title: Medium- or Higher-Dose Acetylsalicylic Acid for Acute Kawasaki Disease and Patient Outcomes.
abstract: To investigate the effect of medium- or higher-dose acetylsalicylic acid (ASA) for treating acute-phase Kawasaki disease to prevent coronary artery aneurysm (CAA).
  
  
  
  Among the children with acute Kawasaki disease investigated in the eighth nationwide survey in the Republic of Korea, 8456 children with adequate data were included in this study. The subjects were divided into 2 groups according to the use of medium- or higher-dose ASA (≥30 mg/kg/day), or-low dose ASA (3-5 mg/kg/day) during the acute febrile phase. Both z- score-based criteria and Japanese criteria for CAA were used.
  
  
  
  The prevalence of CAA based on z-score (24.8% vs 18.3%; P = .001) and on the Japanese criteria (19.0% vs 10.4%; P < .001) was higher in the 7947 patients who received medium- or higher-dose ASA compared with the 509 patients who received low-dose ASA. The use of medium- or higher-dose ASA was a significant predictor of CAA based on both sets of criteria by univariate analysis (based on z-score: OR, 1.472, 95% CI, 1.169-1.854, P = .001; based on Japanese criteria: OR, 2.013, 95% CI, 1.507-2.690, P < .001) and multivariate logistic regression analysis (OR, 1.527, 95% CI, 1.166-2.0, P = .003 and OR, 2.198, 95% CI, 1.563-3.092, P < .001, respectively).
  
  
  
  The use of medium- or higher-dose ASA in acute Kawasaki disease did not prevent CAA. A future randomized controlled trial is needed to determine the optimum dose of ASA.
authors.affiliation: Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Gi Beom
authors.initials: GB
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: jjyu@amc.seoul.kr.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Yu
authors.affiliation: Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Kyung Lim
authors.initials: KL
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Soo In
authors.initials: SI
authors.lastname: Jeong
authors.affiliation: Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Song
authors.affiliation: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ji Whan
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Hong
authors.affiliation: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Republic of Korea.
authors.forename: Chan Uhng
authors.initials: CU
authors.lastname: Joo
mesh_terms: D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000209:etiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Kawasaki disease; aspirin; coronary aneurysm