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Multicenter Study
. 2023 Feb 7;12(3):e022417.
doi: 10.1161/JAHA.121.022417. Epub 2023 Jan 31.

Analysis of Coronary Arterial Aneurysm Regression in Patients With Kawasaki Disease by Aneurysm Severity: Factors Associated With Regression

Taichi Kato  1 , Masaru Miura  2   3 , Tohru Kobayashi  4 , Tetsuji Kaneko  3 , Naoya Fukushima  2 , Kenji Suda  5 , Jun Maeda  6 , Shinya Shimoyama  7 , Junko Shiono  8 , Keiichi Hirono  9 , Kazuyuki Ikeda  10 , Seiichi Sato  11 , Fujito Numano  12 , Yoshihide Mitani  13 , Kenji Waki  14 , Mamoru Ayusawa  15 , Ryuji Fukazawa  16 , Shigeto Fuse  17 ; Z‐Score Project 2nd Stage Study Group *
Collaborators, Affiliations
Multicenter Study

Analysis of Coronary Arterial Aneurysm Regression in Patients With Kawasaki Disease by Aneurysm Severity: Factors Associated With Regression

Taichi Kato et al. J Am Heart Assoc. .

Erratum in

Abstract

Background Coronary arterial aneurysms (CAAs) associated with Kawasaki disease (KD) significantly affect prognosis. However, the clinical course of CAAs and factors associated with CAA regression have not been well analyzed. Methods and Results The cohort of the Z-Score 2nd Project Stage study, a multicenter, retrospective, cohort study involving 44 institutions in Japan including 1006 patients with KD, was examined. CAAs were classified by the z score of their internal diameter in the acute phase: small (z<5), medium (5≤z<10), and large (z≥10). The lower limit of small CAA was based on the Japanese Ministry of Health, Labour and Welfare criteria. In the right coronary artery, the CAA regression rates 10 years after diagnosis were 95.5% for small, 83.2% for medium, and 36.3% for large. In the proximal left anterior descending artery, the regression rates 10 years after diagnosis were 95.3% for small, 80.1% for medium, and 28.8% for large. Cox regression analysis showed that diagnosis under the age of 1 year and onset of KD in 2010 to 2012 for the right coronary artery and the left anterior descending artery, and female for the right coronary artery were significantly associated with a high regression rate, whereas large CAAs for the right coronary artery and the left anterior descending artery were significantly associated with a low regression rate. Conclusions The current study, the largest Japanese study of its kind, found that small aneurysm, recent onset, and diagnosis under the age of 1 year predict regression, and that even giant aneurysms could regress. These data may contribute to long-term management of coronary aneurysms. Registration URL: https://www.umin.ac.jp/ctr/; Unique identifier: UMIN000010606.

Keywords: Kawasaki disease; coronary aneurysm; regression.

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Figures

Figure 1
Figure 1. Kaplan–Meier curves for the coronary arterial aneurysm (CAA) regression rate by severity of CAA.
Regression rate classified by CAA severity in the right coronary artery (RCA) (A) and the left anterior descending (LAD) (B).
Figure 2
Figure 2. Kaplan–Meier curves for the coronary arterial aneurysm (CAA) regression rate classified by CAA severity in male and female patients.
A and B, Regression rate of the right coronary artery (RCA) classified by CAA severity in male (A) and female (B) patients. C and D, Regression rate of the left anterior descending artery (LAD) classified by CAA severity in male (C) and female (D) patients.
Figure 3
Figure 3. Kaplan–Meier curves for the coronary arterial aneurysm (CAA) regression rate by the age at onset and the decade at onset.
A and B, Regression rate classified by the age at onset in the right coronary artery (RCA) (A) and the left anterior descending artery (LAD) (B). C and D, Regression rate classified by the decade at onset in the RCA (C) and the LAD (D).
Figure 4
Figure 4. Kaplan–Meier curves for the coronary arterial aneurysm (CAA) regression rate by initial treatment and response.
A and B, Regression rate by initial treatment and response in the right coronary artery (RCA) (A) and left anterior descending artery (LAD) (B).
See this image and copyright information in PMC

References

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