Coronary Artery Aneurysms in Kawasaki Disease: Risk Factors for Progressive Disease and Adverse Cardiac Events in the US Population
| العنوان: | Coronary Artery Aneurysms in Kawasaki Disease: Risk Factors for Progressive Disease and Adverse Cardiac Events in the US Population |
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| المؤلفون: | Sarah D. deFerranti, Akiko Hamaoka-Okamoto, Adriana H. Tremoulet, Erika Berry, Jane W. Newburger, Kevin G. Friedman, Annette L. Baker, David Fulton, Vidya S. Mahavadi, Alexander Tang, Kimberly Gauvreau, Jane C. Burns |
| المصدر: | Journal of the American Heart Association, vol 5, iss 9 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, vol 5, iss 9 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 5, Iss 9, Pp n/a-n/a (2016) |
| بيانات النشر: | eScholarship, University of California, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Pediatrics, coronary aneurysm, Remission, Spontaneous, Myocardial Infarction, Anti-Inflammatory Agents, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, Cardiovascular, Imaging, 0302 clinical medicine, Risk Factors, hemic and lymphatic diseases, Tachycardia, Pediatric Cardiology, Coronary Artery Bypass, Child, Tomography, Original Research, education.field_of_study, Likelihood Functions, Quality and Outcomes, Immunoglobulins, Intravenous, Magnetic Resonance Imaging, X-Ray Computed, Natural history, medicine.anatomical_structure, Heart Disease, Cardiovascular Diseases, Echocardiography, Child, Preschool, 6.1 Pharmaceuticals, Disease Progression, Female, Mortality/Survival, Cardiology and Cardiovascular Medicine, Intravenous, Artery, medicine.medical_specialty, Remission, Population, Immunoglobulins, Regression rate, Mucocutaneous Lymph Node Syndrome, 03 medical and health sciences, Percutaneous Coronary Intervention, Rare Diseases, Clinical Research, 030225 pediatrics, Internal medicine, mental disorders, medicine, Humans, Immunologic Factors, Treatment effect, cardiovascular diseases, education, Preschool, Heart Disease - Coronary Heart Disease, Proportional Hazards Models, Retrospective Studies, Kawasaki disease, business.industry, Spontaneous, Prevention, Ventricular, Evaluation of treatments and therapeutic interventions, nutritional and metabolic diseases, Infant, medicine.disease, United States, cardiovascular outcomes, Logistic Models, Coronary Occlusion, lcsh:RC666-701, Multivariate Analysis, Tachycardia, Ventricular, Heart Transplantation, Tomography, X-Ray Computed, business, Progressive disease, Mace |
| الوصف: | Background The natural history of coronary artery aneurysms ( CAA ) after intravenous immunoglobulin ( IVIG ) treatment in the United States is not well described. We describe the natural history of CAA in US Kawasaki disease ( KD ) patients and identify factors associated with major adverse cardiac events ( MACE ) and CAA regression. Methods and Results We evaluated all KD patients with CAA at 2 centers from 1979 to 2014. Factors associated with CAA regression, maximum CA z ‐score over time ( z Max), and MACE were analyzed. We performed a matched analysis of treatment effect on likelihood of CAA regression. Of 2860 KD patients, 500 (17%) had CAA , including 90 with CAA z ‐score >10. Most (91%) received IVIG within 10 days of illness, 32% received >1 IVIG , and 27% received adjunctive anti‐inflammatory medications. CAA regression occurred in 75%. Lack of CAA regression and higher CAA z Max were associated with earlier era, larger CAA z ‐score at diagnosis, and bilateral CAA in univariate and multivariable analyses. MACE occurred in 24 (5%) patients and was associated with higher CAA z ‐score at diagnosis and lack of IVIG treatment. In a subset of patients (n=132) matched by age at KD and baseline CAA z ‐score, those receiving IVIG plus adjunctive medication had a CAA regression rate of 91% compared with 68% for the 3 other groups ( IVIG alone, IVIG ≥2 doses, or IVIG ≥2 doses plus adjunctive medication). Conclusions CAA regression occurred in 75% of patients. CAA z ‐score at diagnosis was highly predictive of outcomes, which may be improved by early IVIG treatment and adjunctive therapies. |
| وصف الملف: | application/pdf |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::20e4268e64433f72325341959efe08b3 https://escholarship.org/uc/item/2zg0908z |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....20e4268e64433f72325341959efe08b3 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |