Cardiovascular outcomes in children with Kawasaki disease: a population-based cohort study.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
04
05
2022
accepted:
26
10
2022
revised:
05
10
2022
medline:
28
4
2023
pubmed:
16
11
2022
entrez:
15
11
2022
Statut:
ppublish
Résumé
The risk of cardiovascular events after Kawasaki disease (KD) remains uncertain. Our objective was to determine the risk of cardiovascular events and mortality after KD. Population-based retrospective cohort study using Ontario health administrative databases (0-18 years; 1995-2018). pediatric KD hospitalizations. Each case was matched to 100 non-exposed controls. major adverse cardiac events (MACE; cardiovascular death, myocardial infarction, or stroke composite). composite cardiovascular events and mortality. We determined incidence rates and adjusted hazard ratios (aHR) using multivariable Cox models. Among 4597 KD survivors, 79 (1.7%) experienced MACE, 632 (13.8%) composite cardiovascular events, and 9 (0.2%) died during 11-year median follow-up. The most frequent cardiovascular events among KD survivors were ischemic heart disease (4.6 events/1000 person-years) and arrhythmias (4.5/1000 person-years). KD survivors were at increased risk of MACE between 0-1 and 5-10 years, and composite cardiovascular events at all time periods post-discharge. KD survivors had a lower mortality risk throughout follow-up (aHR 0.36, 95% CI 0.19-0.70). KD survivors are at increased risk of post-discharge cardiovascular events but have a lower risk of death, which justifies enhanced cardiovascular disease surveillance in these patients. Among 4597 Kawasaki disease (KD) survivors, 79 (1.7%) experienced major adverse cardiac events (MACE) and 632 (13.8%) had composite cardiovascular events during 11-year median follow-up. KD survivors had significantly higher risks of post-discharge MACE and cardiovascular events versus non-exposed children. Only nine KD survivors (0.2%) died during follow-up, and the risk of mortality was significantly lower among KD survivors versus non-exposed children. Childhood KD survivors should receive preventative counseling and cardiovascular surveillance, aiming to mitigate adult cardiovascular disease.
Sections du résumé
BACKGROUND
The risk of cardiovascular events after Kawasaki disease (KD) remains uncertain. Our objective was to determine the risk of cardiovascular events and mortality after KD.
METHODS
Population-based retrospective cohort study using Ontario health administrative databases (0-18 years; 1995-2018).
EXPOSURE
pediatric KD hospitalizations. Each case was matched to 100 non-exposed controls.
PRIMARY OUTCOME
major adverse cardiac events (MACE; cardiovascular death, myocardial infarction, or stroke composite).
SECONDARY OUTCOMES
composite cardiovascular events and mortality. We determined incidence rates and adjusted hazard ratios (aHR) using multivariable Cox models.
RESULTS
Among 4597 KD survivors, 79 (1.7%) experienced MACE, 632 (13.8%) composite cardiovascular events, and 9 (0.2%) died during 11-year median follow-up. The most frequent cardiovascular events among KD survivors were ischemic heart disease (4.6 events/1000 person-years) and arrhythmias (4.5/1000 person-years). KD survivors were at increased risk of MACE between 0-1 and 5-10 years, and composite cardiovascular events at all time periods post-discharge. KD survivors had a lower mortality risk throughout follow-up (aHR 0.36, 95% CI 0.19-0.70).
CONCLUSION
KD survivors are at increased risk of post-discharge cardiovascular events but have a lower risk of death, which justifies enhanced cardiovascular disease surveillance in these patients.
IMPACT
Among 4597 Kawasaki disease (KD) survivors, 79 (1.7%) experienced major adverse cardiac events (MACE) and 632 (13.8%) had composite cardiovascular events during 11-year median follow-up. KD survivors had significantly higher risks of post-discharge MACE and cardiovascular events versus non-exposed children. Only nine KD survivors (0.2%) died during follow-up, and the risk of mortality was significantly lower among KD survivors versus non-exposed children. Childhood KD survivors should receive preventative counseling and cardiovascular surveillance, aiming to mitigate adult cardiovascular disease.
Identifiants
pubmed: 36380069
doi: 10.1038/s41390-022-02391-3
pii: 10.1038/s41390-022-02391-3
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1267-1275Informations de copyright
© 2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
Références
Burgner, D. & Harnden, A. Kawasaki disease: what is the epidemiology telling us about the etiology? Int J. Infect. Dis. 9, 185–194 (2005).
pubmed: 15936970
pmcid: 7110839
Singh, S., Vignesh, P. & Burgner, D. The epidemiology of Kawasaki disease: a global update. Arch. Dis. Child 100, 1084–1088 (2015).
pubmed: 26111818
Robinson, C. et al. Incidence and short-term outcomes of Kawasaki disease. Pediatr. Res. 90, 670–677. https://doi.org/10.1038/s41390-021-01496-5 (2021).
McCrindle, B. W. et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation 135, e927–e999 (2017).
pubmed: 28356445
Taubert, K. A. Epidemiology of Kawasaki disease in the United States and worldwide. Prog. Pediatr. Cardiol. 6, 181–185 (1997).
Holman, R. C., Curns, A. T., Belay, E. D., Steiner, C. A. & Schonberger, L. B. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 112, 495–501 (2003).
pubmed: 12949272
Oates-Whitehead, R. M. et al. Intravenous immunoglobulin for the treatment of Kawasaki disease in children. Cochrane Database Syst. Rev. 2003, CD004000. https://doi.org/10.1002/14651858.CD004000 (2003).
Orenstein, J. M. et al. Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study. PLoS One 7, e38998 (2012).
pubmed: 22723916
pmcid: 3377625
Burns, J. C. & Glodé, M. P. Kawasaki syndrome. Lancet Lond. Engl. 364, 533–544 (2004).
Naoe, S., Takahashi, K., Masuda, H. & Tanaka, N. Kawasaki disease. With particular emphasis on arterial lesions. Acta Pathol. Jpn 41, 785–797 (1991).
pubmed: 1785339
Kato, H. et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 94, 1379–1385 (1996).
pubmed: 8822996
Bang, J. S. et al. Long-term prognosis for patients with Kawasaki disease complicated by large coronary aneurysm (diameter ≥ 6 mm). Korean Circ. J. 47, 516–522 (2017).
pubmed: 28765744
pmcid: 5537154
Tsuda, E. et al. A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am. Heart J. 167, 249–258 (2014).
pubmed: 24439987
McNeal-Davidson, A. et al. The fate and observed management of giant coronary artery aneurysms secondary to Kawasaki disease in the Province of Quebec: the complete series since 1976. Pediatr. Cardiol. 34, 170–178 (2013).
pubmed: 22706758
Friedman, K. G. et al. Coronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population. J. Am. Heart Assoc. 5, e003289. https://doi.org/10.1161/JAHA.116.003289 (2016).
Holve, T. J. et al. Long-term cardiovascular outcomes in survivors of Kawasaki disease. Pediatrics 133, e305–e311 (2014).
pubmed: 24446449
Miura, M. et al. Association of severity of coronary artery aneurysms in patients with Kawasaki disease and risk of later coronary events. JAMA Pediatr. 172, e180030 (2018).
pubmed: 29507955
pmcid: 5875323
McCrindle, B. W. et al. Medium‐term complications associated with coronary artery aneurysms after Kawasaki disease: a study from the International Kawasaki Disease Registry. J. Am. Heart. Assoc. 9, e016440. https://doi.org/10.1161/JAHA.119.016440 (2020).
Suda, K. et al. Long-term prognosis of patients with Kawasaki disease complicated by giant coronary aneurysms: a single-institution experience. Circulation 123, 1836–1842 (2011).
pubmed: 21502578
Cheung, Y. F., Yung, T. C., Tam, S. C. F., Ho, M. H. K. & Chau, A. K. T. Novel and traditional cardiovascular risk factors in children after Kawasaki disease: implications for premature atherosclerosis. J. Am. Coll. Cardiol. 43, 120–124 (2004).
pubmed: 14715193
Gupta-Malhotra, M. et al. Atherosclerosis in survivors of Kawasaki disease. J. Pediatr. 155, 572–577 (2009).
pubmed: 19595365
Dietz, S. M., Tacke, C. E. A., Hutten, B. A. & Kuijpers, T. W. Peripheral endothelial (dys)function, arterial stiffness and carotid intima-media thickness in patients after Kawasaki disease: a systematic review and meta-analyses. PLoS One 10, e0130913 (2015).
pubmed: 26161871
pmcid: 4498761
National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 128, S213–S256 (2011).
Gordon, J. B., Kahn, A. M. & Burns, J. C. When children with Kawasaki disease grow up: myocardial and vascular complications in adulthood. J. Am. Coll. Cardiol. 54, 1911–1920 (2009).
pubmed: 19909870
pmcid: 2870533
McCrindle, B. W., McIntyre, S., Kim, C., Lin, T. & Adeli, K. Are patients after Kawasaki disease at increased risk for accelerated atherosclerosis? J. Pediatr. 151, 244–248 (2007).
pubmed: 17719931
Banks, L. et al. Factors associated with low moderate-to-vigorous physical activity levels in pediatric patients with Kawasaki disease. Clin. Pediatr. (Philos.) 51, 828–834 (2012).
Baker, A. L. et al. Physical and psychosocial health in children who have had Kawasaki disease. Pediatrics 111, 579–583 (2003).
pubmed: 12612239
Statistics Canada. Ontario [Province] and Canada [Country] (Table). Census Profile. 2016 Census. Statistics Canada; 2017. Accessed December 10, 2019. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/index.cfm?Lang=E .
von Elm, E. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet Lond. Engl. 370, 1453–1457 (2007).
Benchimol, E. I. et al. The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement. PLoS Med. 12, e1001885 (2015).
pubmed: 26440803
pmcid: 4595218
Manlhiot, C. et al. Epidemiology of Kawasaki disease in Canada 2004 to 2014: comparison of surveillance using administrative data vs periodic medical record review. Can. J. Cardiol. 34, 303–309 (2018).
pubmed: 29395706
Patel, T. et al. Endpoints in diabetes cardiovascular outcome trials. Lancet 391, 2412 (2018).
pubmed: 29916379
Miao, B. et al. Incidence and predictors of major adverse cardiovascular events in patients with established atherosclerotic disease or multiple risk factors. J. Am. Heart Assoc. 9, e014402. https://doi.org/10.1161/JAHA.119.014402 (2020).
Lim, W. H. et al. Impact of pretransplant and new-onset diabetes after transplantation on the risk of major adverse cardiovascular events in kidney transplant recipients: a population-based cohort study. Transplantation 105, 2470–2481 (2021).
pubmed: 33560726
Hussain, M. A. et al. Association between statin use and cardiovascular events after carotid artery revascularization. J. Am. Heart Assoc. 7, e009745 (2018).
pubmed: 30369318
pmcid: 6201401
Sud, M. et al. Association between adherence to fractional flow reserve treatment thresholds and major adverse cardiac events in patients with coronary artery disease. JAMA 324, 2406 (2020).
pubmed: 33185655
McCormick, N., Bhole, V., Lacaille, D. & Avina-Zubieta, J. A. Validity of diagnostic codes for acute stroke in administrative databases: a systematic review. PLoS One 10, e0135834 (2015).
pubmed: 26292280
pmcid: 4546158
McCormick, N., Lacaille, D., Bhole, V. & Avina-Zubieta, J. A. Validity of myocardial infarction diagnoses in administrative databases: a systematic review. PLoS One 9, e92286 (2014).
pubmed: 24682186
pmcid: 3969323
Canadian Institute for Health Information (CIHI). Health Indicators 2013. Canadian Institute for Health Information; 2013. Accessed December 18, 2019. https://secure.cihi.ca/free_products/HI2013_EN.pdf .
Shah, B. R. et al. Surname lists to identify South Asian and Chinese ethnicity from secondary data in Ontario, Canada: a validation study. BMC Med. Res. Methodol. 10, 42. https://doi.org/10.1186/1471-2288-10-42 (2010).
Simon, T. D., Haaland, W., Hawley, K., Lambka, K. & Mangione-Smith, R. Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 3.0. Acad. Pediatr. 18, 577–580 (2018).
pubmed: 29496546
pmcid: 6035108
Lin, M. T. et al. Acute and late coronary outcomes in 1073 patients with Kawasaki disease with and without intravenous γ-immunoglobulin therapy. Arch. Dis. Child 100, 542–547 (2015).
pubmed: 25564534
Nakamura, Y. et al. Mortality among Japanese with a history of Kawasaki disease: results at the end of 2009. J. Epidemiol. 23, 429–434 (2013).
pubmed: 24042393
Nakamura, Y., Yanagawa, H., Harada, K., Kato, H. & Kawasaki, T. Mortality among persons with a history of Kawasaki disease in Japan: the fifth look. Arch. Pediatr. Adolesc. Med. 156, 162 (2002).
pubmed: 11814378
Carlton-Conway, D. et al. Behaviour sequelae following acute Kawasaki disease. BMC Pediatr. 5, 14 (2005).
pubmed: 15916701
pmcid: 1156909
Kourtidou, S. et al. Kawasaki disease substantially impacts health-related quality of life. J. Pediatr. 193, 155–163.e5 (2018).
pubmed: 29198542
Printz, B. F. et al. Noncoronary cardiac abnormalities are associated with coronary artery dilation and with laboratory inflammatory markers in acute Kawasaki disease. J. Am. Coll. Cardiol. 57, 86–92 (2011).
pubmed: 21185506
pmcid: 3577068
Moran, A. M. et al. Abnormal myocardial mechanics in Kawasaki disease: rapid response to gamma-globulin. Am. Heart J. 139, 217–223 (2000).
pubmed: 10650293
Yonesaka, S. et al. Histopathological study on Kawasaki disease with special reference to the relation between the myocardial sequelae and regional wall motion abnormalities of the left ventricle. Jpn Circ. J. 56, 352–358 (1992).
pubmed: 1578606
Tsuda, E. et al. The 30-year outcome for patients after myocardial infarction due to coronary artery lesions caused by Kawasaki disease. Pediatr. Cardiol. 32, 176–182 (2011).
pubmed: 21120463
Hirata, S., Nakamura, Y., Matsumoto, K. & Yanagawa, H. Long-term consequences of Kawasaki disease among first-year junior high school students. Arch. Pediatr. Adolesc. Med. 156, 77 (2002).
pubmed: 11772195
Yeom, J. S., Cho, J. Y. & Woo, H. O. Understanding the importance of cerebrovascular involvement in Kawasaki disease. Korean J. Pediatr. 62, 334–339 (2019).
pubmed: 31096739
pmcid: 6753317
Ichiyama, T. et al. Cerebral hypoperfusion during acute Kawasaki disease. Stroke 29, 1320–1321 (1998).
pubmed: 9660380
Amano, S. & Hazama, F. Neutral involvement in kawasaki disease. Acta Pathol. Jpn 30, 365–373 (1980).
pubmed: 7395511
Korematsu, S. et al. The characterization of cerebrospinal fluid and serum cytokines in patients with Kawasaki disease. Pediatr. Infect. Dis. J. 26, 750–753 (2007).
pubmed: 17848892
Hoshino, S., Tsuda, E. & Yamada, O. Characteristics and fate of systemic artery aneurysm after Kawasaki disease. J. Pediatr. 167, 108–112.e1–2 (2015).
pubmed: 25981909
Dhillon, R. et al. Endothelial dysfunction late after Kawasaki disease. Circulation 94, 2103–2106 (1996).
pubmed: 8901658
Ooyanagi, R. et al. Pulse wave velocity and ankle brachial index in patients with Kawasaki disease. Pediatr. Int J. Jpn Pediatr. Soc. 46, 398–402 (2004).
Iemura, M., Ishii, M., Sugimura, T., Akagi, T. & Kato, H. Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart Br. Card. Soc. 83, 307–311 (2000).
Bronstein, D. E., Besser, R. E. & Burns, J. C. Passive surveillance for Kawasaki disease in San Diego County. Pediatr. Infect. Dis. J. 16, 1015–1018 (1997).
pubmed: 9384331
Kao, A. S., Getis, A., Brodine, S. & Burns, J. C. Spatial and temporal clustering of Kawasaki syndrome cases. Pediatr. Infect. Dis. J. 27, 981–985 (2008).
pubmed: 18852687
pmcid: 2870532