Abstract | INTRODUCTION: METHODS AND RESULTS: The clinical history of 80 patients (73% male; median age at diagnosis 2.2 years) seen from 1990 to 2008 with CAAs after KD were reviewed, 19 (24%) of whom received systemic corticosteroids in the acute phase (14 for ≤ 3 days, 5 for 4+ days). CAA z-scores were assessed at baseline, 2-3 months, and 1 year after the acute phase. Linear regression models adjusted for repeated measures were used to determine the association between change in CAA z-score over time and corticosteroid use, adjusting for patient age at diagnosis, gender, intravenous immunoglobulin use, total days of fever, albumin level, hemoglobin level and platelet count. RESULTS: The corticosteroid treated group had longer duration of fever in the acute phase (median 17 vs. 11 days, p=0.04). Adjusted CAA z-scores at diagnosis, 2-3 months and 1 year follow-up for CAA in the left anterior descending decreased (from +5.5 to +3.5 to +1.9) in those not treated with corticosteroids, but progressed for those treated with corticosteroids (from +7.4 to +17.5 to +15.8), regardless of duration of corticosteroid treatment. Similar results were noted for CAA of the right coronary artery and the left main coronary artery. CONCLUSIONS: The use of corticosteroids in the acute phase of KD for patients with evolving CAAs may be associated with worsening involvement and impaired vascular remodelling and warrants further study.
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Authors | Kyle Millar, Cedric Manlhiot, Rae S M Yeung, Zeeshanefatema Somji, Brian W McCrindle |
Journal | International journal of cardiology
(Int J Cardiol)
Vol. 154
Issue 1
Pg. 9-13
(Jan 12 2012)
ISSN: 1874-1754 [Electronic] Netherlands |
PMID | 20851480
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. |
Chemical References |
- Glucocorticoids
- meprednisone
- Prednisone
|
Topics |
- Adolescent
- Child
- Child, Preschool
- Coronary Aneurysm
(chemically induced)
- Female
- Glucocorticoids
(adverse effects, therapeutic use)
- Humans
- Infant
- Male
- Mucocutaneous Lymph Node Syndrome
(drug therapy)
- Prednisone
(adverse effects, analogs & derivatives, therapeutic use)
- Retrospective Studies
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