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Percutaneous coronary intervention versus coronary artery bypass grafting for stenotic lesions after Kawasaki disease

Hiromi Muta1, Masahiro Ishii

  • 1Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan. qze0534@nifty.com

The Journal of Pediatrics
|March 23, 2010
PubMed

Insights

Coronary artery bypass grafting (CABG) shows better long-term efficacy than percutaneous coronary intervention (PCI) for Kawasaki disease patients, with significantly fewer repeat revascularization procedures needed.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Kawasaki disease can lead to coronary artery stenosis.
  • Long-term outcomes of revascularization strategies for these lesions are critical.

Purpose of the Study:

  • To compare the long-term efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for treating coronary artery stenosis after Kawasaki disease.

Main Methods:

  • A nationwide survey of Japanese pediatricians in hospitals with >=100 beds was conducted.
  • Data were collected via questionnaires, with a 82% return rate (1347/1637).
  • Primary endpoint: composite of all-cause death and Q-wave myocardial infarction. Secondary endpoint: repeat revascularization.

Main Results:

  • 67 patients received PCI, and 81 received CABG.
  • No significant difference in primary endpoints between PCI and CABG (HR 1.35; P=.7).
  • PCI group had significantly higher rates of repeat revascularization (HR 2.23; P=.04), especially in younger patients (<12 years) with ischemic changes.

Conclusions:

  • Percutaneous coronary intervention (PCI) demonstrates lower long-term efficacy compared to coronary artery bypass grafting (CABG) in Kawasaki disease patients.
  • Increased need for repeat revascularization procedures is a key factor contributing to PCI's lower efficacy.
Abstract

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