Abstract:
BACKGROUND:The natural history of coronary artery aneurysms (CAA) after intravenous immunoglobulin (IVIG) treatment in the United States is not well described. We describe the natural history of CAA in US Kawasaki disease (KD) patients and identify factors associated with major adverse cardiac events (MACE) and CAA regression. METHODS AND RESULTS:We evaluated all KD patients with CAA at 2 centers from 1979 to 2014. Factors associated with CAA regression, maximum CA z-score over time (zMax), and MACE were analyzed. We performed a matched analysis of treatment effect on likelihood of CAA regression. Of 2860 KD patients, 500 (17%) had CAA, including 90 with CAA z-score >10. Most (91%) received IVIG within 10 days of illness, 32% received >1 IVIG, and 27% received adjunctive anti-inflammatory medications. CAA regression occurred in 75%. Lack of CAA regression and higher CAA zMax were associated with earlier era, larger CAA z-score at diagnosis, and bilateral CAA in univariate and multivariable analyses. MACE occurred in 24 (5%) patients and was associated with higher CAA z-score at diagnosis and lack of IVIG treatment. In a subset of patients (n=132) matched by age at KD and baseline CAA z-score, those receiving IVIG plus adjunctive medication had a CAA regression rate of 91% compared with 68% for the 3 other groups (IVIG alone, IVIG ≥2 doses, or IVIG ≥2 doses plus adjunctive medication). CONCLUSIONS:CAA regression occurred in 75% of patients. CAA z-score at diagnosis was highly predictive of outcomes, which may be improved by early IVIG treatment and adjunctive therapies.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Friedman KG,Gauvreau K,Hamaoka-Okamoto A,Tang A,Berry E,Tremoulet AH,Mahavadi VS,Baker A,deFerranti SD,Fulton DR,Burns JC,Newburger JWdoi
10.1161/JAHA.116.003289subject
Has Abstractpub_date
2016-09-15 00:00:00issue
9issn
2047-9980pii
JAHA.116.003289journal_volume
5pub_type
杂志文章abstract::Background Higher fibroblast growth factor-23 ( FGF -23) levels are associated with incident heart failure ( HF ) in MESA (the Multiethnic Study of Atherosclerosis). FGF -23 is also associated with left ventricular hypertrophy. Whether the FGF -23 association with HF is similar for heart failure with reduced ejection ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.010653
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doi:10.1161/JAHA.117.005672
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
doi:10.1161/JAHA.114.001650
更新日期:2015-09-22 00:00:00
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doi:10.1161/JAHA.119.012171
更新日期:2019-05-07 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
doi:10.1161/JAHA.117.005967
更新日期:2017-09-18 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.116.003318
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doi:10.1161/JAHA.117.007971
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journal_title:Journal of the American Heart Association
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pub_type: 杂志文章
doi:10.1161/JAHA.115.002290
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doi:10.1161/JAHA.117.007582
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.012744
更新日期:2019-11-05 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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更新日期:2013-09-26 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.013165
更新日期:2019-09-03 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.012008
更新日期:2019-05-07 00:00:00
abstract:BACKGROUND:Roux-en-Y gastric bypass (RYGB) reduces obesity-associated comorbidities and cardiovascular mortality. RYGB improves endothelial dysfunction, reducing c-Jun N-terminal kinase (JNK) vascular phosphorylation. JNK activation links obesity with insulin resistance and endothelial dysfunction. Herein, we examined ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.006441
更新日期:2017-11-14 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.016010
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-03-09 00:00:00