Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE
Issued Date
2022-02-01
Resource Type
ISSN
15387933
eISSN
15387836
Scopus ID
2-s2.0-85118880008
Pubmed ID
34714962
Journal Title
Journal of Thrombosis and Haemostasis
Volume
20
Issue
2
Start Page
366
End Page
374
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Thrombosis and Haemostasis Vol.20 No.2 (2022) , 366-374
Suggested Citation
Cohen O. Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE. Journal of Thrombosis and Haemostasis Vol.20 No.2 (2022) , 366-374. 374. doi:10.1111/jth.15574 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86183
Title
Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE
Author(s)
Author's Affiliation
Ramathibodi Hospital
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
The Amalia Biron Research Institute of Thrombosis and Hemostasis
McMaster University
Università degli Studi di Milano
Tokai University School of Medicine
Université de Genève Faculté de Médecine
Technische Universität München
Thrombosis Research Institute
The Alfred
Tel Aviv University
Università degli Studi dell'Insubria
Harvard Medical School
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
The Amalia Biron Research Institute of Thrombosis and Hemostasis
McMaster University
Università degli Studi di Milano
Tokai University School of Medicine
Université de Genève Faculté de Médecine
Technische Universität München
Thrombosis Research Institute
The Alfred
Tel Aviv University
Università degli Studi dell'Insubria
Harvard Medical School
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
Other Contributor(s)
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.