Cardiac Complications in 38 Cases of Kawasaki Disease with Coronary Artery Aneurysm Diagnosed by Echocardiography

Abstract Background: The severity of the cardiac complications resulting from Kawasaki disease (KD) appears to be directly correlated to the magnitude of the coronary artery aneurysm (CAA). However, there remains some unclear about the risk factors for medium-large CAA identified after acute KD.Methods: We analyzed 90 patients diagnosed with CAA in KD hospitalized from January 2013 through August 2021. Patients were stratified based on the coronary artery z-score adjusted for body surface area as the medium-large CAA group and small-sized CAA group. The association of baseline characteristics was investigated within the groups. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with medium-large CAA development.Results: In total, 353 pediatric cases with KD were investigated during the study period, of whom 90 (25.5%) presented with CAA, including medium-large CAA in 20 patients (5.7%) after acute KD. The medium-large CAA group showed significantly higher Harada risk scores, the incidence of thrombosis, serum globulin concentration values, proportions of C-reactive protein > 40 mg/L, proportions of albumin < 35 g/L, and lower values of albumin-to-globulin ratio (A/G ratio) than those in the small-sized CAA group (P < 0.05). Medium-large CAA was significantly associated with the A/G ratio (odds ratio, 3.503; 95% confidence interval [CI]: 1.068–11.492). The area under the receiver operating characteristic curve was 0.684 (95% CI: 0.558–0.810), and the cutoff point of 1.35 showed a sensitivity and specificity for predicting medium-large CAA of 80% and 59%, respectively.Conclusions: A lower A/G ratio independently predicts medium-large CAA in patients with KD. Medium-large CAA is associated with greater odds of developing thrombosis. Thus, close monitoring with routine echocardiography is recommended.

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Delayed Coronary Artery Aneurysm in Patients With Kawasaki Disease

AAP Grand Rounds ◽

10.1542/gr.45-1-10 ◽

2021 ◽

Vol 45 (1) ◽

pp. 10-10

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm

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Incomplete Kawasaki disease with a giant coronary artery aneurysm; an unexpected finding in an adult male

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2021.100756 ◽

2021 ◽

Vol 34 ◽

pp. 100756

Author(s):

Anu S. Salwan ◽

Assad I.A. Mohammedzein ◽

Masoud A. Alzeerah

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Adult Male ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Unexpected Finding ◽

Incomplete Kawasaki Disease ◽

Giant Coronary Artery Aneurysm

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An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States

Cardiology in the Young ◽

10.1017/s1047951119000982 ◽

2019 ◽

Vol 29 (06) ◽

pp. 828-832 ◽

Cited By ~ 2

Author(s):

Laxmi V. Ghimire ◽

Fu-Sheng Chou ◽

Narayan B. Mahotra ◽

Sharan P. Sharma

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Length Of Stay ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Developed Countries ◽

The United States ◽

Hospital Charge ◽

Acquired Heart Disease ◽

The Developed Countries

AbstractBackground:Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries.Methods:Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed.Results:There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January–March quarter had the highest rate compared to the lowest in the July–September quarter (OR=1.62, p < 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97–4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64–3.80), p < 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12–4.54 days) versus 3.60 days (95 % CI: 3.48–3.72 days), p < 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay.Conclusions:This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.

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Abstract 34: Genome-wide Association Study Identified New Susceptibility Loci To Coronary Artery Aneurysm-related In Kawasaki Disease

Circulation ◽

10.1161/circ.131.suppl_2.34 ◽

2015 ◽

Vol 131 (suppl_2) ◽

Author(s):

Kyu Yeun Kim ◽

Mo Kyung Jung ◽

Yoon-Sun Bae ◽

Woohyuk Ji ◽

Dongjik Shin ◽

...

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Association Study ◽

Genome Wide Association Study ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Genome Wide Association ◽

Korean Children ◽

Genome Wide ◽

Increased Risk

Kawasaki disease (KD) is an acute systemic vasculitis syndrome that predominantly affects children younger than 5 years of age, and may causes serious, sometimes life-threatening, cardiac sequela associated with coronary artery aneurysm (CAA). To identify genetic variants that confers a highly increased risk of coronary artery aneurysm-related in Kawasaki disease. In this study, we carried out genome-wide association study (GWAS) in a Korean children population including 102 CAA-related KD cases and 126 controls. Fifteen genetic loci were found to be significantly correlated with KD risk (P<1.0X10(-7)). Our case-control study revealed that rs4236089 C allele in chloride intracellular channel 5 (CLIC5) gene at 6p21.1 was significantly associated with KD patients with CAA (odds ratio (OR)=4.6, P=7.53X10(-7)). These findings suggest that the CLIC5 gene may play a crucial role in CAA development pathway of KD.

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