File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Low dose oral anticoagulation therapy in Chinese children with congenital heart disease

TitleLow dose oral anticoagulation therapy in Chinese children with congenital heart disease
Authors
Issue Date1998
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
Citation
Journal Of Paediatrics And Child Health, 1998, v. 34 n. 6, p. 563-567 How to Cite?
AbstractObjectives: This study aims to evaluate the efficacy of a low dose warfarin regimen for Chinese children requiring anticoagulation therapy and its safety when monitored on an outpatient basis. Current recommendations are based on extrapolations from the adult experience and a high target international normalised ratio (INR) is adopted amongst the Western countries. Methodology: This is a 10-year retrospective study from January 1986 to June 1996. Effectiveness of warfarin therapy was monitored by the prothrombin time, standardised and expressed as the INR. A target INR of 1.5- 2.5 was adopted for children with cardiac diseases requiring anticoagulation therapy for primary and secondary prophylaxis against thromboembolism. From the clinical records, demographic data, induction warfarin dosage, changes of dosages and related events on follow-up, frequency of outpatient visits, complications and serial INR results were reviewed. Results: Thirty-five patients (23 boys, 12 girls) were included with a mean age at initiation of warfarin therapy of 8.4±5.8 years. Amongst these, 66% (n = 23) were after isolated valvar replacement, 28% (n = 10) after Fontan operation with or without valvar replacement and 6% (n = 2) after deep vein thrombosis. Regression estimate of the induction dose was 0.05-0.13 mg kg-1 in order to achieve the target INR range after 2 days of warfarin therapy. The daily maintenance warfarin dose was correlated with the bodyweight [dose (mg day- 1)=0.04 x bodyweight (kg)+ 0.87, r= 0.63, P<0.0001]. Young children required significantly higher daily warfarin maintenance dose when adjusted for bodyweight [dose (mg kg day-1)=antilog10{-0.02 x age (years)-0.80}, r=- 0.74, P<0.0001]. The mean maintenance warfarin dosage was significantly lower in patients after the Fontan operation, with or without valvar replacement, in the absence of apparent liver dysfunction. The total period of follow-up was 159 patient-years. No serious bleeding complications or embolic phenomena were documented. One patient died of thrombosis of the mitral valve prosthesis. The overall incidence of thrombosis was 0.6 per 100 patient- years. Conclusions: A low dose warfarin regimen to maintain a target INR of 1.5-2.5 provides adequate protection in Chinese children against thromboembolism whilst allowing safe outpatient monitoring of the anticoagulation status.
Persistent Identifierhttp://hdl.handle.net/10722/170292
ISSN
2015 Impact Factor: 1.477
2015 SCImago Journal Rankings: 0.692
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorLeung, MPen_US
dc.date.accessioned2012-10-30T06:07:16Z-
dc.date.available2012-10-30T06:07:16Z-
dc.date.issued1998en_US
dc.identifier.citationJournal Of Paediatrics And Child Health, 1998, v. 34 n. 6, p. 563-567en_US
dc.identifier.issn1034-4810en_US
dc.identifier.urihttp://hdl.handle.net/10722/170292-
dc.description.abstractObjectives: This study aims to evaluate the efficacy of a low dose warfarin regimen for Chinese children requiring anticoagulation therapy and its safety when monitored on an outpatient basis. Current recommendations are based on extrapolations from the adult experience and a high target international normalised ratio (INR) is adopted amongst the Western countries. Methodology: This is a 10-year retrospective study from January 1986 to June 1996. Effectiveness of warfarin therapy was monitored by the prothrombin time, standardised and expressed as the INR. A target INR of 1.5- 2.5 was adopted for children with cardiac diseases requiring anticoagulation therapy for primary and secondary prophylaxis against thromboembolism. From the clinical records, demographic data, induction warfarin dosage, changes of dosages and related events on follow-up, frequency of outpatient visits, complications and serial INR results were reviewed. Results: Thirty-five patients (23 boys, 12 girls) were included with a mean age at initiation of warfarin therapy of 8.4±5.8 years. Amongst these, 66% (n = 23) were after isolated valvar replacement, 28% (n = 10) after Fontan operation with or without valvar replacement and 6% (n = 2) after deep vein thrombosis. Regression estimate of the induction dose was 0.05-0.13 mg kg-1 in order to achieve the target INR range after 2 days of warfarin therapy. The daily maintenance warfarin dose was correlated with the bodyweight [dose (mg day- 1)=0.04 x bodyweight (kg)+ 0.87, r= 0.63, P<0.0001]. Young children required significantly higher daily warfarin maintenance dose when adjusted for bodyweight [dose (mg kg day-1)=antilog10{-0.02 x age (years)-0.80}, r=- 0.74, P<0.0001]. The mean maintenance warfarin dosage was significantly lower in patients after the Fontan operation, with or without valvar replacement, in the absence of apparent liver dysfunction. The total period of follow-up was 159 patient-years. No serious bleeding complications or embolic phenomena were documented. One patient died of thrombosis of the mitral valve prosthesis. The overall incidence of thrombosis was 0.6 per 100 patient- years. Conclusions: A low dose warfarin regimen to maintain a target INR of 1.5-2.5 provides adequate protection in Chinese children against thromboembolism whilst allowing safe outpatient monitoring of the anticoagulation status.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPCen_US
dc.relation.ispartofJournal of Paediatrics and Child Healthen_US
dc.subject.meshAdministration, Oralen_US
dc.subject.meshAnticoagulants - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Defects, Congenital - Therapyen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshInternational Normalized Ratioen_US
dc.subject.meshMaleen_US
dc.subject.meshProthrombin Timeen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshThromboembolism - Prevention & Controlen_US
dc.subject.meshWarfarin - Administration & Dosage - Therapeutic Useen_US
dc.titleLow dose oral anticoagulation therapy in Chinese children with congenital heart diseaseen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1440-1754.1998.00310.xen_US
dc.identifier.pmid9928651-
dc.identifier.scopuseid_2-s2.0-0032447118en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032447118&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume34en_US
dc.identifier.issue6en_US
dc.identifier.spage563en_US
dc.identifier.epage567en_US
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridLeung, MP=7201944800en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats