Document Detail

Multicenter and retrospective case study of warfarin and aspirin combination therapy in patients with giant coronary aneurysms caused by Kawasaki disease.
MedLine Citation:
PMID:  19436123     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To determine the prognosis of patients with giant coronary aneurysms (GA) caused by Kawasaki disease (KD) treated with combined oral warfarin and aspirin. METHODS AND RESULTS: A multicenter follow-up study of 83 patients (65 males, 18 females) with GA who had been treated for > or =3 months with warfarin. Most patients were placed on the combination therapy as soon as the GA was detected and remained on it for 6.0 +/-5.3 years, giving a total of 482 patient-years. Target international normalized ratio of prothrombin time ranged from 1.5 to > or =2.5. During this observational period, 5 patients suffered from 8 episodes of acute myocardial infarction and 1 died. Coronary thrombus formation enforced 6 courses of intracoronary thrombolysis in 3 patients (1-4 times). Consequently, freedom of cardiac events was 92.5% at 1 year and 91% at 10 years and the linearized cardiac event rate was 2.9% patient-year. Hemorrhagic complications occurred on 8 occasions (1 subdural hematoma) in 5 patients, giving 1.7% patient-year. CONCLUSIONS: The combination of warfarin and aspirin has an acceptably high cardiac-event-free survival in patients with GA caused by KD, though it has a certain risk of hemorrhagic complications.
Kenji Suda; Yoshiyuki Kudo; Takashi Higaki; Yuichi Nomura; Masaru Miura; Masahiko Matsumura; Mamoru Ayusawa; Shunichi Ogawa; Toyojiro Matsuishi
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-05-12
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-26     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1319-23     Citation Subset:  IM    
Department of Pediatrics and Child Health, Kurume University School of Medicine, Asahi-machi, Kurume, Japan.
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MeSH Terms
Administration, Oral
Anticoagulants / therapeutic use*
Aspirin / therapeutic use*
Child, Preschool
Coronary Aneurysm / diagnosis,  drug therapy*,  etiology*
Coronary Thrombosis / epidemiology
Drug Therapy, Combination
Follow-Up Studies
Mucocutaneous Lymph Node Syndrome / complications*
Retrospective Studies
Risk Factors
Treatment Outcome
Warfarin / therapeutic use*
Reg. No./Substance:
0/Anticoagulants; 50-78-2/Aspirin; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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