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Cardiac sequelae of Kawasaki disease in Japan: statistical analysis
Y Nakamura1, Y Fujita, M Nagai
1Department of Public Health, Jichi Medical School, Tochigi, Japan.
Insights
Kawasaki disease can lead to cardiac sequelae in 16.3% of patients. While overall rates declined, potentially due to IVIG, older children showed increased cardiac complications.
Area of Science:
- Pediatrics
- Cardiology
- Epidemiology
Background:
- Kawasaki disease is a significant cause of acquired heart disease in children.
- Cardiac sequelae, including coronary artery abnormalities, pose long-term health risks.
Purpose of the Study:
- To analyze the prevalence and trends of cardiac sequelae in Kawasaki disease patients in Japan.
- To identify demographic and temporal factors associated with cardiac sequelae.
Main Methods:
- Analysis of nationwide survey data from July 1982 to December 1988.
- Inclusion of 46,864 reported cases of Kawasaki disease.
- Assessment of cardiac sequelae occurring one month or more after disease onset.
Main Results:
- 16.3% (7637/46,864) of patients developed cardiac sequelae.
- Higher prevalence observed in males, infants under 1 year, and children over 5 years.
- Overall cardiac sequelae prevalence declined, but increased in children over 5 years.
Conclusions:
- The declining trend in cardiac sequelae may be linked to increased intravenous immunoglobulin (IVIG) use.
- Specific age groups, particularly older children, require targeted management strategies for Kawasaki disease.
- Further research into IVIG administration protocols for different age groups is warranted.
Abstract:
The proportions of Kawasaki disease patients with cardiac sequelae in Japan were analyzed using nationwide survey data from the 6 1/2-year period July 1982 through December 1988. Of 46,864 cases of Kawasaki disease reported in the surveys, 7637 or 16.3% had cardiac sequelae such as dilation or stenosis of coronary arteries, myocardial infarction, and valvar lesions 1 month or more after onset. The prevalence of cardiac sequelae was particularly high in males, infants younger than 1 year, and children older than 5 years of age. In sequential observation, there was no correlation between the prevalence of cardiac sequelae and periods of high or low incidence of the disease. The prevalence of cardiac sequelae overall declined steadily over the observation period, perhaps as a consequence of increasing use of intravenous gamma globulin. However, children older than the age of 5 years manifested increasing prevalence of cardiac sequelae over the observation period, probably as a result of lower rates of intravenous gamma globulin administration.