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January 20, 2014PEDIATRICS

Long-term Cardiovascular Outcomes in Survivors of Kawasaki Disease

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Why the study?

Does a history of Kawasaki disease increase the long-term risk of adverse cardiovascular events in survivors?

Population

2,764 patients from the Kaiser Permanente Northern California population, including 546 patients with a…

Comparison

History of Kawasaki disease vs Matched patients without a history of Kawasaki…

Design

Cohort

Follow-up

average 14.9 years

Key result

A history of Kawasaki disease was associated with a low rate of adverse cardiovascular events through age 21, with no significant difference compared to matched controls (HR 0.81; 95% CI 0.16-4.0).

Authors

THTaylor HolveAPAjay PatelQCQuyen Chau

Discussion

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Overview

Supports standard surveillance for Kawasaki survivors to age 21; leaves open need for longer-term studies in aneurysm subgroups.

Study Design

Type

Cohort (n=2,764)

Structured PICO

Does a history of Kawasaki disease increase the long-term risk of adverse cardiovascular events in survivors?

P
Population
2,764 patients from the Kaiser Permanente Northern California population, including 546 patients with a history of Kawasaki disease (79% received intravenous immunoglobulin, 5% had persistent coronary aneurysm) and 2,218 matched patients without Kawasaki disease.
I
Intervention
History of Kawasaki disease
C
Comparator
Matched patients without a history of Kawasaki disease
O
Outcome
Adverse cardiac events occurring at age ≥15 years (including acute coronary syndrome, coronary revascularization, heart failure, ventricular arrhythmia, valve disease, aortic aneurysm, and all-cause mortality)composite

Main Result

Effect estimate: HR 0.81 (95% CI 0.16-4.0)

Absolute Event Rate: 0.246% vs 0.217%

Survivors of Kawasaki disease have a low rate of long-term adverse cardiovascular events through age 21 that is comparable to matched controls, although those with persistent coronary aneurysms remain at higher risk.

Limitations

  • Requires additional validation studies with longer-term follow-up
  • Requires additional validation studies
  • Requires studies with longer-term follow-up

Cite This Study

Holve et al. (2014) conducted a cohort in Kawasaki disease (n=2,764). History of Kawasaki disease vs. Matched patients without Kawasaki disease was evaluated on Adverse cardiac events occurring at age ≥15 years (HR 0.81, 95% CI 0.16-4.0). A history of Kawasaki disease was associated with a low rate of adverse cardiovascular events through age 21, with no significant difference compared to matched controls (HR 0.81; 95% CI 0.16-4.0).

synapsesocial.com/papers/6a09fde516dfdfe7ed34889dhttps://doi.org/10.1542/peds.2013-1638
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