Abstract 1801: Long-term Prognosis of Kawasaki Syndrome With Giant Coronary Aneurysms: A Multi-Center Study
[BACKGROUND] Still certain number of patients with Kawasaki syndrome (KS) develops giant coronary aneurysms and coronary stenosis, leading to ischemic heart disease. The aim of this study was to determine long-term prognosis of KS with giant aneurysms in large sample volume.
[METHODS] Questionnaires were sent to 6 participating institutions and 170 patients (126 male and 44 female) were identified as the subject of this study who developed giant coronary aneurysms with > 8 mm in diameter. From medical chart, patients’ information concerning demographics such as coronary pathology (isolated RCA, isolated LCA, and bilateral aneurysm) and medical treatment (with warfarin or without warfarin) and catheter and surgical interventions were collected. Based on these data, we calculated survival rate, cardiac event free rate (CEFR), and acute thrombotic event free rate (ATEFR) using Kaplan-Meyer’s analysis. Cardiac events included catheter and surgical intervention and acute myocardial infarction (AMI). Acute thrombotic events included AMI and intracoronary thrombolysis (ICT).
[RESULT] Subject’s age was 2.9 ± 2.8 years old at the onset of KS and median observational period was 13.4 years (range 0 –31.2 years). In this period, 11 patients died or underwent cardiac transplantation, giving 96.9, 96.2, and 89.8% of survival rate at 5, 10, and 20 years, respectively. Of 170, 78 (45.9%) patients encountered cardiac events including 22 CABG and 20 PCI, giving CEFR of 73.5, 63.9, and 39.7 % at 5, 10, and 20 years, respectively. Concerning coronary pathology, patients with bilateral coronary aneurysms showed significantly lower CEFR than those with isolated RCA and LCA lesion (Bilateral vs. LCA and RCA = 65 vs. 80 and 88 at 5 years, 56 vs. 66 and 81% at 10 years, 25 vs. 50 and 70% at 20 years, p < .0001). Patients with warfarin treatment (n=77) showed significantly higher ATEFR than patients without warfarin (n=93) (90 vs. 76% at 5 year, 90 vs. 73% at 10 years, 82 vs. 71% at 15 years, p < .05).
[CONCLUSIONS] Long-term survival of KS with giant coronary aneurysms is