Regression of Coronary Artery Aneurysm with Atorvastatin treatment During the First Six Months of Kawasaki Disease
Keywords:
Kawasaki disease, coronary aneurysm, atorvastatin, coronary regressionAbstract
Background: Kawasaki disease (KD) is a childhood vasculitis that resulted in coronary artery aneurysm (CAA) for approximately 5 % of patients when treated with intravenous immunoglobulin (IVIG). The inflammation and endothelial dysfunction of coronary artery may persist after acute illness of KD. We sought to determine the benefit effects of statins in decreasing inflammation and inducing regression of CAA in post-acute KD patients.
Methods: A retrospective cohort study of CAA in KD patients admitted to Nakornping Hospital and Chiang Mai University Hospital during September 1, 2014 to August 31, 2019 was performed. All patients were managed according to the American Heart Association KD guideline. The atorvastatin group had received 0.2 mg/kg/day of atorvastatin in addition to IVIG and aspirin since earliest CAA detection until the CAA regressed to normal size. All data were analyzed comparing outcome of both groups at 2 and 6 months by adjusted factors (age group, sex, IVIG treatment and CAA risk classification), using odds ratio and 95% CI.
Results: Of 102 KD patients with CAA, 28 patients (27.5%) were in atorvastatin group and 74 patients (72.5%) were in control group. There were 23 (82.1%) small CAAs and 5 (17.9%) medium CAAs in atorvastatin group and 54 (73%) small CAAs and 20 (27%) medium CAAs in control group. After adjusted for age, sex and CAA risk classification, patients who received atorvastatin had tend to be higher rate of CAA regression in subacute phase of KD. However, the rate of CAA regression at 2 and 6 months were not different between two groups (odds ratio 4.17, 95% CI 0.35-63.23, p-value =0.241).
Conclusions: Atorvastatin treatment in subacute phase KD had no statistical effect on the reduction of coronary aneurysms.
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