Background: Inferior vena cava (IVC) thrombosis is a rare form of venous thromboembolism (VTE). The optimal treatment strategies and outcomes are unclear in patients with this presentation. Objective: We aimed to compare baseline characteristics, treatment patterns and 24-month outcomes in IVC thrombosis patients (n = 100) with lower extremity deep vein thrombosis (LEDVT) patients (n = 7629). Methods: GARFIELD–VTE is a prospective, observational registry of 10 868 patients with objectively diagnosed VTE from 415 sites in 28 countries. Results: IVC thrombosis patients were younger (51.9 vs. 59.8 years), more frequently had active cancer (26.0% vs. 8.9%) or history of cancer (21.0% vs. 12.2%), and less frequently had recent trauma or surgery than LEDVT patients. IVC thrombosis was more frequently treated with parenteral anticoagulants alone (35.1% vs. 15.9%), whereas patients with LEDVT more commonly received vitamin K antagonists (32.0% vs. 25.8%) or direct oral anticoagulants (49.0% vs. 35.1%). Thrombolysis (11.0% vs. 3.6%) and surgical/mechanical interventions (4.0% vs. 1.4%) were more frequent in IVC thrombosis. At 24-months, the rate per 100 person-years (95% confidence interval) of all-cause mortality was higher in patients with IVC thrombosis than LEDVT (13.28 [8.57–20.58] vs. 4.91 [4.55–5.3]); the incidence of cancer-associated mortality was comparable as was the incidence of VTE recurrence (4.11 [1.85–9.15] vs. 4.18 [3.84–4.55]). Major bleeding was slightly higher in IVC thrombosis (2.03 [0.66–6.31] vs. 1.66 [1.45–1.89]). Conclusion: In summary, IVC thrombosis patients have higher all-cause mortality rates than those with LEDVT, a finding only partly attributable to malignancy.

Cohen, O., Ageno, W., Farjat, A., Turpie, A., Weitz, J., Haas, S., et al. (2022). Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 20(2 (February 2022)), 366-374 [10.1111/jth.15574].

Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE

Mantovani L. G.
Membro del Collaboration Group
;
2022

Abstract

Background: Inferior vena cava (IVC) thrombosis is a rare form of venous thromboembolism (VTE). The optimal treatment strategies and outcomes are unclear in patients with this presentation. Objective: We aimed to compare baseline characteristics, treatment patterns and 24-month outcomes in IVC thrombosis patients (n = 100) with lower extremity deep vein thrombosis (LEDVT) patients (n = 7629). Methods: GARFIELD–VTE is a prospective, observational registry of 10 868 patients with objectively diagnosed VTE from 415 sites in 28 countries. Results: IVC thrombosis patients were younger (51.9 vs. 59.8 years), more frequently had active cancer (26.0% vs. 8.9%) or history of cancer (21.0% vs. 12.2%), and less frequently had recent trauma or surgery than LEDVT patients. IVC thrombosis was more frequently treated with parenteral anticoagulants alone (35.1% vs. 15.9%), whereas patients with LEDVT more commonly received vitamin K antagonists (32.0% vs. 25.8%) or direct oral anticoagulants (49.0% vs. 35.1%). Thrombolysis (11.0% vs. 3.6%) and surgical/mechanical interventions (4.0% vs. 1.4%) were more frequent in IVC thrombosis. At 24-months, the rate per 100 person-years (95% confidence interval) of all-cause mortality was higher in patients with IVC thrombosis than LEDVT (13.28 [8.57–20.58] vs. 4.91 [4.55–5.3]); the incidence of cancer-associated mortality was comparable as was the incidence of VTE recurrence (4.11 [1.85–9.15] vs. 4.18 [3.84–4.55]). Major bleeding was slightly higher in IVC thrombosis (2.03 [0.66–6.31] vs. 1.66 [1.45–1.89]). Conclusion: In summary, IVC thrombosis patients have higher all-cause mortality rates than those with LEDVT, a finding only partly attributable to malignancy.
Articolo in rivista - Articolo scientifico
anticoagulation; deep vein thrombosis; inferior vena cava thrombosis; pulmonary embolism; venous thromboembolism;
English
29-ott-2021
2022
20
2 (February 2022)
366
374
none
Cohen, O., Ageno, W., Farjat, A., Turpie, A., Weitz, J., Haas, S., et al. (2022). Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 20(2 (February 2022)), 366-374 [10.1111/jth.15574].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/347218
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