Key result
High-dose ASA plus initial IVIG shows no benefit over IVIG alone for coronary artery lesions.
Why the study?
The necessity of acetylsalicylic acid administration combined with intravenous immunoglobulin therapy in treating acute Kawasaki disease remains unclear.
Does high-dose acetylsalicylic acid combined with initial IVIG reduce the presence of coronary artery lesions in patients aged ≤10 years with acute Kawasaki disease compared to IVIG without routine ASA?
Population
735 patients with Kawasaki disease aged ≤10 years in eight Japanese hospitals
Comparison
High-dose ASA with initial IVIG vs initial IVIG without routine ASA
Design
Multicentre retrospective cohort study
Follow-up
Within 1 month of onset
Authors
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Omitting high-dose ASA with initial IVIG was not associated with more coronary lesions; leaves open whether routine use should be abandoned pending RCTs.
Cohort (n=735)
Yes
Does high-dose acetylsalicylic acid combined with initial IVIG reduce the presence of coronary artery lesions in patients aged ≤10 years with acute Kawasaki disease compared to IVIG without routine ASA?
Absolute Event Rate: 3.6% vs 4%
Omitting high-dose aspirin from initial IVIG therapy in acute Kawasaki disease does not appear to increase the risk of coronary artery lesions.
Hayashi et al. (2024) conducted a cohort in Acute Kawasaki disease (n=735). High-dose acetylsalicylic acid (ASA) with initial IVIG vs. Initial IVIG without routine ASA was evaluated on Presence of coronary artery lesions (coronary artery diameter >+2.5 SD of body surface area within 1 month of onset). High-dose ASA combined with initial IVIG was not associated with a reduced risk of coronary artery lesions compared to IVIG without routine ASA (3.6% vs 4.0%).
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