<
h4 class=""
h4"">Objective
h4>It
has been claimed t
hat t
he aneurysm rate for Kawasaki disease (KD) patients in Japan is lower t
han in t
he U.S. However it
has been difficult to compare coronary artery (CA) outcomes between t
he two countries because of different definitions for CA abnormalities. T
herefore, we compared CA internal diameters between Japanese and U.S. KD patients using standard definitions and met
hods.<
h4 class=""
h4"">Study design
h4>
We retrospectively reviewed CA outcomes in 1082 KD patients from 2 centers in the U.S. and 3 centers in Japan and compared Z-max scores (maximum internal diameter for the left anterior descending or right coronary artery expressed as standard deviation units from the mean (Z-score) normalized for body surface area) obtained within 12 weeks after onset and calculated using two different regression equations from Canada (Dallaire) and Japan (Fuse). We defined a Z-max of < 2.5 as normal and a Z-max of ¡Ý 10 as giant aneurysm.<h4 class=""h4"">Resulth4>
The median Z-max for the U.S. and Japanese subjects was 1.9 and 2.3 SD units, respectively (p < 0.001). There was no significant difference in rates of patients with Z-max ¡Ý 5.0 between the countries. In a multivariable model adjusting for age, sex, and treatment response, being Japanese was still associated with a higher Z-max score.<h4 class=""h4"">Conclusionh4>
Previously reported differences in aneurysm rates between Japan and the U.S. likely resulted from use of different definitions and nomenclature. Adoption of Z-scores as a standard for reporting CA internal diameters will allow meaningful comparisons among different countries and will facilitate international, collaborative clinical trials.