Warfarin therapy in Kawasaki disease with coronary aneurysms
10.3760/cma.j.issn.1673-4408.2017.08.003
- VernacularTitle:华法林在川崎病合并冠状动脉瘤中的治疗进展
- Author:
Dan YANG
- Keywords:
Warfarin;
Kawasaki Disease;
Coronary Aneurysm
- From:
International Journal of Pediatrics
2017;44(8):523-526
- CountryChina
- Language:Chinese
-
Abstract:
Kawasaki disease (KD),an acute systemic vasculitis disease,has become one of the most common causes of acquired heart diseases in children.Coronary artery lesion(CAL) is the most important complication of KD.Clinically,the lesion degree can be classified into Ⅰ ～ Ⅴ.For pediatric patients with CAL at Ⅳ degree(giant aneurysms or multiple aneurysms in one coronary artery without stenosis)or Ⅴ degree(stenosis or obstruction shown in coronary angiography,with or without myocardial ischemia),a long-term medication therapy of a low dosage aspirin combined with warfarin or low-molecular-weight heparin is recommended.This review summarizes,the indications,the starting dose,international normalized ratio(INR),and maintenance dose.The related factors,including clinical features (like age,gender,height,weight,target INR),drug interaction,food interaction,adverse reactions and genotypes(VKORC1,CYP2C9)are also considered in warfarin treatment of KD with coronary aneurysms.Multicenter RCTs with high quality and large sample size are required in order to provide advice for reasonable,effective,and safe application as well as to achieve precision medicine.
