Abstract 13931: The Survey of the Outcome in Patients with Giant Aneurysm Caused by Kawasaki Disease
(Background) The long-term outcome in patients with giant aneurysm (GA) caused by Kawasaki disease (KD) remains unknown.
(Methods) The outcome of GA patients had been surveyed by questionnaire in the society of Kinki area KD research between 2010 and 2011. The outcome and the incidence of cardiac events (CE) were investigated. Death, myocardial infarction (MI), syncope, and ventricular tachycardia were included in CE. Survival rate, CE free rate and coronary artery bypass grafting (CABG) free rate were analyzed by Kaplan-Meier method, and differences were assessed by the log-rank test.
(Results) The 245 pts (187 male 58 female) pts were enrolled. The median age at the onset of KD was 2 years. Ten patients had had recurrence of acute KD. The interval from the onset of KD to the survey ranged from 0.2 to 51 years, and the median was 20 years. In the medication, 238 pts (97%) had the anticoagulant therapy, and 62 pts had coumadin. Eleven patients had delivery. Twenty-one patients had the peripheral artery lesions. Death and MI occurred in 15 pts (6%) and 57 pts (23%), respectively. Thrombolytic therapy, percutaneous coronary intervention, and CABG were done in 35 pts, 17 pts, and 90 pts (36%), respectively. The number of patients without CE and revascularization was 119 pts (49%). The CE free rate at 35 years was 64%, while CABG free rate at 30 years was 52%. The overall survival rate at 30 years was 90%. The survival rate at 30 years in patients with GA at the right coronary or the left coronary artery was 96%, and that in patients with bilateral GA was 87% (p=0.02). The 30-year survival rate in patients without the history of MI was 99%, and that in patients with the history of MI was 64% (p<0.01). The 30-year survival rate in CABG group was 91%.
(Conclusions) The outcome in patients without the history of MI was good. The survival rate in patients with bilateral GA was significant lower than that in patients with unilateral GA. CABG can improve the outcome in this population.
- © 2012 by American Heart Association, Inc.