BACKGROUND: The risk factors for recently reported cases of giant coronary aneurysms due to Kawasaki disease have not been elaborated. METHODS: Fifty-three patients with giant coronary aneurysms, diagnosed as Kawasaki disease in 2005 and 2006, were selected from the 19th nationwide survey of the disease in Japan. With all the other patients recorded at the same hospitals as a control group, OR and their 95%CI were calculated to delineate the risk factors. RESULTS: In multivariate analyses, patients aged younger than 1 year (OR compared with 1-2-year-olds = 6.57) and those older than 5 years (OR compared with 1-2-year-olds = 4.24), those who received additional intravenous immunoglobulin (IVIG) without the use of steroid (OR = 8.38) and those who received steroid administration with or without the additional use of IVIG (OR = 220.51 and 83.83, respectively), showed significantly higher OR for giant coronary aneurysms. As for IVIG therapy, the additional use of IVIG (OR = 14.84), total dosage of IVIG exceeding 2500 mg/kg (OR compared with 1500-2499 mg/kg = 12.26) and the duration of IVIG administration for more than 3 days (OR = 30.12), were found to significantly increase the risk of developing giant aneurysms in univariate analyses that were adjusted for sex and age. CONCLUSIONS: The observation of 53 patients with giant coronary aneurysms due to Kawasaki disease among those included in the nationwide survey presented some risk factors, together with considerations about the associated aneurysms.
BACKGROUND: The risk factors for recently reported cases of giant coronary aneurysms due to Kawasaki disease have not been elaborated. METHODS: Fifty-three patients with giant coronary aneurysms, diagnosed as Kawasaki disease in 2005 and 2006, were selected from the 19th nationwide survey of the disease in Japan. With all the other patients recorded at the same hospitals as a control group, OR and their 95%CI were calculated to delineate the risk factors. RESULTS: In multivariate analyses, patients aged younger than 1 year (OR compared with 1-2-year-olds = 6.57) and those older than 5 years (OR compared with 1-2-year-olds = 4.24), those who received additional intravenous immunoglobulin (IVIG) without the use of steroid (OR = 8.38) and those who received steroid administration with or without the additional use of IVIG (OR = 220.51 and 83.83, respectively), showed significantly higher OR for giant coronary aneurysms. As for IVIG therapy, the additional use of IVIG (OR = 14.84), total dosage of IVIG exceeding 2500 mg/kg (OR compared with 1500-2499 mg/kg = 12.26) and the duration of IVIG administration for more than 3 days (OR = 30.12), were found to significantly increase the risk of developing giant aneurysms in univariate analyses that were adjusted for sex and age. CONCLUSIONS: The observation of 53 patients with giant coronary aneurysms due to Kawasaki disease among those included in the nationwide survey presented some risk factors, together with considerations about the associated aneurysms.
Authors: Sherif R Y Rizk; Galal El Said; Lori B Daniels; Jane C Burns; Howaida El Said; Khaled A Sorour; Soliman Gharib; John B Gordon Journal: Am J Cardiol Date: 2014-11-29 Impact factor: 2.778