Evidence map›Paper›PMID 39240388›Full record

Observational studyEuropean journal of pediatrics2024

Regression effect of renin-angiotensin-aldosterone system inhibitors on Kawasaki disease patients with coronary artery aneurysm: a prospective, observational study.

Eisuke Suganuma, Masaru Miura, Yutaro Koyama, Tohru Kobayashi, Tetsuji Kaneko, Tatsunori Hokosaki, Fujito Numano, Kenji Furuno, Junko Shiono, Shigeto Fuse and 2 more

Abstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in European journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. New avenues in childhood vasculitis.Pediatric rheumatology online journal · 2025
    Review
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

12 authors.

Eisuke SuganumaDivision of Infectious Diseases and Immunology and Allergy, Saitama Children's Medical Center, Saitama, Japan.
Masaru MiuraDepartment of Cardiology, Tokyo Metropolitan Children's Medical Center, 2-18-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan. masaru10miura@gmail.com.
Yutaro KoyamaDepartment of Cardiology, Tokyo Metropolitan Children's Medical Center, 2-18-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
Tohru KobayashiDepartment of Data Science, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
Tetsuji KanekoClinical Research Support Center, Tokyo Metropolitan Children's Medical Center, 2-18-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
Tatsunori HokosakiDepartment of Pediatric Cardiology, Yokohama City University Hospital, Kanagawa, Japan.
Fujito NumanoDepartment of Pediatrics, Niigata University Medical & Dental Hospital, Niigata, Japan.
Kenji FurunoDepartment of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan.
Junko ShionoDepartment of Pediatric Cardiology, Ibaraki Children's Hospital, Ibaraki, Japan.
Shigeto FuseDepartment of Clinical Laboratory, NTT EAST Medical Center Sapporo, Hokkaido, Japan.
Ryuji FukazawaDepartment of Pediatrics, Nippon Medical School Hospital, Tokyo, Japan.
Yoshihide MitaniDepartment of Pediatrics, Mie University Graduate School of Medicine, Mie, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study is to investigate whether angiotensin type 1 receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEis) can regress coronary artery aneurysm (CAA) in patients with Kawasaki disease (KD).

methodsThis multicenter, prospective, observational study was conducted at 53 institutions throughout Japan. We enrolled patients who were diagnosed with KD after January 2015 and had a medium or large CAA (maximum luminal diameter ≥ 4 mm or z score ≥  + 5) 30 days or later after KD onset.

resultsOf the 209 patients, 47 (22%) were taking ARBs/ ACEis. Compared with those in the non-ARB/ACEi group, the baseline CAA diameter was significantly greater (6.7 mm vs. 5.5 mm, p < 0.01), and bilateral CAA (70% vs. 59%, p = 0.01) and giant CAA (32% vs. 20%, p = 0.08) were more frequently observed in the ARB/ACEi group. Although the overall regression rates did not differ between the groups (67% vs. 65%), the regression rates of giant CAA were approximately 1.6 times greater in the ARB/ACEi group than in the non-ARB/ACEi group (36% vs. 23%). Multivariate Cox regression analysis after adjustment for other clinical variables suggested that ARBs/ACEis may be a factor in CAA regression (hazard ratio [HR]: 1.5, 95% confidence interval [CI]: 0.91-2.46).

conclusionsAlthough ARBs/ ACEis were used more frequently in patients with severe CAA, these patients had similar CAA regression rates to patients not taking ARBs/ACEis. ARBs/ACEis may be beneficial agents aimed at inducing CAA regression in KD patients. WHAT IS KNOWN: • Large CAAs are less likely to regress and are always at risk of life-threatening cardiac events. • Moderate CAA, age less than 1 year, and female sex have been reported to be factors that promote the regression of CAA. WHAT IS NEW: • Although ARBs/ACEis were used more frequently in patients with severe CAA, these patients had a similar rate of CAA regression to patients who did not take ARBs/ACEis. • The regression rates of giant CAA were approximately 1.6 times greater in the ARB/ACEi group than in the non-ARB/ACEi group.

Indexed as

Angiotensin-Converting Enzyme InhibitorsCoronary AneurysmMucocutaneous Lymph Node SyndromeAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsChildChild, PreschoolFemaleHumansInfantJapanMaleProspective StudiesRenin-Angiotensin SystemTreatment OutcomeAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsAngiotensin IICoronary artery aneurysmKawasaki diseaseRegression

Identifiers

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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.