Outcomes Associated with Giant Coronary Artery Aneurysms after Kawasaki Disease: A Single-Center United States Experience

被引:0
|
作者
Elias, Matthew D. [1 ]
Brothers, Julie A. [1 ]
Hogarty, Alexa N. [1 ]
Martino, Jordy [1 ]
O'Byrne, Michael L. [1 ]
Patel, Chandni [1 ]
Stephens, Paul [1 ]
Tingo, Jennifer [1 ]
Vetter, Victoria L. [1 ]
Ravishankar, Chitra [1 ]
Giglia, Therese M. [1 ]
机构
[1] Childrens Hosp Philadelphia, Div Cardiol, 3401 Civ Ctr Blvd, Philadelphia, PA 19104 USA
来源
JOURNAL OF PEDIATRICS | 2024年 / 274卷
关键词
LONG-TERM CONSEQUENCES; SCIENTIFIC STATEMENT; PROGNOSIS;
D O I
10.1016/j.jpeds.2024.114145
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives To determine the long-term outcomes among a cohort of patients with Kawasaki disease (KD) and a history of giant coronary artery aneurysms (CAAs) at a single US center. Study design Medical records for all patients with KD and giant CAAs at a pediatric academic institution were reviewed. Primary outcomes included major adverse cardiovascular events (MACE) and normalization of CA luminal diameter, using Kaplan-Meier analyses. Results There were 60 patients with KD and giant CAAs identified between 1989 and 2023. The majority of patients were male (71.7%) with a median age at diagnosis of 0.9 years (range, 0.2-13.3 years). Patients were followed for a median of 11 years, up to 34.5 years. MACE occurred in 13 patients (21.7%) at a median of 1.4 years (range, 0.04-22.6 years) after KD diagnosis. The 10-, 20-, and 30-year MACE-free rates were 75%, 75%, and 60%. Patients with maximal CAz z scores of >= 20 or bilateral CAA were more likely to have MACE. During follow-up, 26.7% of CAA regressed to a normal luminal diameter at a median of 3.6 years (range, 0.6-12.0 years). The 10-, 20- and 30-year likelihood of CA regression to normal luminal diameter was 36%, 46%, and 46%. Conclusions Over 30 years, MACE occurred in nearly 22% of patients, more often in those with bilateral CAA or CAz z scores of >= 20. Despite regression to a normal luminal diameter in >25% of CAAs, patients with a history of KD-associated giant CAA require ongoing surveillance for cardiac complications, even years after the initial disease. (J Pediatr 2024;274:114145).
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页数:9
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