Pediatr Cardiol. 2026 Jun 18. doi: 10.1007/s00246-026-04313-0. Online ahead of print.
ABSTRACT
Most medium to small-sized coronary artery aneurysms (CAAs) caused by Kawasaki disease (KD) can regress. To clarify the outcomes of patients with regressed-CAAs (r-CAAs). We reviewed characteristics and outcomes in 139 patients (male, 101; female, 38) with r-CAAs between 1978 and 2022 using medical records, including coronary angiograms and coronary computed tomography angiograms (CCTAs). The prevalence of localized stenosis (LS) and outcomes were calculated using the Kaplan-Meier method. Furthermore, the cut-off points of the maximum CAA diameter in the initial angiogram for coronary artery calcification (CAC) in late CCTAs were analyzed. The 25-year incidence of LS was 9.8% (95% CI, 3.6-23.8), and the 25-year cardiac event-free survival rate was 95.3% (95% CI 72.9-99.3). All LS cases were associated with CAC. Cut-off values of the initial maximum CAA diameter for CAC in branches and at bifurcations were 4.9 mm (n = 129, AUC 0.859, p < 0.0001) and 5.7 mm (n = 43, AUC 0.951, p = 0.0013), respectively. The corresponding Z scores were 6.75 (AUC 0.846, p < 0.0001) and 6.65 (AUC 0.921, p = 0.0014), respectively. The cut-off value of the interval time from the onset of KD to CAC detection was 10.0 years (AUC 0.673, p = 0.0053) in branches. LS with CAC in patients with r-CAAs can occur more than 10 years after the onset of KD. CAC after CAA regression is likely to appear at a maximum diameter of more than 5.0 mm (z score 6.7) in young adults; however, it may appear with aging in smaller r-CAAs.
PMID:42313129 | DOI:10.1007/s00246-026-04313-0