title: Prevalence and the long-term coronary risks of patients with Kawasaki disease in a general population <40 years: a national database study.
abstract: BACKGROUND
  Patients with Kawasaki disease (kDa) may develop coronary arterial lesions and subsequent coronary events. The first reported case in Taiwan was in 1976, and the annual incidence from 2003 to 2006 was 69/100 000 children < 5 years. A population study from Taiwan, a country with a high incidence of kDa, national health insurance, and easily accessible medical care, would adequately reflect the long-term risk.
  
  
  RESULTS
  We retrieved the data of kDa patients from a national health insurance 2000 to 2010 database of Taiwan, a country with a child health index similar to those in the United States. The occurrence of coronary complications and interventions was identified by the respective International Classification of Diseases, Ninth Revision, codes. The prevalence of kDa in the population < 40 years was 34.9/100 000 (male/female ratio, 1.47). Coronary complications occurred in 1254 patients (5.37%; male/female ratio, 2.19), with an average annual risk of 2.4% (2.7% for males and 2.0% for females). An acute myocardial infarction occurred in 19 patients (0.08%; 18 males and 1 female), of whom one third were aged between 10 and 15 years (median, 15.7 years; range, 0.7-36.7 years). A coronary intervention was performed by catheterization in 18 patients (all males) at a median age of 24.5 years and by surgery in 10 patients (male/female ratio, 4.0) at a median age of 21.7 years, with mortality at discharge being 0% and 25%, respectively.
  
  
  CONCLUSIONS
  This study estimated the overall prevalence of kDa (≈1/2940) in a population < 40 years. They, particularly the males, carry long-term coronary risks from a young age. Risk stratification for a timely coronary intervention and risk modification are mandatory.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. wumh@ntu.edu.tw
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Chen
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Min-Tai
authors.initials: MT
authors.lastname: Lin
authors.forename: Shin-Chung
authors.initials: SC
authors.lastname: Huang
authors.forename: San-Kuei
authors.initials: SK
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology* / Q000401:mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology; D009313:National Health Programs; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult