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Children with Kawasaki disease need long-term surveillance for heart disease

ACR 2020
Reuters Health - 11/11/2020 - Children with Kawasaki disease remain at an increased risk for heart problems more than 10 years after they leave the hospital, according to a new study.

"The results justify additional follow up and surveillance for cardiovascular disease and cardiovascular disease risk factors, such as obesity, high blood pressure and high cholesterol, in Kawasaki disease survivors," Dr. Cal Robinson of The Hospital for Sick Children and the University of Toronto, in Canada, said at a November 7 press briefing at ACR Convergence, the 2020 virtual annual meeting of the American College of Rheumatology.

The risk of long-term cardiovascular events after a childhood KD diagnosis remains unclear, he noted.

Using health administrative databases, Dr. Robinson and colleagues identified nearly 4,600 children with a KD diagnosis in Ontario between 1995 and 2018. They matched each one of these cases to 100 children in Ontario without a KD diagnosis. Participants were followed for a maximum of 24 years.

During a median follow up of 11 years, 16.2% of KD survivors experienced cardiac events compared with 5.2% of controls; a major adverse cardiac event (MACE) occurred in 1.7% of KD survivors compared with 0.7% of controls.

The most frequent cardiovascular events among KD survivors were ischemic heart disease, arrhythmias, hypertension and peripheral vascular disease.

"Kawasaki disease survivors have a higher incidence of cardiac events and run significant increased risk for cardiac events for more than 10 years after their initial diagnosis," Dr. Robinson reported.

Their risk is highest in the first year after hospital discharge and gradually decreases over time. But by more than 10 years after their illness, they still have a 37% higher risk of experiencing cardiac events, he noted.

"However, despite the higher risk of cardiac events, death was uncommon in children with Kawasaki disease in our study," Dr. Robinson reported.

Summing up, he said the results provide "additional information that can be helpful in counseling patients and families after a diagnosis of Kawasaki disease about their long-term prognosis as well as the importance of taking steps early to reduce their risk of adult heart disease, such as increasing their physical activity, implementing a heart healthy diet and avoiding smoking."

By Megan Brooks

SOURCE: https://bit.ly/3lfEWUG ACR Convergence 2020, presented November 6, 2020.

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