Chih W.-L.Wu P.-Y.Sun L.-C.MING-TAI LINJOU-KOU WANGMEI-HWAN WU2020-12-212020-12-2120160022-3476https://www.scopus.com/inward/record.uri?eid=2-s2.0-84957060381&doi=10.1016%2fj.jpeds.2015.12.076&partnerID=40&md5=d762f50f71d0c0f88bb647f0835c2fc6https://scholars.lib.ntu.edu.tw/handle/123456789/529279Objective To explore the implication of serial coronary changes on the late coronary outcomes in patients with Kawasaki disease (KD) with coronary aneurysms ?4 mm. Study design We performed a retrospective review of 78 patients with KD with large coronary aneurysms (1980-2013, male: 76.9%; 792 patient-years). Progressive coronary dilatation was defined for those with progressive enlargement of coronary arteries in 3 consecutive echocardiograms. Results We studied 27 patients with KD with giant aneurysms (?8 mm) and 51 patients with KD with medium aneurysms (4-8 mm). All the giant and 43.1% of medium aneurysms persisted during the study period. For the patients with giant aneurysms, their 10-year freedom from acute myocardial infarction/cardiovascular death and all ischemia was 66% and 52%, respectively. The median intervals for the aneurysm diameters reaching their peak were 3.3 months (giant) and 0.25 months (medium), respectively. In patients with giant aneurysms, the 10-year freedom from ischemia was much lower in those with progressive coronary dilatation (28% vs 59%, P =.021). In patients with medium aneurysms, the probability of 5-year persistence of aneurysm was much greater (67.2% vs 14.8%, P < 10-3) in those with progressive coronary dilatation. Male sex and intravenous immunoglobulin therapy were not associated with the late outcomes in the patients with KD who had aneurysms larger than 4 mm. Conclusions In addition to coronary diameters 1 month after the onset of KD, progressive coronary dilatation at 2 or more months after diagnosis may be an indicator of duration, and the severity of vasculitis and adverse dilative remodeling were associated with worse late coronary outcomes. ? 2016 Elsevier Inc.[SDGs]SDG3acetylsalicylic acid; warfarin; immunoglobulin; acute heart infarction; adolescent; adult; aneurysm; Article; computer assisted tomography; coronary artery aneurysm; coronary artery dilatation; echocardiography; electrocardiogram; female; follow up; heart failure; heart infarction; human; immunotherapy; infant; ischemia; long term care; longitudinal study; major clinical study; male; mucocutaneous lymph node syndrome; outcome assessment; prediction; priority journal; retrospective study; ST segment; sudden cardiac death; body size; chemistry; child; complication; Coronary Aneurysm; coronary artery blood flow; coronary blood vessel; dilatation; heart muscle ischemia; Kaplan Meier method; mucocutaneous lymph node syndrome; pathology; preschool child; time factor; treatment outcome; Adolescent; Body Size; Child; Child, Preschool; Coronary Aneurysm; Coronary Circulation; Coronary Vessels; Dilatation; Echocardiography; Female; Humans; Immunoglobulins, Intravenous; Infant; Kaplan-Meier Estimate; Male; Mucocutaneous Lymph Node Syndrome; Myocardial Infarction; Myocardial Ischemia; Retrospective Studies; Time Factors; Treatment Outcomejournal article10.1016/j.jpeds.2015.12.076268521792-s2.0-84957060381