Despite research showing Kawasaki disease (KD) is associated with coronary artery aneurysms (CAAs) and that the incidence of KD has significantly increased during the past 20 years, little is known regarding the risk of long-term cardiovascular events in children without large CAAs. To determine the risk and timing of such events (diagnoses and procedures) and the risk of all-cause mortality in children with KD, study investigators analyzed data on patients aged 0-18 who survived hospitalization with a KD diagnosis from 1995-2018. Cases of KD were matched to 100 non-exposed controls by age, sex, and index year and followed until death or March 2019. Incidence rates and unadjusted hazard ratios were determined for cardiovascular events, major adverse events (MACE; cardiovascular death, myocardial infarction (MI) or stroke composite) and all-cause mortality, with the KD and non-exposed cohorts compared during the following time periods: 0-1, 1-5, 5-10 and more than 10 years. Among KD survivors, 16.2% experienced cardiovascular events, 1.75 MACE, and 0.2% mortality during a median 11.1-year follow-up. KD survivors were at increased risk of cardiovascular events and MACE compared with non-exposed children at 0-1, 1-5, and 5-10 years, and cardiovascular events at more than 10 years follow-up, and they experienced cardiovascular events sooner than non-exposed children.

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