of the combination of the neutrophilto-lymphocyte ratio (NLR) and lactate dehydrogenase level for coronary artery lesions (CAL) in patients with acute Kawasaki disease (aKD) . Methods We retrospectively reviewed a total of 215 patients diagnosed with aKD. Patients were divided into two groups according to their CAL: aKD patients without CAL (n = 134) and those with CAL (n = 81) . We compared the differences in age at diagnosis, sex, and laboratory and echocardiography data between the two groups. Multivariate logistic regression analysis was performed to evaluate the risk factors for predicting CALs in patients with aKD. Receiver operating characteristic (ROC) curve analysis was performed to detect the sensitivity and specificity of the NLR, LDH, and the combination of the two values in patients with CAL with aKD. Results PLT, ALB, LDH, CK, and CK-MB in aKD patients without CAL were significantly greater than those inpatients with CAL, whereas hs-CRP andTBIL were significantly lower than those in patients with CAL (P < 0. 05) . Echocardiography data showed that LCAd, RCAd, LVDd, IVSd, and LVPWd were significantly greater in aKD patients with CAL than in those without CAL (P < 0. 05) . After adjusting for age at diagnosis, sex, LDH, CK, IVSd, LVPWd, LVDd, and LVEF, NLH remained an independent risk indicator related to CAL (OR: 1. 210, 95% CI: 1.0221.432, P = 0 . 027) . ROC analysis revealed that LDH demonstrated excellent sensitivity (90 . 28%), whereas the NLR showed excellent specificity (91 . 79%) . The combined evaluation exhibited good sensitivity (52 . 78%), specificity (80 . 30%), and AUC (0 . 727, 95% CI: 0.660 to 0 . 787); these findings indicate that the combined assessment is superior to the single-index assessment using the NLR (P Combination vs. NLR = 0.007) . *Correspondence: Yu Wan[drwanyu@163.com](drwanyu@163.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Li et al. Italian Journal of Pediatrics (2026) 52:1 Page 2 of 8 Conclusion The present research concluded that NLH is an independent risk indicator related to CAL in aKD patients. When the NLR is > 4.06 and/or LDH is < 370.4 U/L, aKD patients are more likely to develop CAL. The combination of NLR and LDH level has good predictive value for CAL in aKD patients. Clinical trial number Not applicable. Keywords Acute Kawasaki disease, Coro

FAQs

What is the study’s main objective regarding NLR and LDH?

To evaluate the predictive value of combining the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) for coronary artery lesions in acute Kawasaki disease patients.

How were patients grouped for analysis?

A total of 215 acute Kawasaki disease patients were divided into two groups based on coronary artery lesions: without CAL (n=134) and with CAL (n=81).

Which markers were reported to be associated with coronary artery lesions?

The study reports differences in several laboratory markers and echocardiography measures between groups, and concludes that NLH is an independent risk indicator for CAL.

Sep 29, 2026

Uploaded by Aldword