High persistence rate of established coronary artery lesions secondary to Kawasaki disease among a panethnic Canadian population.
The incidence of resolution of proximal coronary artery lesions subsequent to Kawasaki disease over an 11-year period was studied retrospectively. In 28 patients proximal coronary artery lesions were identified by two-dimensional echocardiography or angiography at 1 to 3 months after disease onset. Follow-up data were adequate in 27 patients, 17 of whom were boys; 18 were white, two black, four Oriental (non-Japanese), and three of East Indian origin. Age at onset of Kawasaki disease ranged from 11 weeks to 9 years (mean 2.5 years). Coronary artery lesions were categorized as ectatic (internal diameter greater than 3 mm in those less than 5 years of age) or aneurysmal (internal lumen of a segment one and one-half times larger than an adjacent segment). Resolution was assessed by two-dimensional echocardiography or angiography during a follow-up period of 3 months to 11 years (mean 2.7 years). Apparent resolution (vessel diameter less than 3 mm) of coronary artery lesions occurred in four (15%) patients--one with aneurysmal lesions, three with ectatic lesions--all within 1 year of disease onset. Eight patients developed myocardial infarction; one of these patients died. The resolution rate was less than previously reported. This high rate would warrant closer attention to the state and sequelae of coronary artery lesions, including obstructive coronary artery disease, in follow-up assessments.
Turner-Gomes
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S
Rose
V
V
Brezina
A
A
Smallhorn
J
J
Rowe
R D
RD
D000783:Aneurysm / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004108:Dilatation, Pathologic / Q000175:diagnosis; D004452:Echocardiography; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009864:Ontario; D012189:Retrospective Studies