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Medium- or Higher-Dose Acetylsalicylic Acid for Acute Kawasaki Disease and Patient Outcomes

Title
Medium- or Higher-Dose Acetylsalicylic Acid for Acute Kawasaki Disease and Patient Outcomes
Authors
Kim, Gi BeomYu, Jeong JinYoon, Kyung LimJeong, Soo InSong, Young HwanHan, Ji WhanHong, Young MiJoo, Chan Uhng
Ewha Authors
홍영미
SCOPUS Author ID
홍영미scopus
Issue Date
2017
Journal Title
JOURNAL OF PEDIATRICS
ISSN
0022-3476JCR Link1097-6833JCR Link
Citation
vol. 184, pp. 125 - +
Publisher
MOSBY-ELSEVIER
Indexed
SCI; SCIE; SCOPUS WOS
Abstract
Objective To investigate the effect of medium-or higher-dose acetylsalicylic acid (ASA) for treating acute-phase Kawasaki disease to prevent coronary artery aneurysm (CAA). Study design Among the children with acute Kawasaki disease investigated in the eighth nationwide survey in the Republic of Korea, 8456 children with adequate data were included in this study. The subjects were divided into 2 groups according to the use of medium-or higher-dose ASA (>= 30 mg/kg/day), or-low dose ASA (3-5 mg/kg/ day) during the acute febrile phase. Both z-score-based criteria and Japanese criteria for CAA were used. Results The prevalence of CAA based on z-score (24.8% vs 18.3%; P = .001) and on the Japanese criteria (19.0% vs 10.4%; P < .001) was higher in the 7947 patients who received medium-or higher-dose ASA compared with the 509 patients who received low-dose ASA. The use of medium- or higher-dose ASA was a significant predictor of CAA based on both sets of criteria by univariate analysis (based on z-score: OR, 1.472, 95% CI, 1.169-1.854, P =.001; based on Japanese criteria: OR, 2.013, 95% CI, 1.507-2.690, P < .001) and multivariate logistic regression analysis (OR, 1.527, 95% CI, 1.166-2.0, P = .003 and OR, 2.198, 95% CI, 1.563-3.092, P < .001, respectively). Conclusions The use of medium-or higher-dose ASA in acute Kawasaki disease did not prevent CAA. A future randomized controlled trial is needed to determine the optimum dose of ASA.
DOI
10.1016/j.jpeds.2016.12.019
Appears in Collections:
의과대학 > 의학과 > Journal papers
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