Abstract 18815: High Dose Aspirin is Associated With Decrease of Hemoglobin and Do Not Affect the Disease Outcome in Acute Stage of Kawasaki Disease
Introduction: Kawasaki disease (KD) is a systemic vasculitis of unknown etiology. Although intravenous immunoglobulin (IVIG) has been shown to reduce the incidence of coronary artery lesions (CAL) effectively, the role and appropriate dose of aspirin during acute phase is still unclear. Thus, this study was conducted to evaluate the effect of treatment and the change of serum hepcidin with or without high dose aspirin in the acute stage of KD.
Hypothesis: High dose aspirin is not benefit for acute stage of KD.
Methods: Retrospective analysis of KD patients from two medical centers during 1999-2009 in Taiwan. All patients were initially treated with a single dose of IVIG (2 g/kg) during a 12-h period. High dose aspirin was given (> 50 mg/kg/day) until the fever subsided then low-dose aspirin (3-5 mg/kg/day) was prescribed until all signs of inflammation resolved at group 1. Low-dose aspirin was prescribed without high-dose aspirin at group 2. A total of 851 KD patients (group 1, N= 305, group 2, N= 546) were enrolled in this study. patients.
Results: There were no significant difference between group 1 and group 2 including gender distribution (p=0.51), IVIG resistant rate (31/305 vs. 38/546, p=0.07), CAL formation rate (52/305 vs. 84/546, p=0.67), and total hospital days (6.3 ± 0.2 vs. 6.7 ± 0.2, p=0.13). There were also no significant difference between total white blood counts, hemoglobin levels, platelet counts, CRP and serum hepcidin levels before IVIG treatment between group 1 and group 2 (all p>0.1). After IVIG treatment, there were significant lower hemoglobin and higher CRP as well as lower decrease of CRP levels in group 1 than in group 2 (p=0.006, <0.001 and =0.012, respectively). Furthermore, there were also high serum hepcidin and lower decrease of hepcidin levels in group 1 than in group 2 (p=0.04, and =0.02, respectively).
Conclusions: These results provide evidence supporting high dose aspirin in acute phase of KD may affect the improvement of inflammatory markers. It also caused lower hemoglobin level that was associated with higher hepcidin level after IVIG treatment. It seems unneeded of high dose aspirin in acute phase of KD.
Author Disclosures: H. Kuo: None. K. Hsieh: None.
- © 2015 by American Heart Association, Inc.