Abstract 189: Natural History of Coronary Artery Aneurysms in Kawasaki Disease in US population and Risk Factors for Persistent Aneurysms
| Autor: | Kevin G Friedman, Akiko Hamaoko-Okamoto, Kimberly Gauvreau, Sarah de Ferranti, Annette Baker, David Fulton, Adriana Tremoulet, Alexander Tang, Erika Berry, Vidya S Mahavadi, Jane Burns, Jane Newburger |
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| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Circulation. 131 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.131.suppl_2.189 |
| Popis: | Background: The late natural history of coronary artery aneurysms (CAA) after IVIG treatment in the US is not well described. Methods: We evaluated all KD patients (pts) at 2 centers from 1984-2014. Entry criteria were: 1) IVIG treatment; 2) CAA, defined as LAD or RCA z-score ≥ 3 or Japanese Ministry of Health criteria; and 3) ≥1 follow-up (f/u) echo. Kaplan Meier curves evaluated time to CAA regression (z < 2.5) and Cox regression examined factors associated with persistent CAA and major adverse cardiac events (MACE= death, MI, CABG, PCI, occluded CA). Results: Of 2592 KD pts, 408 (15%) met entry criteria and were 72% male; 54% white, 21% Asian, 7% black, 18% other race. Median age at fever onset was 1.8 y [IQR: 0.7-4.4y], 74% had complete KD, and fever days before 1 st IVIG were 7d [IQR 6-10d]. IVIG retreatment occurred in 35% and adjunctive anti-inflammatory therapy in 37%, both increased over time (p Over median f/u of 2.6 y (0.01-29.0y), 313 (77%) had CAA regression at median of 1.1 mo (IQR =0.3-16.9mo). Univariate risk factors for CAA persistence were z ≥ 8 at diagnosis (HR 0.22, p Day 10 (HR 0.46, p8 at diagnosis (p Conclusion: Most CAA regress within the first year after treatment. Persistent CAA are more likely in pts with larger CAA, multi-vessel CAA and late IVIG treatment. In pts with large CAA, time to regression has gotten shorter in more recent eras, possibly related to greater use of adjunctive therapies. |
| Databáze: | OpenAIRE |
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