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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 G.B.Yu J.J.Yoon K.L.Jeong S.I.Song Y.H.Han J.W.Hong Y.M.Joo C.U.
Ewha Authors
홍영미
SCOPUS Author ID
홍영미scopus
Issue Date
2017
Journal Title
Journal of Pediatrics
ISSN
0022-3476JCR Link
Citation
Journal of Pediatrics vol. 184, pp. 125 - 1.29E03
Keywords
aspirincoronary aneurysmKawasaki disease
Publisher
Mosby Inc.
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
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 (≥30mg/kg/day), or-low dose ASA (3-5mg/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. © 2016 Elsevier Inc.
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DOI
10.1016/j.jpeds.2016.12.019
Appears in Collections:
의과대학 > 의학과 > Journal papers
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