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 Vol. 18 No. 6, December 2007
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AAP Grand Rounds 18:64-65 (2007)
© 2007 American Academy of Pediatrics

CARDIOLOGY

Risk of Atherosclerosis After Kawasaki Disease

Source: (1) McCrindle BW, McIntyre S, Kim C, et al. Are patients after Kawasaki Disease at increased risk for accelerated atherosclerosis? J Pediatr. 2007;151(3):244–248; doi:10.1016/j.jpeds.2007.03.056.[CrossRef][Medline] (2) Dalla Pozza R, Bechtold S, Urschel S, et al. Subclinical atherosclerosis, but normal autonomic function after Kawasaki Disease. J Pediatr. 2007;151(3):239–243; doi:10.1016/j.jpeds.2007.03.057[CrossRef][Medline]

The first 20% of the full text of this article appears below.

McCrindle et al, from the University of Toronto, sought to assess whether children with a history of Kawasaki disease (KD) have increased risk factors and abnormalities suggestive of early atherosclerosis.

Patients between the ages of 10 and 20 years were selected from a database of all patients with KD seen at the Hospital for Sick Children between 1982 and 1998. These patients were randomly sampled from three groups based on current coronary artery involvement. Healthy control subjects of similar age were concurrently recruited from community groups. The medical records of the patients with KD were reviewed to determine characteristics of the acute KD episode, including initial coronary artery involvement, disease management, and current cardiovascular findings.

Atherosclerosis risk factors included recent and past medical history, smoking and smoke exposure, medication use, and family history. All participants underwent physical examinations and laboratory investigations. Brachial artery reactivity (BAR) in response to flow mediated dilation (FMD) and nitroglycerin was assessed using vascular ultrasonography

A total of 52 patients with KD were enrolled. Two-thirds were male. The mean age at time of KD episode was four years, with 96% having typical KD. Treatment included aspirin for 92% and intravenous gamma globulin for 64%. Coronary artery involvement at the time of KD episode included aneurysms in 37%, ectasia only in 16%, and no involvement in 47%. The mean time between the KD episode and the time of the study was 11.2 ± 3.7 years.

Coronary artery involvement at the . . . [Full Text of this Article]

David Danford, MD, FAAP
Pediatric Cardiology, Children’s Memorial Hospital, Omaha, NE