Clinical InvestigationEchocardiography in ChildrenDiagnosis of Coronary Artery Abnormalities in Patients with Kawasaki Disease According to Established Guidelines and Z Score Formulas
Section snippets
Methods
We reviewed 12,926 patients diagnosed with KD who received intravenous immunoglobulin or other regimens from the data of the KD nationwide survey obtained from 98 hospitals in Korea from January 2012 to December 2014.
This survey assesses the epidemiologic features of KD by reviewing medical records, and it has been performed by the Korean Society of Kawasaki Disease every 3 years since 1991.17 The present survey collected demographic data, such as age, sex, province of residence, and date of
Results
Table 3 shows demographic data of the inclusion and exclusion groups. Men constituted 59% of the included patients. Besides sex, no statistical differences were seen between the two groups.
Among included patients, the diameters of the LMCA, LAD, RCA, and LCx were obtained in 6,754, 5,673, 6,709, and 246 cases, respectively, and their maximum diameters were 18.0, 13.3, 18.0, and 6.2 mm, respectively.
The prevalence rates and statistical differences in CAA according to the Japanese criteria and
Discussion
In this study, we found that the distinct guidelines and Z score formulas produced inconsistent CAA prevalence. In addition, when compared with one another, the five Z score formulas produced different CAA prevalence rates. We confirmed this difference by plotting all the calculated Z scores; the variation increased with the magnitude of the coronary Z scores.
Several studies have examined the diagnostic discrepancies between the JCS and AHA guidelines.7,8 In a study conducted by de Zorzi et al.,
Conclusion
The two guidelines showed a clear diagnostic difference. Specifically, more patients were identified as having coronary dilation or aneurysm using the AHA guidelines compared with those using the Japanese criteria. Additionally, the prevalence of CAA was significantly different, and we found misclassification of CAA or aneurysm subtype between each criterion or across the various Z score formulas. The prevalence of CAA was more significantly associated with BSA than with age. By plotting Z
Acknowledgment
We thank the members of the Korean Society of Kawasaki Disease for their assistance with data acquisition.
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Conflicts of interest: None.