Document Detail


Presentation, management and outcomes of thrombosis for children with cardiomyopathy.
MedLine Citation:
PMID:  16801999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thrombosis in children with dilated and inflammatory cardiomyopathy is an unpredictable complication with potentially important morbidity. OBJECTIVE: To determine the prevalence, associated factors, management and outcomes of thrombosis in this setting. METHODS: Data were obtained from review of medical records. Factors associated with thrombosis and the impact on outcome were sought. RESULTS: From 1990 to 1998, 66 patients that presented with dilated cardiomyopathy were followed for a median interval of 1.4 years (range 0 to 9.79 years) from first presentation. Thrombosis was diagnosed in four patients at presentation and in four patients during follow-up. Thrombosis was noted in one additional patient at examination after death. The overall nine-year period prevalence of thrombosis was 14%. Anticoagulation was started at presentation in 31% of patients. The mean left ventricular ejection fraction at presentation was significantly lower in those given anticoagulation (19+/-8%) versus those who were not (32+/-15%; P < 0.001). The mean ejection fraction at presentation was similar in those patients with (25+/-10%) versus those without thrombosis (28+/-15%; P = 0.44). During follow-up, 11 patients died and seven underwent cardiac transplantation. Kaplan-Meier estimates of freedom from death or transplantation were 88% at three months, 81% at one year and 70% at five years. Survival free of transplantation was not affected by thrombosis. CONCLUSIONS: Thrombosis is common in children with cardiomyopathy, can occur at any time in the patients' clinical course and is not related to clinical features or survival free of transplantation. The relevance and prevention of thrombosis in this setting remains unclear.
Authors:
Brian W McCrindle; Tara Karamlou; Harvey Wong; Nirupama Gangam; Kalyani R Trivedi; Kyong-Jin Lee; Lee N Benson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  22     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-27     Completed Date:  2006-08-10     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  685-90     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Canada. brian.mccrindle@sickkids.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anticoagulants / therapeutic use*
Cardiomyopathy, Dilated / complications*,  mortality,  physiopathology
Child
Child, Preschool
Female
Follow-Up Studies
Heart Transplantation
Humans
Infant
Infant, Newborn
Male
Ontario / epidemiology
Retrospective Studies
Stroke Volume / physiology
Survival Rate
Thrombosis / complications*,  physiopathology,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections

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