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Mid-term outcome of patients with Kawasaki disease, single-centre experience
Carl Gillebert1, Kristien Vandeyk, Els Troost
1Division of Cardiology, University Hospitals Leuven, Belgium.
Insights
Kawasaki disease survivors have excellent mid-term outcomes, with normal heart function. However, nearly half of adult Kawasaki disease patients require long-term aspirin treatment for coronary artery health.
Area of Science:
- Pediatric Cardiology
- Rheumatology
- Internal Medicine
Background:
- Increasing number of childhood Kawasaki disease patients reaching adulthood.
- Limited understanding of long-term health perspectives for these individuals.
- Need to evaluate mid-term outcomes in adult survivors of childhood Kawasaki disease.
Purpose of the Study:
- To assess the mid-term clinical outcomes of patients diagnosed with Kawasaki disease in childhood.
- To identify long-term sequelae and management strategies in adult survivors.
- To evaluate the cardiovascular health and treatment needs of this cohort.
Main Methods:
- Retrospective review of patient records from a pediatric and congenital cardiology database.
- Inclusion of patients diagnosed with Kawasaki disease.
- Analysis of disease characteristics, treatment, and follow-up data using descriptive statistics.
Main Results:
- Thirty-five patients (18 boys, median age at diagnosis 1.9 years) were analyzed.
- Coronary artery involvement was frequent (94% left, 58% right).
- Excellent mid-term outcomes observed: no recurrences, arrhythmias, or deaths; normal or normalized left ventricular ejection fraction. However, 43% remained on low-dose aspirin at latest follow-up.
Conclusions:
- Mid-term outcomes for childhood Kawasaki disease survivors are generally excellent.
- A significant proportion (43%) of adult survivors require ongoing low-dose aspirin therapy.
- Long-term cardiovascular monitoring and management are crucial for Kawasaki disease patients.
Background:
More and more children, who suffered from Kawasaki disease in childhood, reach today adulthood. The future perspectives of these patients are not yet well defined, therefore, we wanted to determine mid-term outcome of our Kawasaki patients.
Methodology:
All patients with the diagnosis of Kawasaki disease were selected from the database of paediatric and congenital cardiology of our hospital. The records were reviewed for disease characteristics and follow-up data. Descriptive statistics were performed.
Results:
Thirty-five patients were included (18 boys, median age at diagnosis 1.9 years, range from 0.4 to 12.2 years). In 94% of the cases, the left coronary artery was affected, whereas in 58% the right coronary artery was involved in the disease process. In three patients the left ventricular ejection fraction worsened below 50%. One patient underwent a balloon dilatation and stenting of a coronary artery, and in another patient inotropic support was needed. Aspirin was given in all, sandoglobulin in thirty patients; in 10% of the cases corticosteroids were administered. The active disease process terminated after a median of 0.5 months, ranging from 0.1 to 2.0 months. The patient cohort was followed for a median of 4 years (range from 0.1 to 17.7 years). During this follow-up time, no reoccurrences, no significant arrhythmias, and no deaths occurred. In all patients, the left ventricular ejection fraction remained normal or normalized. However, at the latest follow-up, 43% was still treated with a low dose of aspirin.
Conclusions:
The mid-term outcome of patients who suffered from Kawasaki disease during childhood is excellent. However, almost half of them were treated with oral aspirin during follow-up.
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