Asian Pacific Society of Cardiology Consensus Statement on Management of Coronary Artery Disease in Adults with Late Complications of Kawasaki Disease

K. Yeo, R. Fukazawa, Mamoru Ayusawa, Ming-Tai Lin, Koji Maemura, Paul Tern, Sofian Johar, Oktavia Lilyasari, Aurelia Leus, S. Lo, Hiroyoshi Yokoi, Y. Mitani
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Abstract

Despite reductions in the mortality of Kawasaki disease with advances in its treatment, a proportion of patients still develop coronary artery dilatation that may persist even into adulthood. These lesions carry an increased risk of myocardial ischaemia and infarction. However, published clinical guidelines on the management and long-term follow up of patients with these late complications of Kawasaki disease are limited. The Asian Pacific Society of Cardiology convened an expert panel to review the available literature and develop consensus recommendations to guide clinicians in this area. The panel developed statements on the assessment and risk stratification of coronary artery disease, investigations for follow up, as well as considerations around treatment of stenotic lesions with medical therapy, percutaneous coronary intervention and coronary artery bypass grafting. Each statement was voted on by each panel member and consensus was reached when 80% of experts voted ‘agree’ or ‘neutral’. This process resulted in the development of consensus recommendations to guide cardiologists and internists in the follow up and management of patients with coronary artery lesions as a late complication of Kawasaki disease.
亚太心脏病学会关于成人川崎病晚期并发症冠状动脉疾病处理的共识声明
尽管随着治疗的进步,川崎病的死亡率有所降低,但仍有一部分患者出现冠状动脉扩张,甚至可能持续到成年。这些病变增加了心肌缺血和梗死的风险。然而,关于川崎病这些晚期并发症患者的管理和长期随访的已出版的临床指南有限。亚太心脏病学会召集了一个专家小组,审查现有文献,并制定共识建议,以指导该领域的临床医生。该小组就冠状动脉疾病的评估和风险分层、随访调查以及对药物治疗、经皮冠状动脉介入治疗和冠状动脉旁路移植术治疗狭窄病变的考虑发表了声明。每个陈述由每个小组成员投票,当80%的专家投票“同意”或“中立”时达成共识。这一过程导致了共识建议的发展,以指导心脏病学家和内科医生对作为川崎病晚期并发症的冠状动脉病变患者进行随访和管理。
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