Follow-Up Duration of Echocardiography in Patients with Kawasaki Disease with No Initial Coronary Aneurysms - 06/05/22
Abstract |
Objective |
To evaluate the optimal duration of echocardiographic follow-up in patients with Kawasaki disease without an initial coronary aneurysm.
Study design |
In this single-center, retrospective, observational study, we reviewed the results of follow-up echocardiography in children with Kawasaki disease enrolled in the Prospective Observational Study on Stratified Treatment with Immunoglobulin Plus Steroid Efficacy for Kawasaki Disease from a children's hospital. The main enrollment criterion was the absence of coronary aneurysms, defined as a maximum z-score (Zmax) ≥2.5, in the proximal right coronary artery and the proximal left anterior descending artery within 9 days from treatment initiation. The primary outcome was Zmax on follow-up echocardiography at up to 5 years.
Results |
Among 386 patients, 106 (27.5%) received prednisolone with intravenous immunoglobulin for first-line therapy, and 57 (14.8%) showed a poor response. Echocardiography at 1 month detected 9 patients with a Zmax ≥2, including 3 (0.8%) with coronary aneurysms requiring additional antithrombotic treatment and observation. Of 7 patients (1.8%) with normal echocardiographic findings at 1 month but a Zmax ≥2 later, 2 were lost to follow-up and 5 experienced spontaneous resolution, but none of the 7 patients required any change in management.
Conclusions |
The optimal duration of echocardiographic follow-up may be 1 month in patients with no initial coronary aneurysms and a Zmax <2 at 1 month. Coronary artery abnormalities observed after 1 month are rare and mostly benign in this category of patients.
Le texte complet de cet article est disponible en PDF.Keywords : z-score, coronary artery lesion, American Heart Association
Abbreviations : CA, CAL, IVIG, Post-RAISE, Zmax
Plan
| M.M. has received honoraria from the Japan Blood Products Organization, Teijin Pharma Ltd, and Nihon Pharmaceutical Co, Ltd outside the submitted work. Y.M. has received a Health Science and Labor Research Grant and grants from the Tokyo Metropolitan Government Hospitals, the Japan Agency for Medical Research and Development, the Center for Clinical Trials of the Japan Medical Association, the Japan Science and Technology Agency, the New Energy and Industrial Technology Development Organization, and the Japan Society for the Promotion of Science outside the submitted work. None of these entities were involved in this study in any manner. The other authors declare no conflicts of interest. |
Vol 244
P. 133 - mai 2022 Retour au numéro
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