cardiovascular-agents and Mucocutaneous-Lymph-Node-Syndrome

Coronary artery aneurysm (CAA) is a rare disease, and there are limited data on prescribing patterns for CAA. The aim of our study was to investigate prescribing patterns for CAA in Taiwan via the National Health Insurance Research Database (NHIRD).. We included all CAA patients in Taiwan from 2005 to 2011. Data from 1 year before and after the CAA diagnosis were used to analyze examinations, comorbidities and prescribing patterns.. A total of 1397 patients diagnosed with CAA were enrolled in our study. Most pediatric patients with CAA were diagnosed with Kawasaki disease (95.7%). In pediatric CAA patients, the utilization rates of aspirin and gamma globulins were 82.9 and 53.6%, respectively, after CAA diagnosis. Among the antithrombotic agents, aspirin was used most commonly, followed by dipyridamole (16.9%), heparin (5.8%) and warfarin (4.6%). In adult CAA patients, common comorbidities included hypertension (63.4%), hyperlipidemia (39.6%), and diabetes mellitus (26.1%). Coronary atherosclerosis was identified in 72.5% of adult patients after CAA diagnosis. Antithrombotic agents, particularly aspirin, clopidogrel and heparin, were prescribed more frequently after CAA diagnosis. Among the prescribed medications, aspirin (75.8%), β-blockers (48.3%), statins (47.6%), metformin (14.4%), sulfonylureas (14.4%) and isosorbide mononitrate (32.9%) were frequently observed in each category.. Kawasaki disease was the main cause of CAA in pediatric patients, and coronary artery disease was the most common comorbidity in adult CAA patients. The most commonly used antithrombic agent after CAA diagnosis was aspirin in both adult and pediatric patients.

Topics: Adolescent; Adult; Age Factors; Aged; Cardiovascular Agents; Child; Child, Preschool; Comorbidity; Coronary Aneurysm; Coronary Artery Disease; Databases, Factual; Drug Prescriptions; Drug Utilization; Female; Humans; Male; Middle Aged; Mucocutaneous Lymph Node Syndrome; Practice Patterns, Physicians'; Retrospective Studies; Risk Factors; Taiwan; Time Factors; Young Adult

Kawasaki disease (KD) is the most common cause of acquired heart disease in children in Japan, North America and Europe. Undiagnosed and untreated KD can have clinically significant consequences later in life. The clinical spectrum of missed childhood KD is frequently being recognized during adulthood. We report four adult cases of acute coronary events, in which coronary angiography was suggestive of sequelae of KD.. Four adults who presented with acute coronary events, had coronary angiography for evaluation. Indoor-admission files were analyzed for the clinical details of individual cases.. Two cases were below 40 years of age. None of the patients had any known conventional risk factors for atherosclerosis. Case 4 had a clinical history of childhood KD. Coronary angiography revealed ectasia of multiple coronary arteries and stenosis in distal segments in the first three cases and large thrombosed aneurysm with calcified walls in the fourth case.. We hereby report four adult cases with acute coronary events, who had markedly dilated coronary artery segments suggestive of possible sequelae of childhood KD.

Topics: Adult; Aged; Anterior Wall Myocardial Infarction; Cardiovascular Agents; Coronary Aneurysm; Coronary Angiography; Coronary Artery Bypass; Coronary Artery Disease; Coronary Stenosis; Coronary Thrombosis; Delayed Diagnosis; Humans; India; Male; Mucocutaneous Lymph Node Syndrome; Myocardial Infarction; Predictive Value of Tests; Tertiary Care Centers; Treatment Outcome; Vascular Calcification

Topics: Cardiovascular Agents; Computed Tomography Angiography; Coronary Aneurysm; Coronary Angiography; Echocardiography; Humans; Immunosuppressive Agents; Infant; Male; Mucocutaneous Lymph Node Syndrome; Severity of Illness Index; Treatment Outcome

Topics: Adult; Biomarkers; Cardiac Catheterization; Cardiovascular Agents; Cardiovascular Diseases; Child; Coronary Artery Bypass; Diagnostic Imaging; Electrocardiography; Humans; Life Style; Mucocutaneous Lymph Node Syndrome; Severity of Illness Index