title: Difference in Risk Factors for Subtypes of Acute Cardiac Lesions Resulting from Kawasaki Disease.
abstract: Few studies discuss the risk factors for acute cardiac lesions (within 30 days) resulting from Kawasaki disease (KD). We aimed to clarify the characteristics of patients with cardiac lesions within 30 days and determine the risk factors for acute cardiac lesion subtypes. Using the 23rd nationwide survey of KD in Japan, we analyzed data from patients with or without acute cardiac lesions resulting from KD (n = 31,380). We subdivided patients with acute cardiac lesions into three types: acute valvular lesions, coronary aneurysms, and giant coronary aneurysms (GCA), and calculated the odds ratios of potential risk factors for acute cardiac lesion subtypes. The prevalence of acute cardiac lesions was 8.6%, and these lesions were more prevalent among males than females (1.98:1). Male sex, age <1 year, and atypical definite cases predicted coronary artery lesions (CAL). The risk factors for valvular lesions differed from the risk factors for CALs, but GCA risk factors were similar to CAL risk factors: age <1 year, later presentation to hospital, atypical definite cases, and resistance to initial intravenous immunoglobulin (IVIG) therapy. Resistance to IVIG therapy was a significant risk factor for acute GCA. We found differences in cardiac lesion risk factors within 30 days of diagnosing KD between acute CAL and valvular lesions resulting from KD. In particular, pediatricians should consider atypical definite cases and resistance to initial IVIG when assessing the risk of acute-phase GCA.
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Maho
authors.initials: M
authors.lastname: Yamashita
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ae
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yashiro
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Aoyama
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Makino
authors.affiliation: Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. nakamuyk@jichi.ac.jp.
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
mesh_terms: D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology*; D004351:Drug Resistance; D004452:Echocardiography; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000188:drug therapy*; D016017:Odds Ratio; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: Epidemiology; Giant coronary aneurysm; Lesions; Mucocutaneous lymphnode syndrome; Resistance of initial IVIG; Valvular lesions