Are patients after Kawasaki disease at increased risk for accelerated atherosclerosis?
OBJECTIVE
To assess whether patients after Kawasaki disease (KD) have increased risk factors and abnormalities suggestive of early atherosclerosis in systemic arteries.


METHODS
In a case-control study, we compared 52 patients after typical Kawasaki disease with varying coronary artery involvement (67% males; mean time from illness episode 11.2 +/- 3.7 years) studied between 10 and 20 years of age with 60 healthy control subjects (50% males). Brachial artery reactivity (BAR) was assessed using vascular ultrasonography, and atherosclerosis risk assessment was performed. Differences between cases and controls and factors associated with endothelial function in cases were determined.


RESULTS
Case patients had lower resting systolic blood pressure (P < .001), lower apolipoprotein AI levels (P < .05), and higher levels of glycosylated hemoglobin (P = .007). There were no significant differences in BAR between case patients and control subjects in response to increased flow (P = .60) and nitroglycerine (P = .93). For case patients, significant factors in multivariable analysis for lower flow-mediated BAR included higher fasting triglyceride levels (P = .04) and lower free fatty acid levels (P < .001). No significant relationship was noted with past or current coronary artery involvement.


CONCLUSIONS
Patients with KD have some abnormalities for risk factors for atherosclerosis, but systemic arterial endothelial dysfunction is not present in the long term.
McCrindle
Brian W
BW
Division of Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada. brian.mccrindle@sickkids.ca
McIntyre
Susan
S
Kim
Christopher
C
Lin
Tammy
T
Adeli
Khosrow
K
D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology*; D018660:Blood Pressure Monitoring, Ambulatory; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D003324:Coronary Artery Disease / Q000453:epidemiology; D003331:Coronary Vessels / Q000473:pathology; D004108:Dilatation, Pathologic; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D015999:Multivariate Analysis; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D018084:Ultrasonography, Interventional