**14. Natural history**

The percentage of patients developing coronary aneurysms is reduced with timely administration of intravenous immunoglobulin. Nearly 50% of those coronary artery aneurysms will show angiographic regression within 1 to 2 years following the illness, with smaller lesions having a greater chance of resolution (Newburger et al., 2004). The size of the aneurysm is a major predictor for the development of myocardial infarction (Yeu et al., 2008). As aneurysms remodel with time, however, the risk of coronary artery stenosis increases.

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There is evidence that Kawasaki disease in childhood may increase the risk of cardiovascular disease in adulthood. Patients with coronary artery aneurysms have an increase in carotid artery intima-media thickness, and increased systemic arterial stiffness with higher pulse wave velocities (Cheung et al., 2007; Ooyanagi et al., 2004; Suzuki et al., 1996). Furthermore there are data demonstrating abnormal vascular endothelial function and lipid profiles in patients. The exact level of increased risk is uncertain.
