SAT0512 LONG-TERM FOLLOW-UP OF CARDIOVASCULAR OUTCOMES IN KAWASAKI DISEASE. OBSERVATIONAL STUDY FROM A SINGLE CENTER
Authors: D. Prieto-Peña, José Luis Martín-Varillas, Lara Sánchez Bilbao, Eva Peña Sainz-Pardo, Monica Calderón-Goercke, Natalia Palmou-Fontana, María Teresa Viadero, María Jesús Cabero, Miguel A. González-Gay, Ricardo Blanco
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology which can lead to coronary aneurysm (CA) formation in 15-20% of patients. Long-term rates of adverse cardiac events are not well-known. Objectives: a) to compare demographic, clinical and laboratory features of patients who developed coronary aneurysm with patients who did not. b) to assess long-term cardiovascular outcomes in the subgroup of patients who developed cardiac aneurysms. <h3>Methods</h3> Single center study of 55 patients with KD who were diagnosed between 1994-2009. KD diagnosis was based on the classic classification criteria<sup>1</sup>. We considered two groups: a) patients who presented CA at diagnosis. b) patients who did not present CA. Statistical analysis was performed with SPSS. Student's t test or Mann-Whitney U test was used to compare continuous variables, and Chi-squared test or Fisher's exact test for categorical variables as appropriate. <h3>Results</h3> Out of 55 patients with KD, 8 patients (3 men/5 women) presented CA at diagnosis. Differences between the two groups mentioned above are shown in <b>Table 1</b>. Mean age at diagnosis was lower in patients who presented CA (1.74 vs 3.88 years; p=0.044). The duration of symptoms was longer in patients with CA (14.0 vs 12.0 days; p=0.015), however there were no qualitative differences in the symptomatology. Regarding laboratory markers, C- reactive protein (CRP) levels were significantly higher in patients who developed CA (17.0 vs 10.8 mg/dL; p=0.047). There was also a tendency to higher levels of erythrocyte sedimentation rate (ERS) and higher platelet count. All patients received intravenous immunoglobulin (IVIG) and antiplatelet agents at the time of diagnosis. Some of the patients with CA required glucocorticoids and anti-TNF agents. <b>Table 2</b> shows the characteristics of the 8 patients with CA who were followed-up for a mean of 13.7 ± 7.8 years. The mean size of the aneurysms was 5.6 ± 2.3 mm. Left coronary artery was the most common location (n=5). In two patients, cardiac arrhytmia was described. Five patients underwent ergometry tests being negative for ischemia in all of them. Coronary tomography was performed in other two patients observing persistence of CA in just one of the patients after 131 months of follow-up. <h3>Conclusion</h3> In our cohort, patients with KD who presented CA at the time of diagnosis were younger, had a longer duration of symptoms and higher levels of CRP. All patients received early treatment with IVIG and antiplatelet agents. At long-term follow up, persistent coronary affection was reported in just one of the patients. No severe cardiovascular outcomes were shown. <h3>References</h3> [1] Wood LE, et al. Expert Rev Cardiovasc Ther. 2007; 5: 553-61 <h3>Disclosure of Interests</h3> D. Prieto-Peña: None declared, José Luis Martín-Varillas: None declared, Lara Sánchez Bilbao: None declared, Eva Peña Sainz-Pardo: None declared, Monica Calderón-Goercke: None declared, Natalia Palmou-Fontana: None declared, María Teresa Viadero: None declared, María Jesús Cabero: None declared, Miguel A González-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker's bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ricardo Blanco Grant/research support from: Abbvie, MSD, and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen