Medium- or Higher-Dose Acetylsalicylic Acid for Acute Kawasaki Disease and Patient Outcomes

Objective To investigate the effect of medium- or higher-dose acetylsalicylic acid (ASA) for treating acute-phase Kawasaki disease to prevent coronary artery aneurysm (CAA). Study design Among the children with acute Kawasaki disease investigated in the eighth nationwide survey in the Republic of Korea, 8456 children with adequate data were included in this study. The subjects were divided into 2 groups according to the use of medium- or higher-dose ASA (≥30 mg/kg/day), or-low dose ASA (3-5 mg/kg/day) during the acute febrile phase. Both z- score–based criteria and Japanese criteria for CAA were used. Results The prevalence of CAA based on z -score (24.8% vs 18.3%; P  = .001) and on the Japanese criteria (19.0% vs 10.4%; P z -score: OR, 1.472, 95% CI, 1.169-1.854, P  = .001; based on Japanese criteria: OR, 2.013, 95% CI, 1.507-2.690, P P  = .003 and OR, 2.198, 95% CI, 1.563-3.092, P Conclusions The use of medium- or higher-dose ASA in acute Kawasaki disease did not prevent CAA. A future randomized controlled trial is needed to determine the optimum dose of ASA.