Acute Coronary Syndrome in Kawasaki Disease From Infancy to Adulthood
Acute coronary syndrome (ACS) remains underrecognized in patients with Kawasaki disease (KD). The population at risk for KD-associated ACS is increasing, yet current ACS guidelines are largely derived from atherosclerotic disease and do not adequately address the distinctive mechanisms, anatomy, and thrombosis risk associated with KD. Because the pathophysiology and management of KD-associated ACS differ in fundamental ways from those of atherosclerotic coronary artery disease, its management requires a coordinated team response, with collaboration between pediatric and adult cardiologists. Recent advances in coronary imaging, interventional techniques, and antithrombotic therapies provide an opportunity to establish a more disease-specific approach. This review synthesizes current evidence on the epidemiology and pathophysiology of coronary artery aneurysms, interventional coronary imaging, acute management, revascularization strategies, antithrombotic therapy, and post-ACS surveillance in patients with KD to guide clinical decision-making and treatment for patients with KD presenting with ACS.
Authors
- Nagib Dahdah (ORCID: https://orcid.org/0000-0001-7715-3169)
- Kenji Suda (ORCID: https://orcid.org/0000-0002-9540-2648)
- Pei‐Ni Jone (ORCID: https://orcid.org/0000-0001-5145-0341)
- André Jakob (ORCID: https://orcid.org/0000-0003-3580-2268)
- Satsuki Fukushima (ORCID: https://orcid.org/0000-0002-9481-8860)
- Yoshihide Mitani (ORCID: https://orcid.org/0000-0002-6038-8161)
- Jane W. Newburger (ORCID: https://orcid.org/0000-0002-7794-9017)
- Jane C. Burns (ORCID: https://orcid.org/0000-0001-5679-1217)
- Alain Fraisse (ORCID: https://orcid.org/0000-0003-1969-421X)
- Nadine F. Choueiter (ORCID: https://orcid.org/0000-0001-9882-6596)
- Matthew I. Tomey (ORCID: https://orcid.org/0000-0001-5626-0467)
- Yasutsugu Shiono (ORCID: https://orcid.org/0000-0003-4150-0899)
- Toshihiro Tamura (ORCID: https://orcid.org/0000-0001-8655-0203)
- Hiroyoshi Yokoi (ORCID: https://orcid.org/0000-0002-4972-3723)
- Ming‐Tai Lin (ORCID: https://orcid.org/0000-0002-1718-7137)
- John B. Gordon
- Luis G. Quiñonez
- Jiken Bhatt
- Etsuko Tsuda
Institutions
- Kurume University (JP)
- Boston Children's Hospital (US)
- Mount Sinai Hospital (US)
- Harvard University (US)
- Mie University (JP)
- Wakayama Medical University (JP)
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- Tenri Hospital (JP)
- Rady Children's Hospital-San Diego (US)
- Fukuoka Hospital (JP)
- Mount Sinai Hospital (US)
- National Cerebral and Cardiovascular Center (JP)
- Lurie Children's Hospital (US)
- National Taiwan University Hospital (TW)
- San Diego Cardiac Center (US)
- Boston Children's Museum (US)
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- Ludwig-Maximilians-Universität München (DE)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- Circulation
- Published
- 2026-09-21
- DOI
- https://doi.org/10.1161/circulationaha.126.080727
- Primary Topic
- Kawasaki Disease and Coronary Complications
- Type
- article
- Field-Weighted Citation Impact
- 0.00