Incidence of coronary artery lesions in children with recurrent Kawasaki disease

ABSTRACT

Objective

Coronary artery lesions (CALs) are a major complication of Kawasaki disease (KD); however, data on CAL incidence and risk factors in recurrent KD are limited.

Methods

Ninety-seven children with recurrent KD were retrospectively enrolled from 2013 to 2022, and CAL incidence was tracked during admission, discharge, and during follow-up.

Results

Initially, 27.8% had CAL at admission and discharge, declining to 7.2% at 12 months post-discharge. Most patients (66 of 97, 68.0%) did not exhibit CAL at any of the time points, 7 cases presented CAL at all time points, indicating a persistent CAL. The remaining 20 cases presented CAL at admission but recovered at discharge or during follow-up. Notably, transient CALs had presented at discharge, or during the follow-up, but finally resolved at 12 months after discharge. Notably, prior IVIG resistance and increased prothrombin time seemed associated with CAL in recurrent KD, suggesting they could help identify patients needing close monitoring.

Conclusion

The study highlights decreasing CAL incidence over time in recurrent KD but with diverse patterns, emphasizing the importance of monitoring and further investigations to confirm these findings.

KEYWORDS:

• Recurrent Kawasaki disease
• coronary artery lesion
• incidence
• risk factor
• follow-up

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions statement

S Qian, Y Yuan, and X Chen conceived and designed the study. X Chen, L Gao, Z Zhen, Y Wang, J Na, W Yu, and Z Tian participated in data collection. X Chen, L Gao, and Z Zhen analyzed the data. S Qian and W Yu coordinated the project and funding for the project. All authors contributed to the manuscript and approved its final version for publication. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation

Ethics statement

This study was approved by the Ethics Committee of Beijing Children’s Hospital (2022-E-015-R) and complied with the Declaration of Helsinki. All data were fully anonymized and the requirement for informed consent was waived. This study adhered to the STROBE (STrengthening Reporting of OBservational studies in Epidemiology) guidelines for reporting observational studies.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/1744666X.2024.2314213

Additional information

Funding

This paper was funded by the National Natural Science Foundation of China [grant number 81800436].