Coronary Artery Outcomes in Kawasaki Disease by Treatment Day Within 10 Days of Fever Onset

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Rheumatology

Background:

• Kawasaki disease (KD) is a critical childhood illness potentially causing coronary artery aneurysms (CAAs).
• Intravenous immunoglobulin (IVIG) is effective in preventing CAAs when administered within 10 days of fever onset in KD patients.
• Delayed treatment for KD, especially with incomplete criteria, may increase the risk of adverse cardiac outcomes.

Purpose of the Study:

• To evaluate the association between the day of treatment and the prevalence of coronary artery aneurysms (CAAs) in children with Kawasaki disease (KD).
• To determine if delaying KD treatment within the first 10 days of fever onset impacts the risk of developing CAAs.

Main Methods:

• Retrospective cohort study of 290 children treated for KD within 10 days of fever onset.
• Analysis of the prevalence of coronary artery abnormalities (maximum z score ≥2.5) based on the day of treatment initiation.
• Subgroup analyses conducted by age, sex, and treatment year.

Main Results:

• No statistically significant difference in the odds of developing coronary artery abnormalities was found for each day of delayed treatment within 10 days of fever onset (aOR, 0.87; P = .13).
• Subgroup analyses did not reveal a significant association between treatment day and adverse coronary outcomes, though the sample size for infants under 6 months was limited.

Conclusions:

• The study findings support current clinical recommendations for managing Kawasaki disease.
• Similar odds of developing adverse coronary outcomes were observed regardless of treatment day within the initial 10-day period following fever onset.