Acute myocardial infarction caused by Kawasaki disease requires more intensive therapy: Insights from the Japanese registry of All Cardiac and Vascular Diseases—Diagnosis Procedure combination

Abstract

BackgroundKawasaki disease (KD) induces coronary arteritis which causes subsequent coronary aneurysms, and contributes to acute myocardial infarction (AMI). However, the difference of real-world treatment selection and mortality between AMIcomplicated KD and AMI due to typical atherosclerosis (AMI-non KD) is unknown. MethodThe aim of the present study was to reveal the current treatment strategy and prognosis of AMI-complicated KD compared with AMI due to typical atherosclerosis using data from 2012 to 2019 of a nationwide claim database, the Japanese Registry of All Cardiac and Vascular Diseases -Diagnosis Procedure Combination. ResultsCompared with AMI-non KD (n = 70,227), AMI-complicated KD (n = 73) 1) underwent less percutaneous coronary intervention (PCI) and more coronary artery bypass grafting, intracoronary thrombolysis or intravenous coronary thrombolysis, 2) underwent stentless PCI using old balloon angioplasty or rotablator, when they underwent PCI, 3) needed in-hospital cardiopulmonary resuscitation and intensive mechanical therapy such as intra-aortic balloon pump, percutaneous cardiopulmonary support or respirator, whereas presented similar in-hospital mortality. ConclusionsCompared with AMI-non KD, AMI-complicated KD underwent non-PCI strategy such as bypass surgery or thrombolysis, required intensive therapy with mechanical supports, and presented similar in-hospital mortality. When AMI-complicated KD underwent PCI, stentless PCI using balloon angioplasty or rotablator was more performed compared with AMI-non KD.