Key result
Coronary arteries with regressed acute-phase aneurysms in Kawasaki disease patients had significantly greater maximum intimal thickness compared to angiographically normal arteries (median 475 µm vs 355 µm, p=0.007).
Why the study?
Coronary artery aneurysm is an important complication of Kawasaki disease linked to arterial structural damage, but few studies have examined structural changes in coronary arteries not associated with aneurysms.
Do structural changes occur in angiographically normal coronary arteries in patients with Kawasaki disease?
Observational (n=23)
Blinded observers
No
Do structural changes occur in angiographically normal coronary arteries in patients with Kawasaki disease?
Intimal thickening and media disruption occur in coronary arteries of Kawasaki disease patients even when angiographically normal in both acute and convalescent phases.
Answers are grounded in this paper and cite their sources.
May warrant enhanced surveillance after aneurysm regression in Kawasaki disease; leaves open long-term prognostic implications.
Background Coronary artery aneurysm (CAA) is an important complication of Kawasaki disease (KD) that is associated with arterial structure damage. However, few studies have examined structural changes in coronary arteries not associated with CAA.Methods We examined coronary arteries in KD patients with CAAs who underwent follow-up coronary angiography (CAG) and optical coherence tomography (OCT). Coronary arterial branches with no abnormal findings on most recent CAG were classified into two groups. Arteries with an acute-phase CAA that later regressed were classified as group R and arteries with no abnormal findings on either acute or convalescent phase CAG were classified as group N. Coronary arterial wall structural changes were compared between groups using OCT.ResultsFifty-seven coronary arterial branches in 23 patients were evaluated by OCT. Thirty-six branches showed no abnormality on most recent CAG. Both groups R and N comprised 18 branches. Maximum intimal thickness in groups R and N was 475 and 355 µm, respectively (p = 0.007). The incidence of disruption of the media was 100% and 67%, respectively (p = 0.02). Calcification, macrophage accumulation, and thrombus were not found in either group.ConclusionsIntimal thickening and disruption of the media occur not only in coronary arteries with acute phase CAAs that later regress in the convalescent phase, but also in arteries with normal CAG findings in the acute and convalescent phases.
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Tsuchihashi et al. (2021) conducted an observational in Kawasaki disease with coronary artery aneurysm (n=23). Acute-phase coronary artery aneurysm that later regressed (Group R) vs. No abnormal findings in acute or convalescent phases (Group N) was evaluated on Maximum intimal thickness (µm) (p=0.007). Coronary arteries with regressed acute-phase aneurysms in Kawasaki disease patients had significantly greater maximum intimal thickness compared to angiographically normal arteries (median 475 µm vs 355 µm, p=0.007).
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