Analysis of Coronary Arterial Aneurysm Regression in Patients With Kawasaki Disease by Aneurysm Severity: Factors Associated With Regression
Authors: Kato Taichi , Miura Masaru , Kobayashi Tohru , Kaneko Tetsuji , Fukushima Naoya , Suda Kenji , Maeda Jun , Shimoyama Shinya , Shiono Junko , Hirono Keiichi , Ikeda Kazuyuki , Sato Seiichi , Numano Fujito , Mitani Yoshihide , Waki Kenji , Ayusawa Mamoru , Fukazawa Ryuji , Fuse Shigeto , Miura Masaru , Fukazawa Ryuji , Fuse Shigeto , Hamaoka Kenji , Hirono Keiichi , Kato Taichi , Kato Hitoshi , Kobayashi Tohru , Saji Tsutomu , Suda Kenji , Waki Kenji , Yamagishi Hiroyuki , Fukushima Naoya , Tomotsune Masako , Yoshida Makiko , Kaneko Tetsuji , Toyono Manatomo , Furuno Kenji , Shimoyama Shinya , Iwashima Satoru , Moritou Yuji , Kamada Masahiro , Takeda Atsuhito , Shiono Junko , Sano Tetsuya , Omori Daisuke , Fukasawa Yoshie , Mii Sayaka , Nomura Yuichi , Nakamura Tsuneyuki , Maeda Jun , Ishii Masahiro , Ogata Syohei , Kitagawa Atushi , Yamamoto Masaki , Ikeda Kazuyuki , Yamamura Kenichiro , Mitani Yoshihide , Masuda Hiroshi , Kaneko Masahide , Kawamura Yoichi , Komori Akiko , Ayusawa Mamoru , Sato Seiichi , Numano Fujito , Suzuki Hiroshi , Watanabe Kenichi , Hayashi Miyuki , Watanabe Makoto , Kuraishi Kenji , Nishihara Eiki , Katayama Hiroshi , Okumura Kenichi , Takahashi Tsutomu , Horita Norihisa , Matsuzaki Satoshi , Motoki Noriko , Akazawa Yohei , Aso Kentaro , Nagumo Kiyoshi , Takatuki Shinichi , Suganuma Eisuke , Matsuda Shinichi , Hayabuchi Yasunobu , Doi Shouzaburoh , Honda Takafumi , Terai Masaru , Miyamoto Tomoyuki 
Published: January 2023

Background
Coronary arterial aneurysms (CAAs) associated with Kawasaki disease (KD) significantly affect prognosis. However, the clinical course of CAAs and factors associated with CAA regression have not been well analyzed.

Methods and Results

The cohort of the Z‐Score 2nd Project Stage study, a multicenter, retrospective, cohort study involving 44 institutions in Japan including 1006 patients with KD, was examined. CAAs were classified by the
z
score of their internal diameter in the acute phase: small (
z
<5), medium (5≤
z
<10), and large (
z
≥10). The lower limit of small CAA was based on the Japanese Ministry of Health, Labour and Welfare criteria. In the right coronary artery, the CAA regression rates 10 years after diagnosis were 95.5% for small, 83.2% for medium, and 36.3% for large. In the proximal left anterior descending artery, the regression rates 10 years after diagnosis were 95.3% for small, 80.1% for medium, and 28.8% for large. Cox regression analysis showed that diagnosis under the age of 1 year and onset of KD in 2010 to 2012 for the right coronary artery and the left anterior descending artery, and female for the right coronary artery were significantly associated with a high regression rate, whereas large CAAs for the right coronary artery and the left anterior descending artery were significantly associated with a low regression rate.

Conclusions
The current study, the largest Japanese study of its kind, found that small aneurysm, recent onset, and diagnosis under the age of 1 year predict regression, and that even giant aneurysms could regress. These data may contribute to long‐term management of coronary aneurysms.

Registration

URL:
https://www.umin.ac.jp/ctr/
; Unique identifier: UMIN000010606.