Cardiac Events in Kawasaki Disease With Coronary Aneurysms Revisited, A Two-center Retrospective Cohort Study in Thailand

Abstract

Kawasaki disease (KD) is a common vasculitis in children, which may be complicated with coronary artery aneurysms (CAAs). We aimed to report the rates of major adverse cardiac events (MACE) and determine the risks of MACE in children diagnosed with KD and CAAs in Thailand. Data of 170 children diagnosed with KD and CAAs in two centers of Thailand between 1994 and 2019 was retrospectively reviewed. The risks of MACE were analyzed using multivariate analysis. Of 170 patients, forty-nine patients (28.8%) had giant CAAs. During the median time of follow-up (5.4 years; ranging from 22 days to 23 years), 19 patients (11.1%) experienced MACE including 12 coronary artery bypass grafting, 2 percutaneous coronary intervention and 5 patients with evidence of coronary occlusion. Coronary interventions were performed at 4 years (ranging from 0.01 to 9.5 years) after the KD diagnosis. Independent risks of MACE in KD with CAAs were from the presence of giant aneurysms (HR 16.55; 95% CI 2.52 to 108.63; p=0.003) and lack of intravenous immunoglobulin (IVIG) treatment (HR 11.43; 95% CI 2.8 to 46.62; p=0.001). The intervention-free rate at 5 and 10 years in patients with giant CAAs was 78.7% and 52.2%, respectively.Trial registration: TCTR20190125004