Nationwide Survey of Patients With Giant Coronary Aneurysm Secondary to Kawasaki Disease 1999-2010 in Japan

被引：49

作者：

Fukazawa, Ryuji ^{[1
]}

Kobayashi, Tohru ^{[2
]}

Mikami, Masashi ^{[3
]}

Saji, Tsutomu ^{[5
]}

Hamaoka, Kenji ^{[6
]}

Kato, Hitoshi ^{[4
]}

Suzuki, Hiroyuki ^{[7
]}

Tsuda, Etsuko ^{[8
]}

Ayusawa, Mamoru ^{[9
]}

Miura, Masaru ^{[10
]}

Ebata, Ryota ^{[11
]}

Kobayashi, Tomio ^{[12
]}

Yashiro, Mayumi ^{[13
]}

Ogawa, Shunichi ^{[1
]}

机构：

[1] Nippon Med Sch, Dept Pediat, Tokyo, Japan

[2] Natl Ctr Child Hlth & Dev, Dept Dev Strategy, Ctr Clin Res & Dev, Div Clin Res Planning, Tokyo, Japan

[3] Natl Ctr Child Hlth & Dev, Dept Data Management, Ctr Clin Res & Dev, Div Biostat, Tokyo, Japan

[4] Natl Ctr Child Hlth & Dev, Dept Cardiol, Tokyo, Japan

[5] Toho Univ, Omori Med Ctr, Dept Pediat 1, Tokyo, Japan

[6] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Kyoto, Japan

[7] Wakayama Med Univ, Dept Pediat, Wakayama, Japan

[8] Natl Cerebral & Cardiovasc Ctr, Dept Pediat Cardiovasc Surg, Osaka, Japan

[9] Nihon Univ, Sch Med, Dept Pediat, Tokyo, Japan

[10] Tokyo Metropolitan Childrens Med Ctr, Div Cardiol, Tokyo, Japan

[11] Chiba Univ, Grad Sch Med, Dept Pediat, Chiba, Japan

[12] Gunma Childrens Med Ctr, Div Cardiol, Gunma, Japan

[13] Jichi Med Univ, Dept Publ Hlth, Shimotsuke, Tochigi, Japan

来源：

CIRCULATION JOURNAL | 2018年 / 82卷 / 01期

基金：

日本学术振兴会;

关键词：

Aneurysm; Coronary disease; Kawasaki disease; Remote period; LONG-TERM PROGNOSIS; MYOCARDIAL-INFARCTION; ARTERY ANEURYSM; THERAPY; MANAGEMENT; DIAGNOSIS; WARFARIN; LESIONS; PHASE;

D O I：

10.1253/circj.CJ-17-0433

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Giant coronary aneurysm is the most severe sequela in Kawasaki disease, occurring in approximately 0.2% of patients in Japan. Regression is rare, while myocardial infarction (MI) and sudden death are relatively common. Herein, we reviewed patients with giant coronary aneurysm in a 10-year period. Methods and Results: A nationwide questionnaire survey was conducted based on a national epidemiological database from 1999 to 2010. We identified 355 giant coronary aneurysm patients, of whom 209 were analyzed. The 5- and 10-year total cardiac event-free rates were 0.72 and 0.68, respectively. Twelve patients died, and MI was observed in 32 patients (18.1%). Five and 6 deaths were due to coronary rupture and MI, respectively. All ruptures occurred within 1 month of onset, while most MI occurred within 18 months. There was no death beyond 2 years. Aneurysm size was significantly related to the occurrence of MI in both the right and left coronary arteries. At the time of writing, 55% of patients had no exercise limitations. And including patients who cannot perform strenuous exercises, 81% of patients were leading ordinary lives. Conclusions: Severe cardiac events are likely to occur within 2 years from onset of Kawasaki disease, while no deaths occurred beyond this time. Hence, careful monitoring is needed especially for the first 2 years. Most patients with giant coronary aneurysms can lead ordinary lives with appropriate management.

引用

页码：239 / +

页数：11

共 22 条

[1] Coronary artery aneurysm induced by Kawasaki disease in children show features typical senescence [J].