LONG-TERM CONSEQUENCES OF KAWASAKI-DISEASE - A 10-YEAR TO 21-YEAR FOLLOW-UP-STUDY OF 594 PATIENTS

Background The long-term consequences of the cardiovascular sequelae i n Kawasaki disease remain uncertain. Methods and Results We identified 594 consecutive children with acute Kawasaki disease between 1973 and 1983, and this cohort was followed up for 10 to 21 years (mean, 13.6 years). In all patients, we evaluated coronary lesions by coronary ang iography just after the acute stage. One hundred and forty-six patient s (24.6%) were diagnosed as having coronary aneurysms. A second angiog ram was performed 1 to 2 years later in all 146 patients who previousl y had coronary aneurysms, which demonstrated that 72 (49.3%) of these 146 had regression in the coronary aneurysm. A third angiogram was per formed for 62 patients, a fourth for 29, and a fifth for 17. By 10 to 21 years after the onset of the illness, stenosis in the coronary aneu rysm had developed in 28 patients. Myocardial infarction occurred in 1 1 patients, 5 of whom died. In the 26 patients with giant coronary ane urysms, stenotic lesions developed in 12, and no regression occurred. The 448 patients with normal findings at the first angiogram subsequen tly never developed any abnormal cardiac findings. Systemic artery ane urysms developed in 13 patients (2.2%), and valvular heart disease app eared in 7 (1.2%). Conclusions The incidence of coronary aneurysm in a cute Kawasaki disease was 25%, 55% of which showed regression. During follow-up, ischemic heart disease developed in 4.7% and myocardial inf arction in 1.9%. Death occurred in 0.8%.