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Association of steroid administration with larger coronary artery abnormalities in patients with Kawasaki disease

Published online by Cambridge University Press:  14 July 2022

Takanori Suzuki Open the ORCID record for Takanori Suzuki [Opens in a new window] ,
Satoru Kawai ,
Eiji Morihana ,
Shinji Kawabe ,
Naomi Iwata ,
Kazuyoshi Saito ,
Tetsushi Yoshikawa  and
Kazushi Yasuda
Takanori Suzuki*
Affiliation:
Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center, Aichi, Japan Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
Satoru Kawai
Affiliation:
Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center, Aichi, Japan
Eiji Morihana
Affiliation:
Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center, Aichi, Japan
Shinji Kawabe
Affiliation:
Department of Infectious Immunology, Aichi Children’s Health and Medical Center, Aichi, Japan
Naomi Iwata
Affiliation:
Department of Infectious Immunology, Aichi Children’s Health and Medical Center, Aichi, Japan
Kazuyoshi Saito
Affiliation:
Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center, Aichi, Japan Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
Tetsushi Yoshikawa
Affiliation:
Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
Kazushi Yasuda
Affiliation:
Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center, Aichi, Japan
*
Author for correspondence: Takanori Suzuki, MD, Department of Pediatrics, Fujita Health University, 1–98 Dengakugakubo Kutsukake cho, Toyoake, Aichi, 470–1192, Japan. Tel: +81–562–93–2000; Fax: +81–562–93–4593. E-mail: takanori-s@axel.ocn.ne.jp
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Abstract

We sought to elucidate the risk profiles of patients with Kawasaki disease who developed coronary artery abnormalities through a retrospective analysis with special reference to steroid treatment. Demographics of the patients were obtained from medical records, and characteristics of the coronary artery abnormalities were evaluated by echocardiography and coronary angiography, which included number, location, size, and length of coronary artery abnormalities (we evaluated by cardiac catheterisation with the American Heart Association classification with segments). We divided the patients into two groups based on steroid use and compared their characteristics and the complications of coronary artery abnormalities and cardiac events. A total of 29 patients were diagnosed with coronary artery abnormalities by echocardiography and coronary angiography during the study period (24 male; median age, 24 months [range: 2–84 months]). Eighteen patients were treated with aspirin and intravenous immunoglobulin (63%, non-steroid group), whereas 11 received aspirin and intravenous immunoglobulin plus steroids (37%, steroid group). No significant differences were found in the number and location of coronary artery abnormalities between the steroid and non-steroid groups. However, the size and number of segments for coronary artery abnormalities were significantly larger and shorter, respectively, in the steroid group (z-score: non-steroid group 6.3 versus steroid group 8.7; p < 0.01). The coronary artery abnormality segments under steroid use were also shorter (non-steroid group versus steroid group, two segments versus one segment; p = 0.02). Coronary artery abnormality size was larger in patients who used steroids than that of non-steroids. This study showed that steroid use significantly affected coronary artery abnormality size in patients with Kawasaki disease. However, cardiac complications from coronary artery abnormalities and cardiac events were comparable between the steroid and non-steroid groups. Further prospective, multicentre studies are needed to confirm these findings.

Keywords

Kawasaki diseaseintravenous immunoglobulincoronary artery abnormalitiessteroids
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 7 , July 2023 , pp. 1112 - 1116
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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