Coronary thrombosis is a common cardiovascular complication of Kawasaki disease (KD),
which seriously affects the long-term therapeutic effect of KD. The purpose was to
determine the incidence and timing of coronary thrombosis and to identify risk factors
for coronary thrombosis in KD with giant coronary artery aneurysm (GCAA).
Methods and results
A total of 94 consecutive KD patients with GCAA from Children's Hospital Affiliated
to Chongqing Medical University were enrolled retrospectively. The cumulative incidence
of coronary thrombosis in KD patients with GCAA was 59 % (n = 54). Coronary thrombosis mainly occurred in the acute phase (n = 41/54, 76 %), with a median time of 16 days after onset. Cox regression analysis
was used to identify risk factors for coronary thrombosis. Cox regression analysis
indicated that male (hazard ratios, 1.87; 95 % CI, 1.01–3.44; P = 0.43), left anterior descending artery (LAD) involvement (hazard ratios, 3.75;
95 % CI, 1.85–7.39; P < 0.001), coronary absolute diameter ≥ 8 mm (hazard ratios, 2.93; 95 % CI, 1.36–6.29;
P = 0.006) constituted a higher risk of coronary thrombosis after adjusting for confounders.
Kaplan-Meier method showed the cumulative incidence for coronary thrombosis in KD
patients with GCAA was 79 %, 92 %, and 88 % in male, LAD involvement, coronary absolute
diameter > 8 mm, respectively.
Male, LAD involvement, and coronary absolute diameter ≥ 8 mm were associated with
a high incidence of coronary thrombosis. Based on the analysis of the incidence, time
and risk factors of coronary thrombosis in different periods, this study may provide
an essential reference for thromboprophylaxis management of KD with GCAA.