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Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements.

Publication ,  Journal Article
McCrindle, BW; Li, JS; Minich, LL; Colan, SD; Atz, AM; Takahashi, M; Vetter, VL; Gersony, WM; Mitchell, PD; Newburger, JW ...
Published in: Circulation
July 10, 2007

BACKGROUND: Most studies of coronary artery involvement and associated risk factors in Kawasaki disease have used the Japanese Ministry of Health dichotomous criteria. Analysis of serial normalized artery measurements may reveal a broader continuous spectrum of involvement and different risk factors. METHODS AND RESULTS: Clinical, laboratory, and echocardiographic measurements obtained at baseline and 1 week and 5 weeks after presentation were examined in 190 Kawasaki disease patients as part of a clinical trial of primary therapy with pulse steroids in addition to standard intravenous immunoglobulin. Maximum coronary artery z score normalized to body surface area was significantly greater than normal at all time points, decreasing significantly over time from baseline. A maximal z score > or = 2.5 at any time was noted in 26% of patients. Japanese Ministry of Health dimensional criteria were met by 23% of patients. Significant independent factors associated with greater z score at any time included younger patient age, longer interval from disease onset to treatment with intravenous immunoglobulin, lower serum IgM level at baseline, and lower minimum serum albumin level. z scores of the proximal right coronary artery were higher than those in the left anterior descending branch. CONCLUSIONS: Analyses of serial normalized coronary artery measurements in optimally treated Kawasaki disease patients demonstrated that for most patients, measurements are greatest at baseline and subsequently diminish; baseline measurements appear to be good predictors of involvement during early follow-up. When a more precise assessment is used, risk factors for coronary artery involvement are similar to those defined with arbitrary dichotomous criteria.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 10, 2007

Volume

116

Issue

2

Start / End Page

174 / 179

Location

United States

Related Subject Headings

  • Risk Factors
  • Reference Values
  • Mucocutaneous Lymph Node Syndrome
  • Humans
  • Coronary Vessels
  • Coronary Disease
  • Child
  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
 

Citation

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McCrindle, B. W., Li, J. S., Minich, L. L., Colan, S. D., Atz, A. M., Takahashi, M., … Pediatric Heart Network Investigators, . (2007). Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation, 116(2), 174–179. https://doi.org/10.1161/CIRCULATIONAHA.107.690875
McCrindle, Brian W., Jennifer S. Li, L LuAnn Minich, Steven D. Colan, Andrew M. Atz, Masato Takahashi, Victoria L. Vetter, et al. “Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements.Circulation 116, no. 2 (July 10, 2007): 174–79. https://doi.org/10.1161/CIRCULATIONAHA.107.690875.
McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, et al. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007 Jul 10;116(2):174–9.
McCrindle, Brian W., et al. “Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements.Circulation, vol. 116, no. 2, July 2007, pp. 174–79. Pubmed, doi:10.1161/CIRCULATIONAHA.107.690875.
McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW, Pediatric Heart Network Investigators. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007 Jul 10;116(2):174–179.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 10, 2007

Volume

116

Issue

2

Start / End Page

174 / 179

Location

United States

Related Subject Headings

  • Risk Factors
  • Reference Values
  • Mucocutaneous Lymph Node Syndrome
  • Humans
  • Coronary Vessels
  • Coronary Disease
  • Child
  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences