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January 1, 2015Circulation JournalOpen Access

A history of Kawasaki disease was associated with a significantly increased mean carotid intima-media thickness compared to unaffected controls (0.378 mm vs. 0.360 mm).

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Why the study?

Does a history of Kawasaki disease increase carotid intima-media thickness (a surrogate marker of cardiovascular risk) in children and young adults compared to unaffected controls?

Population

161 children and young adults with a history of Kawasaki disease and 82 unaffected controls. KD patients had…

Comparison

History of Kawasaki disease vs Unaffected controls without a history of KD and…

Design

Cross-sectional, 1 image analyst blinded for case or CAA status read all the…

Key result

A history of Kawasaki disease was associated with a significantly increased mean carotid intima-media thickness compared to unaffected controls (0.378 mm vs. 0.360 mm).

Authors

SDSanne M. DietzCTCarline E. TackeJGJohan Gort

Discussion

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Overview

May support vascular surveillance in Kawasaki survivors; leaves open whether this surrogate predicts clinical events.

Study Design

Type

Cross-Sectional (n=243)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does a history of Kawasaki disease increase carotid intima-media thickness (a surrogate marker of cardiovascular risk) in children and young adults compared to unaffected controls?

P
Population
243 children and young adults aged 7-20 years, including 161 with a history of Kawasaki disease and 82 unaffected controls, assessed for carotid intima-media thickness.
E
Exposure
History of Kawasaki disease (observational exposure)
C
Comparator
Unaffected controls (74 unaffected siblings and 8 family members of hospital staff) without a history of KD and not taking cardiovascular medication
O
Outcome
Carotid intima-media thickness (cIMT) measured by B-mode ultrasoundsurrogate

Main Result

Absolute Event Rate: 0.378% vs 0.36%

p-value: p=<0.0001

A history of Kawasaki disease is associated with increased carotid intima-media thickness, particularly in patients with coronary artery aneurysms, suggesting a persistent vasculopathy.

Limitations

  • Cross-sectional design with only one IMT measurement per patient, limiting assessment of progression over time.
  • Potential misclassification of coronary artery aneurysm subgroups due to early echocardiograms being performed at outside centers.
  • Referral bias with a high percentage of severe cases due to the study being conducted at a tertiary center, which may overestimate the mean IMT of the total group.
  • cIMT progression estimates were based on cross-sectional data (only 1 IMT measurement per patient)
  • Potential misclassification of patients in the stratification for CAA subgroups due to early echocardiograms generated by outside centers
  • Referral bias with a high percentage of patients with CAA due to the tertiary center setting, which may have overestimated the mean IMT

Cite This Study

Dietz et al. (2015) conducted a cross-sectional in Kawasaki Disease (n=243). History of Kawasaki disease vs. Unaffected controls was evaluated on Mean combined carotid intima-media thickness (cIMT) in mm (p=<0.0001). A history of Kawasaki disease was associated with a significantly increased mean carotid intima-media thickness compared to unaffected controls (0.378 mm vs. 0.360 mm).

synapsesocial.com/papers/6a93aa2273075f1cdcafd80bhttps://doi.org/10.1253/circj.cj-15-0555
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