Related Experiment Video
Updated: Dec 19, 2025
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Outcomes in Kawasaki disease patients with coronary artery abnormalities at admission
Ryusuke Ae1, Joseph Y Abrams2, Ryan A Maddox2
1Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
Insights
Kawasaki disease (KD) coronary artery lesions (CALs) often improve, but larger CALs, older age, recurrent KD, family history, and delayed treatment are linked to worse outcomes. Prompt diagnosis and intervention are crucial for better coronary health in KD patients.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease (KD) can cause coronary artery lesions (CALs).
- While CALs can improve, sub-acute outcomes at admission are less understood.
- This study focuses on CALs detected upon initial diagnosis of KD.
Purpose of the Study:
- To investigate the sub-acute outcomes of coronary artery lesions (CALs) in patients diagnosed with Kawasaki disease (KD).
- To identify factors associated with the improvement, stability, or progression of CALs within 30 days of onset.
- To inform clinical management strategies for Kawasaki disease.
Main Methods:
- Analysis of a nationwide Japanese KD survey dataset.
- Inclusion of patients with CALs detected at admission, treated with IVIG within 10 days of onset.
- Categorization of coronary outcomes (improved, unchanged, progressed) and use of ordinal logistic regression to identify associated factors.
Main Results:
- Out of 2024 patients, 76.5% showed improved CALs, 19.3% unchanged, and 4.2% progressed.
- Factors associated with worse outcomes included larger CALs (aneurysms, giant aneurysms), age ≥60 months, recurrent KD, parental history of KD, and delayed admission (8-10 days).
- Over 80% of patients with coronary artery dilatations experienced improvement.
Conclusions:
- Patients with larger CALs, older age, recurrent KD, or family history may need intensive treatment.
- Delayed admission correlates with poorer coronary outcomes, emphasizing the need for prompt KD diagnosis and treatment.
- Early intervention is key to improving coronary outcomes in Kawasaki disease.
Background:
Previous studies demonstrated that coronary artery lesions (CALs) resulting from Kawasaki disease (KD) can improve over time. However, limited information is available on sub-acute outcomes of CALs detected at admission during KD illness.
Methods:
The nationwide Japanese KD survey contained substantial information on KD patients with CALs detected at admission and who received standard IVIG treatment within 10 days of disease onset. Coronary outcomes were evaluated by changes in CALs from admission to the first assessment at 30 days from disease onset in three categories: improved, unchanged, and progressed. Ordinal logistic regression analysis was performed to evaluate factors associated with the outcomes.
Results:
Of 2024 patients with CALs detected at admission, improved, unchanged, and progressed outcomes were found in 1548 (76.5%), 390 (19.3%), and 86 (4.2%), respectively. Over 80% of patients with coronary artery (CA) dilatations had improved outcome. Independent factors associated with worse outcomes were larger-size CALs (adjusted ORs [95% CIs]: CA aneurysm = 5.13 [3.65-7.22] and giant CA aneurysms = 7.49 [3.56-15.72] compared with CA dilatation, respectively), age ≥ 60 months (1.45 [1.08-1.94] compared with 12-59 months), recurrent KD (1.57 [1.07-2.29]), parental history of KD (2.23 [1.02-4.85]), and delayed admission (8-10 days from disease onset: 1.76 [1.21-2.57] compared with 1-4 days).
Conclusions:
KD patients with larger CALs, ≥60 months old, and with recurrent status or parental history may require more rigorous treatment. In addition, delayed admission may result in worse coronary outcome, indicating that prompt diagnosis and treatment are required.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management