title: Calcium scoring in patients with a history of Kawasaki disease.
abstract: OBJECTIVE
  The goal of this study was to assess coronary artery calcification in patients ≥10 years or age with a history of Kawasaki disease (KD).
  
  
  BACKGROUND
  Patients with a history of KD and coronary artery aneurysms are at risk for late morbidity from coronary artery events. It is unknown whether patients with KD with acutely normal or transiently dilated coronary arteries also have increased risk of late coronary artery complications. Coronary calcium scoring using noncontrast computed tomography is a well-established tool for risk-stratifying patients with atherosclerotic coronary artery disease, but there are limited data on its role in evaluating patients with a history of KD.
  
  
  METHODS
  We performed coronary artery calcium (CAC) volume scoring using a low radiation dose computed tomography protocol on 70 patients (median age 20.0 years) with a remote history of KD (median interval from acute KD to imaging 14.8 years). Forty-four (63%) patients had no history of coronary dilation, 12 (17%) had a history of transient dilation, and 14 (20%) had coronary aneurysms.
  
  
  RESULTS
  All of the patients with normal coronary artery internal diameter during the acute phase of KD and 11 of 12 patients with transient dilation had CAC scores of zero. Coronary calcification was observed in 10 of the 14 patients with coronary aneurysms, with the degree of calcification ranging from mild to severe and occurring years after the patients' acute KD.
  
  
  CONCLUSIONS
  Coronary calcification was not observed in patients with a history of KD and normal coronary arteries during the acute phase. Therefore, CAC scanning may be a useful tool to screen patients with a remote history of KD or suspected KD and unknown coronary artery status. Coronary calcification, which may be severe, occurs late in patients with coronary aneurysms. The pathophysiology and clinical implications of coronary calcification in patients with aneurysms are currently unknown and warrant further study.
authors.affiliation: Department of Medicine, University of California San Diego School of Medicine, 9444 Medical Center Drive, La Jolla, CA 92037-7411, USA. akahn@ucsd.edu
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Kahn
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Lori B
authors.initials: LB
authors.lastname: Daniels
authors.forename: Susan
authors.initials: S
authors.lastname: Jimenez-Fernandez
authors.forename: Amber S
authors.initials: AS
authors.lastname: Cox
authors.forename: John B
authors.initials: JB
authors.lastname: Gordon
authors.forename: Jane C
authors.initials: JC
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011829:Radiation Dosage; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult