Kawasaki disease primary prevention: Difference between revisions

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==Prevention==
==Prevention==
===AHA Scientific Statement on Kawasaki Disease===
Primary prevention for Kawasaki disease is not applicable.
====Recommendations for Prevention of Thrombosis During the Acute Illness====
The [[American Heart Association|AHA]] Recommendations for the prevention of Thrombosis during the acute illness are:<ref name="McCrindleRowley2017">{{cite journal|last1=McCrindle|first1=Brian W.|last2=Rowley|first2=Anne H.|last3=Newburger|first3=Jane W.|last4=Burns|first4=Jane C.|last5=Bolger|first5=Anne F.|last6=Gewitz|first6=Michael|last7=Baker|first7=Annette L.|last8=Jackson|first8=Mary Anne|last9=Takahashi|first9=Masato|last10=Shah|first10=Pinak B.|last11=Kobayashi|first11=Tohru|last12=Wu|first12=Mei-Hwan|last13=Saji|first13=Tsutomu T.|last14=Pahl|first14=Elfriede|title=Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association|journal=Circulation|volume=135|issue=17|year=2017|pages=e927–e999|issn=0009-7322|doi=10.1161/CIR.0000000000000484}}</ref>
{| class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen" |<nowiki>"</nowiki>'''1.''' Low-dose ASA (3–5 mg·kg−¹·d−¹) should be administered to patients without evidence of coronary artery changes until 4 to 6 weeks after onset of illness.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LemonChiffon" | [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''1.''' For patients with rapidly expanding coronary artery aneurysms or a maximum Z score of ≥10, systemic anticoagulation with LMWH or warfarin (international normalized ratio target 2.0–3.0) in addition to low dose ASA is reasonable. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LemonChiffon" | [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''1.''' For patients at increased risk of thrombosis, for example, with large or giant aneurysms (≥8 mm or Z score ≥10) and a recent history of coronary artery thrombosis, “triple therapy” with ASA, a second antiplatelet agent, and anticoagulation with warfarin or LMWH may be considered. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LightCoral" | [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]
|-
| bgcolor="LightCoral" |<nowiki>"</nowiki>'''1.''' Ibuprofen and other non steroidal anti-inflammatory drugs with known or potential involvement of cyclooxygenase pathway may be harmful in patients taking ASA for its antiplatelet effects. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|}
 
====Recommendations for Risk Stratification of Coronary Artery Abnormalities====
 
{| class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LemonChiffon" | [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''1.''' It is reasonable to use echocardiographic coronary artery luminal dimensions converted to BSA-adjusted Z scores to determine risk stratification. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''2.''' It is reasonable to incorporate both maximal and current coronary artery involvement in risk stratification. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''3.''' It is reasonable to incorporate the presence of additional features other than coronary artery luminal dimensions into decisions regarding risk stratification. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}


==References==
==References==

Revision as of 03:43, 28 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]

Overview

Primary prevention for Kawasaki disease is not applicable. Complications of the disease, however, may be prevented through the use of medical prophylaxis.

Prevention

Primary prevention for Kawasaki disease is not applicable.

References

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