Children with Kawasaki Disease at higher risk for heart prob
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Children who survived hospitalization for Kawasaki disease remained at risk for cardiovascular events for more than 10 years after the index hospitalization, a study in Ontario found.

New research shows that children with Kawasaki Disease remain at an increased risk for cardiovascular events more than 10 years after hospitalization for their condition, highlighting the need for long-term heart disease surveillance and risk reduction strategies for these young patients. Details of the study was presented at ACR Convergence, the American College of Rheumatology's annual meeting.

Researchers in Ontario, Canada noticed that the incidence of KD has significantly increased over the past two decades. However, the risk of long-term cardiovascular events after childhood KD diagnosis remains unknown.

The researchers identified all children up to 18 years of age who survived hospitalization for KD. They included only the first eligible hospitalization, excluding children who were previously diagnosed with KD. They matched each KD case to 100 non-exposed control cases by age, sex and year. They then followed these patients until death or March 2019, or up to 24 years old. They determined the rates of cardiovascular events, major adverse cardiac events (such as heart attack or stroke) and death, comparing children who had KD with those who were not exposed to the disease. They looked specifically at four time periods after hospital discharge: 0-1 year, 1-5 years, 5-10 years and more than 10 years.

They found that, among 4,597 KD survivors, 746 or 16.2% experienced cardiovascular events compared with 5.2% of children without the disease. They also found that 79 or 1.7% experienced major adverse cardiac events compared to 0.7% of children without the disease, and nine died during the median 11-year follow-up period. The most frequent cardiovascular events experienced by KD survivors were ischemic heart disease, arrhythmias, high blood pressure and peripheral vascular disease.

KD survivors were at higher risk of heart problems compared to patients who did not have the disease and they experienced cardiovascular events sooner. Their risk was highest in the first year after they were discharged from the hospital. They were also at higher risk of heart surgery like coronary artery bypass grafting. However, their risk of death during follow-up was lower than non-exposed patients.

"This study results provide a signal that KD survivors have a higher risk of developing heart disease more than ten years after their initial diagnosis. This suggests that KD survivors should be screened at regular intervals for cardiovascular diseases and associated risk factors," says researchers "Cardiovascular risk reduction strategies should be implemented for all KD survivors, including healthy active lifestyle counselling and early intervention when cardiovascular risk factors are identified."

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