title: Prevalence of Kawasaki disease in young adults with suspected myocardial ischemia.
abstract: BACKGROUND
  Up to 25% of patients with untreated Kawasaki disease (KD) and 5% of those treated with intravenous immunoglobulin will develop coronary artery aneurysms. Persistent aneurysms may remain silent until later in life when myocardial ischemia can occur. We sought to determine the prevalence of coronary artery aneurysms suggesting a history of KD among young adults undergoing coronary angiography for evaluation of possible myocardial ischemia.
  
  
  RESULTS
  We reviewed the medical histories and coronary angiograms of all adults <40 years of age who underwent coronary angiography for evaluation of suspected myocardial ischemia at 4 San Diego hospitals from 2005 to 2009 (n=261). History of KD-compatible illness and cardiac risk factors were obtained by medical record review. Angiograms were independently reviewed for the presence, size, and location of aneurysms and coronary artery disease by 2 cardiologists blinded to the history. Patients were evaluated for number of risk factors, angiographic appearance of their coronary arteries, and known history of KD. Of the 261 young adults who underwent angiography, 16 had coronary aneurysms. After all clinical criteria were assessed, 5.0% had aneurysms definitely (n=4) or presumed (n=9) secondary to KD as the cause of their coronary disease.
  
  
  CONCLUSIONS
  Coronary sequelae of KD are present in 5% of young adults evaluated by angiography for myocardial ischemia. Cardiologists should be aware of this special subset of patients who may benefit from medical and invasive management strategies that differ from the strategies used to treat atherosclerotic coronary artery disease.
authors.affiliation: UCSD Sulpizio Cardiovascular Center, Mail Code 7411, 9444 Medical Center Dr, La Jolla, CA 92037-7411, USA. lbdaniels@ucsd.edu
authors.forename: Lori B
authors.initials: LB
authors.lastname: Daniels
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Tjajadi
authors.forename: Hannah H
authors.initials: HH
authors.lastname: Walford
authors.forename: Susan
authors.initials: S
authors.lastname: Jimenez-Fernandez
authors.forename: Vera
authors.initials: V
authors.lastname: Trofimenko
authors.forename: Daryl B
authors.initials: DB
authors.lastname: Fick
authors.forename: Hoang-Anh L
authors.initials: HA
authors.lastname: Phan
authors.forename: Peter E
authors.initials: PE
authors.lastname: Linz
authors.forename: Keshav
authors.initials: K
authors.lastname: Nayak
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Kahn
authors.forename: Jane C
authors.initials: JC
authors.lastname: Burns
authors.forename: John B
authors.initials: JB
authors.lastname: Gordon
mesh_terms: D000328:Adult; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult