PO-0023 Warfarin And Aspirin Combination Therapy For Giant Coronary Arterial Aneurysm In Kawasaki Disease

Abstract

<h3>Introduction</h3> This study sought to assess whether warfarin and aspirin combination therapy can prevent cardiovascular events in children with giant coronary artery aneurysm (CAA) caused by Kawasaki disease. <h3>Method</h3> Children with giant CAA secondary to Kawasaki disease in our hospital were included. They were randomly divided into warfarin group (warfarin + aspirin) and control group (aspirin only). The dose of warfarin was adjusted by INR (1.5–2.0). Follow-up time included 2nd week, 1st month, 3rd month, 6th month and every 6 months afterward. Clinical data and complications were recorded. <h3>Result</h3> Sixty-five children were included with age of 3 months to 13 years. CAA most commonly occurs in right coronary artery, then left anterior descending, and main trunk. Left circumflex artery is rarely affected. CAA in 17 cases (53.1%) retracted in warfarin group, 5(41.7%)in controls. During follow-up, 2 children (6.3%) presented with intracoronary thromboses in warfarin group, 3 (25%) in controls. One case in warfarin group suffered myocardial infarction, 3 (25%) in control. Two children in control group died, while none in warfarin group. Coronary artery stenosis occurred in 2 children (16.7%) in controls, while one in warfarin group. Bleeding event occurred in 9 children including 1 with subarachnoid haemorrhage in warfarin group while only in 3 in the controls. <h3>Conclusion</h3> Warfarin therapy could decrease the risk of thrombosis, myocardial infarction and mortality. Minor bleeding event is common and need to be monitored.