TY - JOUR
T1 - Vena cava filters in patients presenting with major bleeding during anticoagulation for venous thromboembolism
AU - The RIETE Investigators
AU - Mellado, Meritxell
AU - Trujillo-Santos, Javier
AU - Bikdeli, Behnood
AU - Jiménez, David
AU - Núñez, Manuel Jesús
AU - Ellis, Martin
AU - Marchena, Pablo Javier
AU - Vela, Jerónimo Ramón
AU - Clara, Albert
AU - Moustafa, Farès
AU - Monreal, Manuel
AU - Adarraga, M. D.
AU - Aibar, M. A.
AU - Alfonso, M.
AU - Arcelus, J. I.
AU - Ballaz, A.
AU - Baños, P.
AU - Barba, R.
AU - Barrón, M.
AU - Bascuñana, J.
AU - Blanco-Molina, A.
AU - Camon, A. M.
AU - Carrasco, C.
AU - Chasco, L.
AU - Cruzs, A. J.
AU - del Pozo, R.
AU - del Toro, J.
AU - Díaz-Pedroche, M. C.
AU - Díaz-Peromingo, J. A.
AU - Encabo, M.
AU - Falgá, C.
AU - Fernández-Aracil, C.
AU - Fernández-Capitán, C.
AU - Fidalgo, M. A.
AU - Font, C.
AU - Font, L.
AU - Furest, I.
AU - García, M. A.
AU - García-Bragado, F.
AU - García-Morillo, M.
AU - García-Raso, A.
AU - García-Sánchez, I.
AU - Gavín, O.
AU - Gómez, C.
AU - Gómez, V.
AU - González, J.
AU - Grau, E.
AU - Guijarro, R.
AU - Guirado, L.
A2 - Ģībietis, Valdis
A2 - Skride, A.
N1 - Funding Information:
We express our gratitude to Sanofi Spain for supporting this Registry with an unrestricted educational grant. We also express our gratitude to Bayer Pharma AG for supporting this Registry. Bayer Pharma AG?s support was limited to the part of RIETE outside Spain, which accounts for a 24.35% of the total patients included in the RIETE Registry. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data, logistic and administrative support. Coordinator of the RIETE Registry: Manuel Monreal. RIETE Steering Committee Members: Herv? Decousus, Paolo Prandoni and Benjamin Brenner. RIETE National Coordinators: Raquel Barba (Spain), Pierpaolo Di Micco (Italy), Laurent Bertoletti (France), Inna Tzoran (Israel), Abilio Reis (Portugal), Marijan Bosevski (R. Macedonia), Henri Bounameaux (Switzerland), Radovan Mal? (Czech Republic), Philip Wells (Canada) and Peter Verhamme (Belgium). RIETE Registry Coordinating Center: S & H Medical Science Service. The members of the RIETE Group: Spain: Adarraga MD, Aibar MA, Alfonso M, Arcelus JI, Ballaz A, Ba?os P, Barba R, Barr?n M, Bascu?ana J, Blanco-Molina A, Camon AM, Carrasco C, Chasco L, Cruz AJ, del Pozo R, del Toro J, D?az-Pedroche MC, D?az-Peromingo JA, Encabo M, Falg? C, Fern?ndez-Aracil C, Fern?ndez-Capit?n C, Fidalgo MA, Font C, Font L, Furest I, Garc?a MA, Garc?a-Bragado F, Garc?a-Morillo M, Garc?a-Raso A, Garc?a-S?nchez I, Gav?n O, G?mez C, G?mez V, Gonz?lez J, Grau E, Guijarro R, Guirado L, Guti?rrez J, Hern?ndez-Blasco L, Hernando E, Isern V, Jara-Palomares L, Jaras MJ, Jim?nez D, Joya MD, Lima J, Llamas P, Lobo JL, L?pez-Jim?nez L, L?pez-Reyes R, L?pez-S?ez JB, Lorente MA, Lorenzo A, Loring M, Lumbierres M, Madridano O, Maestre A, Marchena PJ, Mart?n M, Mart?n-Martos F, Mellado M, Monreal M, Morales MV, Nieto JA, N??ez MJ, Olivares MC, Otalora S, Otero R, Pedrajas JM, Pellejero G, P?rez-Ductor C, Peris ML, Pons I, Porras JA, Riera-Mestre A, Rivas A, Rodr?guez-D?vila MA, Rodr?guez-Gal?n I, Rosa V, Rubio CM, Ruiz-Artacho P, Sahuquillo JC, Sala-Sainz MC, Samp?riz A, S?nchez-Artola B, S?nchez-Mart?nez R, Sancho T, Soler S, Soto MJ, Suri?ach JM, Tolosa C, Torres MI, Trujillo-Santos J, Uresandi F, Usandizaga E, Valero B, Valle R, Vela J, Vidal G, Villalobos A, Xifre B, Argentina: V?zquez FJ, Vilaseca A, Belgium: Vanassche T, Vandenbriele C, Verhamme P, Brazil: Yoo HHB, Canada: Wells P, Czech Republic: Hirmerova J, Mal? R, Ecuador: Salgado E, France: Benzidia I, Bertoletti L, Bura-Riviere A, Falvo N, Farge-Bancel D, Hij A, Merah A, Mah? I, Moustafa F, Quere I, Israel: Braester A, Brenner B, Ellis M, Tzoran I, Italy: Antonucci G, Bilora F, Bucherini E, Cattabiani C, Ciammaichella M, Dentali F, Di Micco P, Doddi M, Duce R, Giorgi-Pierfranceschi M, Grandone E, Imbalzano E, Lessiani G, Maggi F, Maida R, Mastroiacovo D, Pace F, Pesavento R, Poggio R, Prandoni P, Quintavalla R, Rocci A, Siniscalchi C, Tiraferri E, Tonello D, Vison? A, Zalunardo B, Latvia: Gibietis V, Skride A, Vitola B, Republic of Macedonia: Zdraveska M, Switzerland: Bounameaux H, Calanca L, Fresa M, Mazzolai L, USA: Bikdeli B.
Publisher Copyright:
© 2019, Società Italiana di Medicina Interna (SIMI).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - The association between inferior vena cava filter (IVC) use and outcome in patients presenting with major bleeding during anticoagulation for venous thromboembolism (VTE) has not been thoroughly investigated. We used the RIETE registry to compare the 30-day outcomes (death, major re-bleeding or VTE recurrences) in VTE patients who bled during the first 3 months of therapy, regarding the insertion of an IVC filter. A propensity score matched (PSM) analysis was performed to adjust for potential confounders. From January 2001 to September 2016, 1065 VTE patients had major bleeding during the first 3 months of anticoagulation (gastrointestinal 370; intracranial 124). Of these, 122 patients (11%) received an IVC filter. Patients receiving a filter restarted anticoagulation later (median, 4 vs. 2 days) and at lower doses (95 ± 52 IU/kg/day vs. 104 ± 55 of low-molecular-weight heparin) than those not receiving a filter. During the first 30 days after bleeding (after excluding 246 patients who died within the first 24 h), 283 patients (27%) died, 63 (5.9%) had non-fatal re-bleeding and 19 (1.8%) had recurrent pulmonary embolism (PE). In PSM analysis, patients receiving an IVC filter (n = 122) had a lower risk for all-cause death (HR 0.49; 95% CI 0.31–0.77) or fatal bleeding (HR 0.16; 95% CI 0.07–0.49) and a similar risk for re-bleeding (HR 0.55; 95% CI 0.23–1.40) or PE recurrences (HR 1.57; 95% CI 0.38–6.36) than those not receiving a filter (n = 429). In VTE patients experiencing major bleeding during the first 3 months, use of an IVC filter was associated with reduced mortality rates. Clinical Trial Registration NCT02832245.
AB - The association between inferior vena cava filter (IVC) use and outcome in patients presenting with major bleeding during anticoagulation for venous thromboembolism (VTE) has not been thoroughly investigated. We used the RIETE registry to compare the 30-day outcomes (death, major re-bleeding or VTE recurrences) in VTE patients who bled during the first 3 months of therapy, regarding the insertion of an IVC filter. A propensity score matched (PSM) analysis was performed to adjust for potential confounders. From January 2001 to September 2016, 1065 VTE patients had major bleeding during the first 3 months of anticoagulation (gastrointestinal 370; intracranial 124). Of these, 122 patients (11%) received an IVC filter. Patients receiving a filter restarted anticoagulation later (median, 4 vs. 2 days) and at lower doses (95 ± 52 IU/kg/day vs. 104 ± 55 of low-molecular-weight heparin) than those not receiving a filter. During the first 30 days after bleeding (after excluding 246 patients who died within the first 24 h), 283 patients (27%) died, 63 (5.9%) had non-fatal re-bleeding and 19 (1.8%) had recurrent pulmonary embolism (PE). In PSM analysis, patients receiving an IVC filter (n = 122) had a lower risk for all-cause death (HR 0.49; 95% CI 0.31–0.77) or fatal bleeding (HR 0.16; 95% CI 0.07–0.49) and a similar risk for re-bleeding (HR 0.55; 95% CI 0.23–1.40) or PE recurrences (HR 1.57; 95% CI 0.38–6.36) than those not receiving a filter (n = 429). In VTE patients experiencing major bleeding during the first 3 months, use of an IVC filter was associated with reduced mortality rates. Clinical Trial Registration NCT02832245.
KW - Anticoagulants
KW - Bleeding
KW - Mortality
KW - Vena cava filter
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85065297770&partnerID=8YFLogxK
U2 - 10.1007/s11739-019-02077-5
DO - 10.1007/s11739-019-02077-5
M3 - Article
C2 - 31054013
AN - SCOPUS:85065297770
SN - 1828-0447
VL - 14
SP - 1101
EP - 1112
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
IS - 7
ER -