Risk Factors for Coronary Artery Aneurysms in Children With Kawasaki Disease
6 affiliations
- 1Department of Pediatrics University of California San Diego La Jolla CA USA
- 2Department of Pediatrics Shinshu University School of Medicine Nagano Japan
- 3Department of Pediatrics Ota Memorial Hospital Gunma Japan
- 4Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego CA USA
- 5Department of Public Health Jichi Medical University Tochigi Japan
- 6Rady Children's Hospital San Diego CA USA
Abstract
Background: Coronary artery aneurysm (CAA) remains the most serious cardiovascular complication of Kawasaki disease. We sought to identify consistent risk factors for CAA among large contemporary cohorts from Japan and the United States.
Methods: We conducted a retrospective cohort study including 42 350 children from the 26th and 27th Japanese Nationwide Kawasaki Disease Surveys (2019–2022) and 1216 children from a multiethnic US cohort. Multivariable logistic regression was used to evaluate associations between clinical variables and CAA at 1 month after disease onset (Z score ≥2.5).
Results: In both cohorts, baseline coronary artery dilation at diagnosis (Z score ≥2.5) was strongly associated with CAA 1 month after disease onset (Japan: odds ratio [OR], 22.7 [95% CI, 19.2–26.7]; United States: OR, 13.4 [95% CI, 8.6–21.0]). Age younger than 6 months and intravenous immunoglobulin resistance were also independently associated with increased risk. These associations were also observed for medium to giant CAAs. Stratified analyses demonstrated that intravenous immunoglobulin resistance was most strongly associated with subsequent CAA among children with normal coronary arteries at diagnosis.
Conclusions: Among large Japanese and US cohorts, coronary artery dilation at diagnosis and age younger than 6 months were consistent predictors of CAA. These associations were also observed for medium to giant CAA, underscoring their relevance for clinically significant coronary outcomes. Early coronary artery assessment provides important prognostic information and may inform cardiovascular risk stratification and management in children with Kawasaki disease.
Related
- Clinical outcomes of rivaroxaban and warfarin for anticoagulation in children with giant coronary artery aneurysms after Kawasaki disease
- Safety and Efficacy of Apixaban Therapy for Coronary Artery Aneurysms After Kawasaki Disease
- The predictive performance of RDW for coronary artery lesions in children with Kawasaki disease: a systematic review and meta-analysis
- Relationship between serum Interleukin-6 during the acute phase of children with Kawasaki disease and the coronary artery lesions
- Anatomical distribution pattern of coronary artery lesions in Kawasaki disease and the prognostic value of dynamic Z-scores for recovery time: a retrospective cohort study
BibTeX
@article{yamazaki2026risk,
title = {{Risk Factors for Coronary Artery Aneurysms in Children With Kawasaki Disease}},
author = {Shoko Yamazaki and Koichi Miyata and Xiaoying Sun and Chisato Shimizu and Ryusuke Ae and Kirsten B. Dummer and Adriana H. Tremoulet and Jane C. Burns and Sonia Jain},
journal = {Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease},
year = {2026},
month = sep,
doi = {10.1161/jaha.126.050238},
url = {https://doi.org/10.1161/jaha.126.050238},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Risk Factors for Coronary Artery Aneurysms in Children With Kawasaki Disease
AU - Shoko Yamazaki
AU - Koichi Miyata
AU - Xiaoying Sun
AU - Chisato Shimizu
AU - Ryusuke Ae
AU - Kirsten B. Dummer
AU - Adriana H. Tremoulet
AU - Jane C. Burns
AU - Sonia Jain
PY - 2026
DA - 2026/09/09
JO - Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
DO - 10.1161/jaha.126.050238
UR - https://doi.org/10.1161/jaha.126.050238
AB - Background: Coronary artery aneurysm (CAA) remains the most serious cardiovascular complication of Kawasaki disease. We sought to identify consistent risk factors for CAA among large contemporary cohorts from Japan and the United States. Methods: We conducted a retrospective cohort study including 42 350 children from the 26th and 27th Japanese Nationwide Kawasaki Disease Surveys (2019–2022) and 1216 children from a multiethnic US cohort. Multivariable logistic regression was used to evaluate associations between clinical variables and CAA at 1 month after disease onset (Z score ≥2.5). Results: In both cohorts, baseline coronary artery dilation at diagnosis (Z score ≥2.5) was strongly associated with CAA 1 month after disease onset (Japan: odds ratio [OR], 22.7 [95% CI, 19.2–26.7]; United States: OR, 13.4 [95% CI, 8.6–21.0]). Age younger than 6 months and intravenous immunoglobulin resistance were also independently associated with increased risk. These associations were also observed for medium to giant CAAs. Stratified analyses demonstrated that intravenous immunoglobulin resistance was most strongly associated with subsequent CAA among children with normal coronary arteries at diagnosis. Conclusions: Among large Japanese and US cohorts, coronary artery dilation at diagnosis and age younger than 6 months were consistent predictors of CAA. These associations were also observed for medium to giant CAA, underscoring their relevance for clinically significant coronary outcomes. Early coronary artery assessment provides important prognostic information and may inform cardiovascular risk stratification and management in children with Kawasaki disease.
SN - 2047-9980
ER -