Evidence map›Paper›PMID 35151308›Full record

ArticleBMC pediatrics2022

Myocardial infarction due to thrombotic occlusion despite anticoagulation in Kawasaki disease - a case report.

Diana van Stijn, Nikki J Schoenmaker, R Nils Planken, Dave R Koolbergen, Samantha C Gouw, Taco W Kuijpers, Nico A Blom, Irene M Kuipers

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Diana van StijnDepartment of Pediatric Immunology, Rheumatology and Infectious diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, location H8-253, Amsterdam, 1105 AZ, The Netherlands. d.vanstijn@amsterdamumc.nl.ORCID 0000-0002-4179-9950
Nikki J SchoenmakerDepartment Pediatric Intensive Care Unit (PICU), Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
R Nils PlankenDepartment of Radiology and Nuclear medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Dave R KoolbergenDepartment of Cardiothoracic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Samantha C GouwDepartment of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Taco W KuijpersDepartment of Pediatric Immunology, Rheumatology and Infectious diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, location H8-253, Amsterdam, 1105 AZ, The Netherlands.
Nico A BlomDepartment of Pediatric cardiology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Irene M KuipersDepartment of Pediatric cardiology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Emma Kinderziekenhuis · NLAmsterdam University Medical Centers · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKawasaki disease (KD) is a pediatric vasculitis. Mainly the coronary arteries become affected due to acute inflammation and formation of coronary artery aneurysms (CAAs) can occur. The larger the CAA, the higher the risk for clinical complications and major adverse cardiac events, as the blood flow changes to vortex or turbulent flow facilitating thrombosis. Such patients may develop life threatening thrombotic coronary artery occlusion and myocardial ischemiaunless anti-platelet and anti-coagulation therapy is timely initiated. CASE PRESENTATION: We present a unique case of a 5-year-old girl with KD associated giant CAAs suffering from myocardial ischemia due to acute progressive thrombus growth despite intensive anticoagulation treatment (acetylsalicylic acid, acenocoumarol and clopidogrel) after 21 months of onset of disease. Thrombus growth continued even after percutaneous coronary intervention (PCI) with thrombolytic treatment and subsequent systemic thrombolysis, finally causing lasting myocardial damage. Acute coronary artery bypass grafting (CABG) was performed, although technically challenging at this very young age. Whereas myocardial infarction was not prevented, follow-up fortunately showed favorable recovery of heart failure.

conclusionsAnticoagulation and thrombolysis may be insufficient for treatment of acute coronary syndrome in case of impending thrombotic occlusion of giant coronary aneurysms in KD. Our case demonstrates that a thrombus can still continue to grow despite triple anticoagulation therapy and well-tailored cardiovascular follow-up, which can be most likely attributed to the state of low blood flow inside the aneurysm.

Indexed as

Coronary AneurysmMucocutaneous Lymph Node SyndromeMyocardial InfarctionPercutaneous Coronary InterventionThrombosisAnticoagulantsChildChild, PreschoolFemaleHumansAnticoagulantsAntiplatelet and anticoagulant drugsClopidogrel resistanceCoronary artery aneurysmsImagingThrombosis

Identifiers

PMID35151308
PMCPMC8840548
OpenAlexW4211010288

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.