ST-segment elevation myocardial infarction in Kawasaki disease: A case report and review of literature

Table 1 Antithrombotic therapy in the primary prevention settings of Kawasaki disease

Agent	Indication	Dose	Monitoring	Mechanism of action
Aspirin	Initial therapy for prevention of thrombosis.(Z score ≥ 2.5)	3-5 mg/kg/day	-	Cyclooxygenase-1 inhibitor
Clopidogrel	Resistance to aspirin or aspirin allergy. Dual-antiplatelet therapy for thromboprophylaxis	0.2-1.0 mg/kg/day	-	P2Y12 inhibitor
Prasugrel/ticagrelor	NA	NA	NA	P2Y12 inhibitor
Warfarin	Thromboprophylaxis for large or giant aneurysm. (Z score > 10)		INR 2-3	Vitamin K antagonist
LMWH	Thromboprophylaxis for large or giant aneurysm.(Z score > 10)	Dosage varies according to age and agent	-	Active antithrombin III

NA: Not applicable; INR: International normalized ratio; LMWH: Low molecular weight heparin.

Table 2 Summary of case reports of patients in whom myocardial infarction was present during adulthood who were diagnosed with Kawasaki disease in childhood

Ref.	Age/Sex/Age of KD diagnosis	CV risk factor	Thromboprophylaxis	Follow up	Coronary angiography	Maximal diameter	Treatment
Current case	35/M/2	-	-	-	Aneurysm in the LCX, RCA. Stenosis in the LCX	6.0 mm	PCI
Jiang et al[22]	21/F/2	-	-	-	Aneurysm in the mid-RCA. Thrombosis in the RCA	-	Medication
Rozo et al[23]	36/M/4	DL	-	-	Aneurysm in the left main and proximal LAD. Stenosis in the proximal LAD	-	CABG
Negoro et al[24]	27/M/1	-	-	-	Aneurysm in all coronary arteries. Total occlusion in the mid-RCA	-	Thrombectomy and balloon angioplasty
Negoro et al[24]	32/M/2	Smoker	-	+	Aneurysm in all coronary arteries. Stenosis in proximal the LCX and occlusion in the mid-RCA	-	Directional coronary atherectomy and balloon angioplasty
Shaukat et al[25]	24/M/6	-	-	-	Aneurysm in the RCA and LCX. Occlusion in the proximal LAD, distal LCX and mid RCA	17.0 mm	Thrombolysis
Ariyoshi et al[26]	26/M/3	Smoker	-	-	Aneurysm in the proximal LAD. Total occlusion in the proximal LAD	9.0 mm	PCI
Tsuda et al[27]	26/M/0	Smoker	-	-	Aneurysm in the RCA, LAD and LCX. Total occlusion in the left main	8.1 mm	Thrombolysis
Tsuda et al[27]	24/M/1	-	-	+	Aneurysm in the bifurcation of the left coronary artery and proximal LAD. No significant stenosis	-	Medication
Kodama et al[28]	25/M/7	Smoker	-	-	Aneurysm in the LAD and LCX. Occlusion in the LAD and LCX	-	Thrombolysis
Kawai et al[29]	32/M/4	Smoker	-	-	Aneurysm in the LAD. Total occlusion in the proximal LAD	5.8 mm	PCI
Kawai et al[29]	34/M/3	-	-	-	Aneurysm in the LAD. Total occlusion in the proximal LAD	-	PCI
Shiraishi et al[30]	26/M/3	-	-	-	Aneurysm in the proximal LAD. Total occlusion in the proximal LAD	8.0 mm	Balloon angioplasty
Vijayvergiya et al[31]	20/M/9	-	-	-	Aneurysm in the proximal LAD. There was no stenosis in the coronary artery	13.0 mm	CABG
Sato et al[32]	44/M/3	-	-	-	Aneurysm in the proximal LAD. Occlusion in the LM	8.0 mm	PCI
Kitamura et al[33]	20/M/3	-	-	+	Aneurysm in the LAD. Stenosis in the LAD and RCA	19.0 mm	CABG
Kitamura et al[33]	30/M/0	-	-	+	Aneurysm in the RCA. Stenosis in the RCA	30.0 mm	CABG
Potter et al[34]	36/F/4	-	-	-	Aneurysm in the proximal LAD, RCA. Occlusion in the RCA	8.0 mm	CABG
Motozawa et al[35]	24/M/4	-	Aspirin and ticlopidine	+	Aneurysm in the LAD. Stenosis in the LAD	9.0 mm	Thrombectomy

KD: Kawasaki disease; CV: Cardiovascular; LCX: Left circumflex; RCA: Right coronary artery; PCI: Percutaneous coronary intervention; LAD: Left anterior descending; CABG: Coronary artery bypass graft; LM: Left main; DL: dyslipidemia.