Background: Coronary artery complications are the predominant causes of morbidity and mortality in childhood Kawasaki disease (KD). The aim of this study was to investigate the incidence of coronary artery complications and cardiac sequelae in pediatric patients with KD.
Methods: Using the Taiwan National Health Insurance (NHI) database from 1997 to 2008, records of patients with KD were reviewed retrospectively, utilizing the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 446.1 in pediatric patients aged 18 years or under. The ICD-9CM was also used to identify the outcomes for coronary artery complications (ICD-9-CM codes 410-414), including coronary artery aneurysm (CAA) (ICD-9-CM code 414.11).
Results: From the records of pediatric patients with KD admitted to hospitals between 1997 and 2004, 8148 patients without any history of coronary artery complications before KD were selected for study. Of those patients, 694 patients (8.5%) were followed-up until the end of 2008 to estimate the incidence of coronary artery complications. The ratio of boys to girls with coronary artery complications was 1.84, and the incidence of coronary artery complications was 11.53 per 1,000 person-years. Among the 8148 pediatric patients with KD, 12 patients (0.15%; 8 boys and 4 girls) had myocardial infarction, and 20 patients (0.25%; 12 boys and 8 girls) died during follow-up.
Conclusions: This study is the first report regarding the incidence of coronary artery complications in KD children aged 18 years or younger. The incidence of coronary artery complications was higher as patients progressed in age, and increased by year. However, major complications such as death and myocardial infarction did not frequently occur.
Key words: Cardiac sequelae; Coronary artery complications; Incidence; Kawasaki disease.