Abstract 17014: Prevalence and Predictors of Coronary Artery Disease in Adults With Kawasaki Disease
Background: Kawasaki disease (KD) also known as mucocutaneous lymph node syndrome is a common self-limiting vasculitis of childhood. Self-limiting nature of the disease make those suffered in childhood survive into adult life. Coronary vasculitis due to KD contributes to be a risk factor in young adult population for accelerated coronary atherosclerosis and in turn leading to coronary artery aneurysm and coronary artery disease (CAD). Prevalence of CAD in adult Kawasaki patients is unknown, since long term follow up data is unavailable. Our goal was to determine the prevalence and predictors of CAD in adult patients with Kawasaki disease.
Methods: All patients of age greater than or equal to 18 years with a diagnosis of KD from the National Inpatient Sample database using International Classification of Diseases 9th revision (ICD 9 code 446.1) during 2009-2010 were included in the analysis. We analyzed the demographics, prevalence of CAD and other traditional risk factors in adult patients with KD using ICD 9 codes.
Results: The prevalence of KD amongst adult was 0.0005% (n = 215) out of all in-hospital admissions in United States. The mean age was 27.3 years with women (27.6 years) being older than men (27.1 years) (p=0.81). Traditional risk factors prevalent in our population were hypertension (21%), hyperlipidemia (15.6%), diabetes (11.45%), coronary artery aneurysm (11.16%), tobacco use (8.8%), and obesity (8.8%) with no significant difference between males and females. However, CAD (32.4%) was more prevalent in males (44.68%) compared to females (12.13%) (p=0.03). In unadjusted analysis, age (OR=1.13, p=0.007), female sex (OR=0.17, p=0.04), diabetes (OR=12.16, p=0.04) and hypertension (OR=7.9, p=0.03) were found to be predictors of coronary artery disease. Interestingly, only hypertension (OR=13.2, p=0.03) predicted CAD in multimodel regression analysis after adjusting for demographics and traditional risk factors.
Conclusion: The prevalence of CAD was significantly high in young adults with KD with increased predominance in males. Females were associated with less risk than the males. Hypertension was found to be the only independent predictor of CAD in this population after adjusting for other risk factors.
- © 2013 by American Heart Association, Inc.