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Outcomes of Kawasaki disease with giant coronary aneurysms: a single-centre study in southwest China

Published online by Cambridge University Press:  08 June 2020

Piaoliu Yuan Open the ORCID record for Piaoliu Yuan [Opens in a new window] ,
Danyan Su ,
Krishna D. Mandal ,
Suyuan Qin ,
Na Zhao  and
Yusheng Pang
Piaoliu Yuan
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
Danyan Su
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
Krishna D. Mandal
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
Suyuan Qin
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
Na Zhao
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
Yusheng Pang*
Affiliation:
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, PR China
*
Author for correspondence: Yusheng Pang, MD, PhD, Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, 22 Shuangyong Road, Nanning530021, Guangxi Autonomous Region, PR China. Tel: +86 07715331053; Fax: +86 5356780. E-mail: pangyush@163.com
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Abstract

Background:

Giant coronary aneurysms are the most severe complications of Kawasaki disease. There are few reports of outcomes from China. Most previous studies were based only on absolute aneurysmal dimensions. The aim of the present study was to catalog the outcomes of Kawasaki disease with giant coronary aneurysms in southwest China based on absolute dimensions and the z-score adjusted for body surface area.

Methods and results:

All patients diagnosed with giant coronary aneurysms (z-score ≥ 10 or absolute dimension ≥ 8 mm) between December, 2002 and December, 2018 were included. We retrospectively analysed patient characteristics and clinical data from 38 patients with giant coronary aneurysms. Over a median follow-up period of 30.5 months (range from 1.7 months to 22.3 years), including patients in chronic phase who had been diagnosed prior to 2002, eight patients had myocardial infarction, including two deaths and one patient with coronary artery bypass grafting. The 1-, 2-, and 5-year event-free rates were 0.63, 0.63, and 0.53 for thrombosis, respectively, and 0.86, 0.81, and 0.81 for major adverse cardiac events, respectively. The 1-, 2-, and 5-year regression-free rates were 0.94, 0.85, and 0.67, respectively. A total of 73.7% of patients remained active.

Conclusion:

In the early stages of Kawasaki disease, patients with giant coronary aneurysms often experience major cardiovascular events; however, they are also likely to have normalisation of the coronary internal luminal diameter. With long-term anticoagulation, close cardiologic monitoring, and prompt thrombolytic therapy, most patients can achieve disease-free periods.

Keywords

Kawasaki diseasegiant coronary aneurysmsoutcomefollow-upmyocardial infarction
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 6 , June 2020 , pp. 834 - 839
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Piaoliu Yuan and Danyan Su contributed equally to this work and should be considered co-first authors.

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