Pediatric Anticoagulation: Time for a New Paradigm?

In this volume of The Journal, Baker et al1 reported their experience with combined use of warfarin and aspirin in children with Kawasaki disease (KD) with giant coronary artery aneurysms (CAAs) from their computerized patient database. Not surprisingly, the patients' International Normalized Ratios remained within predetermined therapeutic range only two-thirds of the time after the initial dose stabilization. In their 9 patients followed for a median period of 7.2 years, there were 6 bleeding episodes, which were either major or clinically relevant.

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