Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography
Background Detection of coronary artery lesions (CALs) at initial echocardiography can aid in diagnosing Kawasaki disease (KD) and inform primary adjunctive treatments. We aimed to characterize patients with KD with CALs detected at initial echocardiography. Methods and Results We analyzed data from...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019853 |
| _version_ | 1811332685681917952 |
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| author | Ryusuke Ae Ryan A. Maddox Joseph Y. Abrams Lawrence B. Schonberger Yosikazu Nakamura Masanari Kuwabara Nobuko Makino Koki Kosami Yuri Matsubara Daisuke Matsubara Teppei Sasahara Ermias D. Belay |
| author_facet | Ryusuke Ae Ryan A. Maddox Joseph Y. Abrams Lawrence B. Schonberger Yosikazu Nakamura Masanari Kuwabara Nobuko Makino Koki Kosami Yuri Matsubara Daisuke Matsubara Teppei Sasahara Ermias D. Belay |
| author_sort | Ryusuke Ae |
| collection | DOAJ |
| description | Background Detection of coronary artery lesions (CALs) at initial echocardiography can aid in diagnosing Kawasaki disease (KD) and inform primary adjunctive treatments. We aimed to characterize patients with KD with CALs detected at initial echocardiography. Methods and Results We analyzed data from the nationwide Japanese KD survey that contained information on 103 222 population‐based patients diagnosed with KD across Japan during 2011 to 2018. Patients with CALs detected at initial echocardiography were assessed by age, day of illness, and number of principal KD signs (≥3). Multivariable logistic regression analysis was performed to evaluate factors independently associated with CAL detection. Overall, 3707 (3.6%) patients had CALs detected at initial echocardiography. Patients aged <12 and ≥60 months were associated with CAL detection (adjusted odds ratio [95% CI], 1.28 [1.18‒1.39] and 1.32 [1.20‒1.45], respectively; reference, 12‒59 months). Patients with delayed hospital visits were increasingly at higher risk for CAL detection (days 7‒8, 1.84 [1.63‒2.08]; days 9–10, 4.30 [3.58–5.15]; and days ≥11, 9.12 [7.63‒10.90]; reference, days 1–4). Patients with 3 or 4 principal KD signs were independently associated with CAL detection (1.75 [1.63‒1.88]). These patients were significantly more likely to be aged <12 months but were not associated with delayed hospital visit. Younger patients visited at earlier days of illness. Conclusions Timely diagnosis could be beneficial for patients with KD. However, even when the hospital visit occurred early in the course of illness, patients with 3 or 4 principal KD signs, especially younger patients, were at higher risk of CAL detection at initial echocardiography. |
| first_indexed | 2024-04-13T16:40:42Z |
| format | Article |
| id | doaj.art-27ac7937aae94a07b9a9ee8b39ebc88d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:40:42Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-27ac7937aae94a07b9a9ee8b39ebc88d2022-12-22T02:39:15ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-04-0110710.1161/JAHA.120.019853Kawasaki Disease With Coronary Artery Lesions Detected at Initial EchocardiographyRyusuke Ae0Ryan A. Maddox1Joseph Y. Abrams2Lawrence B. Schonberger3Yosikazu Nakamura4Masanari Kuwabara5Nobuko Makino6Koki Kosami7Yuri Matsubara8Daisuke Matsubara9Teppei Sasahara10Ermias D. Belay11Division of High‒Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GADivision of High‒Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GADivision of High‒Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GADivision of High‒Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GADivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDepartment of Pediatrics Jichi Medical University Tochigi JapanDivision of Public Health Center for Community Medicine Jichi Medical University Tochigi JapanDivision of High‒Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GABackground Detection of coronary artery lesions (CALs) at initial echocardiography can aid in diagnosing Kawasaki disease (KD) and inform primary adjunctive treatments. We aimed to characterize patients with KD with CALs detected at initial echocardiography. Methods and Results We analyzed data from the nationwide Japanese KD survey that contained information on 103 222 population‐based patients diagnosed with KD across Japan during 2011 to 2018. Patients with CALs detected at initial echocardiography were assessed by age, day of illness, and number of principal KD signs (≥3). Multivariable logistic regression analysis was performed to evaluate factors independently associated with CAL detection. Overall, 3707 (3.6%) patients had CALs detected at initial echocardiography. Patients aged <12 and ≥60 months were associated with CAL detection (adjusted odds ratio [95% CI], 1.28 [1.18‒1.39] and 1.32 [1.20‒1.45], respectively; reference, 12‒59 months). Patients with delayed hospital visits were increasingly at higher risk for CAL detection (days 7‒8, 1.84 [1.63‒2.08]; days 9–10, 4.30 [3.58–5.15]; and days ≥11, 9.12 [7.63‒10.90]; reference, days 1–4). Patients with 3 or 4 principal KD signs were independently associated with CAL detection (1.75 [1.63‒1.88]). These patients were significantly more likely to be aged <12 months but were not associated with delayed hospital visit. Younger patients visited at earlier days of illness. Conclusions Timely diagnosis could be beneficial for patients with KD. However, even when the hospital visit occurred early in the course of illness, patients with 3 or 4 principal KD signs, especially younger patients, were at higher risk of CAL detection at initial echocardiography.https://www.ahajournals.org/doi/10.1161/JAHA.120.019853coronary artery abnormalityechocardiographyKawasaki disease |
| spellingShingle | Ryusuke Ae Ryan A. Maddox Joseph Y. Abrams Lawrence B. Schonberger Yosikazu Nakamura Masanari Kuwabara Nobuko Makino Koki Kosami Yuri Matsubara Daisuke Matsubara Teppei Sasahara Ermias D. Belay Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary artery abnormality echocardiography Kawasaki disease |
| title | Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography |
| title_full | Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography |
| title_fullStr | Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography |
| title_full_unstemmed | Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography |
| title_short | Kawasaki Disease With Coronary Artery Lesions Detected at Initial Echocardiography |
| title_sort | kawasaki disease with coronary artery lesions detected at initial echocardiography |
| topic | coronary artery abnormality echocardiography Kawasaki disease |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019853 |
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