Abstract O.62: Estimation Of The Severity Of Coronary Artery Aneurysm By Z-score Of The Internal Diameter In Kawasaki Disease

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-04, Vol.131 (suppl_2)
• Main Authors: Fukushima, Naoya, Miura, Masaru, Kobayashi, Toru, Fuse, Shigeto, Saji, Tsutomu, Yamagishi, Hiroyuki, Kato, Taichi, Hamaoka, Kenji, Nomura, Yuichi, Fukazawa, Ryuji, Kato, Hitoshi, Hirono, Keiichi, Suda, Kenji
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.131.suppl_2.o62

Abstract only Background: The standard values of normal coronary artery internal diameters in Japanese children have been recently established, making it possible to calculate Z-scores based on body surface area. The aim of this study was to clarify the appropriate cut-off points of coronary artery aneurysm (CAA) Z-scores to predict coronary events such as stenosis, obstruction, and thrombosis in patients with Kawasaki disease (KD). Methods: In this multicenter retrospective study, we investigated height, weight, CAA diameters measured by echocardiography in acute phase KD, and coronary events in CAA patients with KD (age 18 years or younger) who had coronary angiography from 1992 to 2011. Results: Interim analysis was performed on data of the 928 patients recruited from 45 institutions. Body surface area (calculated from height and weight) and CAA diameters were available in 702, 680, and 539 cases of right coronary artery (RCA), left main trunk (LMT), left anterior descending artery (LAD), respectively. Coronary events occurred in 62 RCA cases (8.8%), 8 LMT cases (1.2%), and 45 LAD cases (8.3%) . Areas under the ROC curves to predict coronary events were similar for actual diameter, Z-score, and the ratio of actual diameter to that showing a Z-score of zero in each segment. The cut-off points for the actual diameter, Z-score, and ratio which yielding the highest sensitivity plus specificity were 6.3 mm, 9.6, and 3.9 times for RCA; 7.4 mm, 11.1, and 2.8 times for LMT; and 5.3 mm, 8.9, and 3.5 times for LAD. Conclusions: We identified cut-off Z-scores for CAA diameters useful for coronary events prediction. Attention should be paid to coronary events when the Z-score for CAA diameter is over 10.