Efficacy of inferior vena cava filters in anticoagulated patients.
OBJECTIVE
The benefit of an inferior vena cava (IVC) filter in addition to standard anticoagulation regimens is unknown.


METHODS
We examined data for patients who received IVC filters with anticoagulation (AC-Filter) after an episode of venous thromboembolism (VTE) and compared them with data for those who received anticoagulation only (AC-Only). Outcome measures were new pulmonary embolism (PE), recurrent deep vein thrombosis (DVT), and mortality at 90 days and at 5 years. Demographic data included age, gender, and ethnicity/race, prior thromboembolic history, cancer, serum albumin, and time in therapeutic range. In addition, subsets matched for age, gender and race/ethnicity were examined in detail.


RESULTS
AC-Filter patients (n = 251), when compared to AC-Only patients (n = 1377), did not differ significantly with regard to gender or cancer status, but white males in general had better outcomes. AC-Filter patients were more likely to have had a previous history of PE or VTE (P < 0.001). In comparison to AC-Only patients, AC-Filter patients had lower mean serum albumin levels (3.1 +/- 0.8 vs. 3.6 +/-0.8 mg dL(-1), P < 0.001) and were older (65 +/- 16.1 years vs. 60 +/- 17.5 years, P < 0.001). After stratification according to previous history of PE or VTE prior to the index VTE event, no differences in the outcome measures of new PE, recurrent DVT or mortality were identified between groups, but patients with a prior history of PE from either group were more likely to have a new PE (hazard ratio 1.9, P < 0.001).


CONCLUSIONS
These data suggest that IVC filters may not provide any substantial additional benefit for patients who can tolerate anticoagulant therapy.
Billett
H H
HH
Department of Medicine and Epidemiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA. hbillett@montefiore.org
Jacobs
L G
LG
Madsen
E M
EM
Giannattasio
E R
ER
Mahesh
S
S
Cohen
H W
HW
D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D006801:Humans; D013923:Thromboembolism / Q000188:drug therapy* / Q000601:surgery; D016306:Vena Cava Filters
D000925:Anticoagulants