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Long-Term Prognosis for Patients with Kawasaki Disease Complicated by Large Coronary Aneurysm (diameter ≥6 mm)

Ji Seok Bang1,2, Gi Beom Kim1, Bo Sang Kwon1

  • 1Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.

Korean Circulation Journal
|August 3, 2017
PubMed

Insights

Kawasaki disease (KD) patients with large coronary aneurysms have good long-term survival, though many require interventions. Careful monitoring is essential for all KD patients with coronary aneurysms, regardless of size.

Area of Science:

  • Cardiology
  • Pediatric Rheumatology
  • Vascular Medicine

Background:

  • Kawasaki disease (KD) can lead to large coronary artery aneurysms.
  • These aneurysms pose risks of coronary stenosis, obstruction, and ischemic heart disease.
  • Long-term outcomes for KD patients with large coronary aneurysms require further investigation.

Purpose of the Study:

  • To examine the long-term outcomes of patients diagnosed with Kawasaki disease (KD).
  • To specifically assess patients with KD complicated by large coronary aneurysms (diameter ≥6 mm).
  • To evaluate the incidence of coronary stenosis, interventions, and survival rates in this cohort.

Main Methods:

  • Retrospective review of medical records for 71 KD patients with large coronary aneurysms (≥6 mm diameter).
  • Data collected from December 1986 to December 2013 from an institutional database.
  • Analysis included patient demographics, aneurysm size, development of stenosis/occlusion, interventions, and clinical outcomes.

Main Results:

  • Mean follow-up was 12.5 years; 48 patients had giant aneurysms (≥8 mm), 23 had 6-8 mm aneurysms.
  • Coronary stenosis or occlusion occurred in 42.3% of patients.
  • 28.2% required multiple catheter/surgical interventions, with a 33.7% cumulative intervention rate at 20 years; 7 patients experienced myocardial infarction.

Conclusions:

  • Long-term survival for KD patients with large coronary aneurysms is generally good.
  • Despite good survival, a significant proportion (28.2%) underwent multiple interventions.
  • Close follow-up is crucial for KD patients with coronary aneurysms, including those with 6-8 mm diameters, similar to giant aneurysms.
Abstract

Keywords:
Coronary aneurysmMucocutaneous lymph node syndromeMyocardial infarctionPrognosis

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