Long-term Management of Kawasaki Disease: Implications for the Adult Patient

Coronary artery complications from Kawasaki disease (KD) range from no involvement to giant coronary artery aneurysms (CAA). Current long-term management protocols are calibrated to the degree of maximal and current coronary artery involvement reflecting the known likelihood of severe long-term card...

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Main Authors: Cedric Manlhiot, Elizabeth Niedra, Brian W. McCrindle
Format: Article
Language:English
Published: Elsevier 2013-02-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957212002227
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author Cedric Manlhiot
Elizabeth Niedra
Brian W. McCrindle
author_facet Cedric Manlhiot
Elizabeth Niedra
Brian W. McCrindle
author_sort Cedric Manlhiot
collection DOAJ
description Coronary artery complications from Kawasaki disease (KD) range from no involvement to giant coronary artery aneurysms (CAA). Current long-term management protocols are calibrated to the degree of maximal and current coronary artery involvement reflecting the known likelihood of severe long-term cardiac complications. It has recently been suggested that all KD patients may be at potential risk of severe long-term cardiac complications. If this assertion was to be confirmed, current follow-up protocols would need to be extensively modified, with important implications both for the growing adult population with a previous history of KD and for the healthcare system. Based on the available evidence, patients with multiple large and/or giant CAA are at substantial risk of severe long-term cardiac complications and should have regular specialized follow-up. Patients with transient or no CAA have not been reported to be at risk of severe long-term cardiac complications. The influence of KD on the atherosclerotic process remains suboptimally defined, and should be the focus of future studies. Heightened cardiovascular risk factor surveillance and management is recommended regardless of coronary artery involvement. Based on the currently available evidence, existing long-term management protocols seem to be appropriately calibrated to the level of risk. Revised long-term management protocols should incorporate newer, noninvasive imaging methods and intensive management of atherosclerotic risk. There is insufficient evidence at this time to mandate long-term specialized follow-up and invasive testing for patients who have not had CAA.
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spelling doaj-art-e2afe8e3c1c14b1d903187acd4d9f8162025-08-20T02:04:18ZengElsevierPediatrics and Neonatology1875-95722013-02-01541122110.1016/j.pedneo.2012.12.013Long-term Management of Kawasaki Disease: Implications for the Adult PatientCedric ManlhiotElizabeth NiedraBrian W. McCrindleCoronary artery complications from Kawasaki disease (KD) range from no involvement to giant coronary artery aneurysms (CAA). Current long-term management protocols are calibrated to the degree of maximal and current coronary artery involvement reflecting the known likelihood of severe long-term cardiac complications. It has recently been suggested that all KD patients may be at potential risk of severe long-term cardiac complications. If this assertion was to be confirmed, current follow-up protocols would need to be extensively modified, with important implications both for the growing adult population with a previous history of KD and for the healthcare system. Based on the available evidence, patients with multiple large and/or giant CAA are at substantial risk of severe long-term cardiac complications and should have regular specialized follow-up. Patients with transient or no CAA have not been reported to be at risk of severe long-term cardiac complications. The influence of KD on the atherosclerotic process remains suboptimally defined, and should be the focus of future studies. Heightened cardiovascular risk factor surveillance and management is recommended regardless of coronary artery involvement. Based on the currently available evidence, existing long-term management protocols seem to be appropriately calibrated to the level of risk. Revised long-term management protocols should incorporate newer, noninvasive imaging methods and intensive management of atherosclerotic risk. There is insufficient evidence at this time to mandate long-term specialized follow-up and invasive testing for patients who have not had CAA.http://www.sciencedirect.com/science/article/pii/S1875957212002227cardiovascular riskcoronary artery aneurysmsKawasaki diseaselong-term management
spellingShingle Cedric Manlhiot
Elizabeth Niedra
Brian W. McCrindle
Long-term Management of Kawasaki Disease: Implications for the Adult Patient
Pediatrics and Neonatology
cardiovascular risk
coronary artery aneurysms
Kawasaki disease
long-term management
title Long-term Management of Kawasaki Disease: Implications for the Adult Patient
title_full Long-term Management of Kawasaki Disease: Implications for the Adult Patient
title_fullStr Long-term Management of Kawasaki Disease: Implications for the Adult Patient
title_full_unstemmed Long-term Management of Kawasaki Disease: Implications for the Adult Patient
title_short Long-term Management of Kawasaki Disease: Implications for the Adult Patient
title_sort long term management of kawasaki disease implications for the adult patient
topic cardiovascular risk
coronary artery aneurysms
Kawasaki disease
long-term management
url http://www.sciencedirect.com/science/article/pii/S1875957212002227
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