Epidemiology and Risk Factors for Giant Coronary Artery Aneurysms Identified After Acute Kawasaki Disease.
Child, Preschool
Coronary Aneurysm
/ diagnosis
Coronary Artery Disease
/ diagnosis
Dilatation, Pathologic
/ diagnosis
Echocardiography
/ methods
Female
Humans
Immunoglobulins, Intravenous
/ adverse effects
Infant
Japan
/ epidemiology
Logistic Models
Male
Mucocutaneous Lymph Node Syndrome
/ complications
Odds Ratio
Retrospective Studies
Risk Factors
Severity of Illness Index
Surveys and Questionnaires
Cardiac complication
Coronary artery abnormality
Coronary artery aneurysm
Coronary artery dilatation
Giant coronary artery aneurysm
Kawasaki disease
Journal
Pediatric cardiology
ISSN: 1432-1971
Titre abrégé: Pediatr Cardiol
Pays: United States
ID NLM: 8003849
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
27
10
2020
accepted:
25
02
2021
pubmed:
9
3
2021
medline:
22
6
2021
entrez:
8
3
2021
Statut:
ppublish
Résumé
A giant coronary artery (CA) aneurysm is a potentially fatal cardiac complication resulting from Kawasaki disease (KD). We aimed to identify epidemiologic characteristics and potential risk factors associated with giant CA aneurysms identified after acute KD. We analyzed 90,252 patients diagnosed with KD from 2011 to 2018, using data obtained in nationwide KD surveys conducted in Japan. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with subsequent giant CA aneurysm complications (defined as lumen size ≥ 8 mm), adjusting for all potential factors. Giant CA aneurysms were identified in 144 patients (0.16%) after acute KD. The annual prevalence ranged from 0.07 to 0.20% during the study period. In the multivariate analyses, male sex (adjusted odds ratio 2.09 [95% confidence interval 1.41-3.11], recurrent KD (1.90 [1.09-3.33]), IVIG administration at 1-4 days of illness (1.49 [1.04-2.15]) and ≥ 8 days after KD onset (2.52 [1.38-4.60]; reference, 5-7 days), detection of CA dilatations and aneurysms at initial echocardiography (4.17 [1.85-5.41] and 46.5 [28.8-74.8], respectively), and resistance to IVIG treatment (6.09 [4.23-8.75]) were significantly associated with giant CA aneurysm complications identified after acute KD. The annual prevalence of giant CA aneurysms identified after acute KD did not increase during the study period. Patients with larger CA abnormalities detected at initial echocardiography were independently associated with progression to giant CA aneurysm complications after acute KD regardless of the number of days from onset at treatment initiation.
Identifiants
pubmed: 33682062
doi: 10.1007/s00246-021-02571-8
pii: 10.1007/s00246-021-02571-8
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
969-977Références
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