Regression of Giant Coronary Aneurysm Validated by Echocardiography in Kawasaki Disease

Tai, I-Hsin; Hsieh, Kai‐Sheng; Liao, Chien-Chang; Kuo, Ho‐Chang

doi:10.1161/circimaging.120.012153

Cited by 3 publications

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References 4 publications

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“…Studies have shown either persistence or stenosis without regression as a long-term consequence of giant coronary aneurysm (GCA). Only some cases reported a regression of GCA in KD ( 26 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

Sun

et al. 2022

Front. Cardiovasc. Med.

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BackgroundKawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology that occurs during early childhood, commonly involving the coronary artery, and can lead to coronary artery aneurysms (CAAs).MethodsThe demographic, clinical, and laboratory data of KD patients without coronary artery lesions (N-CAL) and with CAA were collected during 2005–2020 at the Second Affiliated Hospital of Wenzhou Medical University. The patients were divided into the development cohort and the validation cohort. First, we compared the general information, symptoms, and laboratory data of N-CAL and CAA patients in the development cohort and the total cohort and screened out the different indices by logistic regression analysis. Then, we established three models and compared the area under the curve (AUC) values of the receiver operating characteristic (ROC) curves to identify meaningful models for CAA, which were further verified by decision curve analysis (DCA). Second, taking into account previous reports on the importance of gender to CAA, gender stratification was conducted.ResultsThe analysis of clinical and blood indices revealed the following novel features: (i) Many factors were found to be related to CAA, including IVIG resistance and the symptoms of rash, oral changes, and cervical lymphadenopathy. (ii) The development cohort was analyzed by logistic regression, and three models were established. The ROC curves showed that Model 2, composed of IVIG resistance, rash, oral changes, and cervical lymphadenopathy, had a better AUC value and easily to evaluate in the prediction of CAA. (iii) The selected model for predicting CAA in the development cohort was further confirmed in the validation cohort through DCAs. (iv)We further compared the items enrolled in the three models above between the N-CAL and CAA groups by sex, and the results indicated that female KD patients without rash, oral changes, and cervical lymphadenopathy were more likely to develop CAA.ConclusionThe absence of rash, oral changes, and cervical lymphadenopathy are risk factors for CAA, especially in female KD patients. Accurately recognizing symptoms, early diagnosis, and standard treatment for KD are key to reducing the incidence of CAA.

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Section: Discussionmentioning

confidence: 99%

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

Sun

et al. 2022

Front. Cardiovasc. Med.

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Imaging of Coronary Artery Abnormalities in Kawasaki Disease with Emphasis on Multimodalities

Tai

Hsieh

2022

Kawasaki Disease

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Prevalence of antecedent Kawasaki disease in young adults with suspected acute coronary syndrome in high incidence cohort

Shyu

et al. 2023

Front. Cardiovasc. Med.

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BackgroundAcute coronary syndrome (ACS) in early adulthood (<40 years old) may be associated with unrevealed diagnoses of Kawasaki disease (KD) in childhood. Daniels et al. showed that 5% of young adults with acute coronary syndrome might have antecedent Kawasaki disease in a cohort with Kawasaki disease incidence rates ranging from about 9 to 20 per 100,000 children under 5 years of age. However, there is no relevant research from the cohort with higher incidence rates (>80–100 per 100,000 children under 5 years of age) of Kawasaki disease.MethodsWe conducted a multicenter, retrospective study by reviewing medical records and angiographic data from two institutions (middle and southern Taiwan, respectively) of adults <40 years of age who underwent coronary angiography for clinically suspected acute coronary syndrome (2009–2019). Angiographic images were independently analyzed by three cardiologists who were blinded to the medical records. Demographic and laboratory data and risk factors of coronary artery disease were integrated to assess the likelihood of antecedent KD.ResultsAll 323 young adults underwent coronary angiography, and 27 had coronary aneurysms. The patients’ clinical and angiographic characteristics were evaluated, and 7.4% had aneurysms likely to be associated with KD. Most subjects were male (23/24), and their low-density lipoprotein (LDL) levels were significantly higher (p = 0.028) than those of subjects unlikely to have KD.ConclusionThis study proposed that the cohort with higher Kawasaki disease incidence rates may have a higher prevalence of young adult ACS associated with antecedent KD. The importance of determining the clinical therapeutic significance of antecedent Kawasaki disease in young adult ACS warrants advanced research. Higher LDL levels may have a long-term cardiovascular impact in KD patients with persistent coronary aneurysms.

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Regression of Giant Coronary Aneurysm Validated by Echocardiography in Kawasaki Disease

Cited by 3 publications

References 4 publications

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

Imaging of Coronary Artery Abnormalities in Kawasaki Disease with Emphasis on Multimodalities

Prevalence of antecedent Kawasaki disease in young adults with suspected acute coronary syndrome in high incidence cohort

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