Go to content

Cardiovascular outcomes in children with Kawasaki disease: a population-based cohort study


Background — The risk of cardiovascular events after Kawasaki disease (KD) remains uncertain. Our objective was to determine the risk of cardiovascular events and mortality after KD.

Methods — Population-based retrospective cohort study using Ontario health administrative databases (0–18 years; 1995–2018). Exposure: pediatric KD hospitalizations. Each case was matched to 100 non-exposed controls. Primary outcome: major adverse cardiac events (MACE; cardiovascular death, myocardial infarction, or stroke composite). Secondary outcomes: composite cardiovascular events and mortality. We determined incidence rates and adjusted hazard ratios (aHR) using multivariable Cox models.

Results — Among 4597 KD survivors, 79 (1.7%) experienced MACE, 632 (13.8%) composite cardiovascular events, and 9 (0.2%) died during 11-year median follow-up. The most frequent cardiovascular events among KD survivors were ischemic heart disease (4.6 events/1000 person-years) and arrhythmias (4.5/1000 person-years). KD survivors were at increased risk of MACE between 0–1 and 5–10 years, and composite cardiovascular events at all time periods post-discharge. KD survivors had a lower mortality risk throughout follow-up (aHR 0.36, 95% CI 0.19–0.70).

Conclusion — KD survivors are at increased risk of post-discharge cardiovascular events but have a lower risk of death, which justifies enhanced cardiovascular disease surveillance in these patients.



Robinson C, Chanchlani R, Gayowsky A, Brar S, Darling E, Demers C, Mondal T, Parekh R, Seow H, Batthish M. Pediatr Res. 2023; 93(5):1267-75. Epub 2022 Nov 15.

View Source

Research Programs

Associated Sites