Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 168, Issue 4, Pages 3825-3828Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2013.06.027
Keywords
Kawasaki disease; Coronary artery aneurysm; Z score; Vasculitis; Echocardiography
Categories
Funding
- National Institutes of Health
- National Heart, Lung, and Blood Institute [HL69413, 108460]
- Japan Foundation for Pediatric Research
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Objective: It has been claimed that the aneurysm rate for Kawasaki disease (KD) patients in Japan is lower than in the U. S. However it has been difficult to compare coronary artery (CA) outcomes between the two countries because of different definitions for CA abnormalities. Therefore, we compared CA internal diameters between Japanese and U. S. KD patients using standard definitions and methods. Study design: We retrospectively reviewed CA outcomes in 1082 KD patients from 2 centers in the U. S. and 3 centers in Japan and compared Z-max scores (maximum internal diameter for the left anterior descending or right coronary artery expressed as standard deviation units from the mean (Z-score) normalized for body surface area) obtained within 12 weeks after onset and calculated using two different regression equations from Canada (Dallaire) and Japan (Fuse). We defined a Z-max of <2.5 as normal and a Z-max of >= 10 as giant aneurysm. Result: The median Z-max for the U. S. and Japanese subjects was 1.9 and 2.3 SD units, respectively (p < 0.001). There was no significant difference in rates of patients with Z-max >= 5.0 between the countries. In a multivariable model adjusting for age, sex, and treatment response, being Japanese was still associated with a higher Z-max score. Conclusion: Previously reported differences in aneurysm rates between Japan and the U. S. likely resulted from use of different definitions and nomenclature. Adoption of Z-scores as a standard for reporting CA internal diameters will allow meaningful comparisons among different countries and will facilitate international, collaborative clinical trials. (C) 2013 Published by Elsevier Ireland Ltd.
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