{"id":47932,"date":"2015-04-28T13:54:14","date_gmt":"2015-04-28T17:54:14","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=47932"},"modified":"2015-05-15T17:08:32","modified_gmt":"2015-05-15T21:08:32","slug":"no-advantage-to-adding-inferior-vena-cava-filters-to-anticoagulation","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2015\/04\/28\/no-advantage-to-adding-inferior-vena-cava-filters-to-anticoagulation\/","title":{"rendered":"No Advantage to Adding Inferior Vena Cava Filters to Anticoagulation"},"content":{"rendered":"<p>Despite a lack of supporting evidence \u00a0many patients with acute venous thromboembolism (VTE) receive inferior vena cava filters to prevent pulmonary embolism (PE). Now <a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=2279714\">a new study published in\u00a0<em>JAMA<\/em><\/a> offers no evidence of benefit for the use of these devices in a high-risk population already receiving anticoagulant drugs.<\/p>\n<p>A group of French physicians randomized nearly 400 hospitalized patients with acute, symptomatic PE to receive a retrievable inferior vena cava filter in addition to anticoagulation or anticoagulation alone.\u00a0At 3 months, recurrent PE had occurred in 6 patients (3%) in the filter group compared with 3 patients (1.5%) in the control group. The two-fold increase in risk with the filter was not statistically significant. All 6 cases in the filter group and 2 of the 3 cases in the control group were fatal. Between three and six months there was one additional case of recurrent PE in each group.<\/p>\n<p>The authors note that the increased use of filters has likely been fueled by the availability of retrievable inferior vena cava filters. Their results show that these devices confer &#8220;no benefit in terms of pulmonary embolism recurrence or mortality&#8221; in these patients.<\/p>\n<p>Based on previous studies the authors say they had anticipated a much higher rate of recurrent PE, about 8%, in the control group. &#8220;We believe that the low rate of events observed in the control group of our study is consistent with contemporary care, indicating that modern management with full-dose anticoagulation therapy is likely very effective even in patients usually considered to be at high risk for recurrence, rendering unnecessary additional therapy such as inferior vena cava filters,&#8221; they write. In addition,\u00a0&#8220;we believe that our negative findings likely reflect the low event rate with effective anticoagulation alone rather than lack of filter efficacy.&#8221; They note, however, that they excluded patients who were unable to take an anticoagulant or who had a recurrence despite adequate anticoagulation.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Despite a lack of supporting evidence \u00a0many patients with acute venous thromboembolism (VTE) receive inferior vena cava filters to prevent pulmonary embolism (PE). Now a new study published in\u00a0JAMA offers no evidence of benefit for the use of these devices in a high-risk population already receiving anticoagulant drugs. A group of French physicians randomized nearly [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[495,9,16],"tags":[280,596,747],"class_list":["post-47932","post","type-post","status-publish","format-standard","hentry","category-anticoagulation-2","category-interventional-cardiology","category-vascular","tag-inferior-vena-cava-filters","tag-pulmonary-embolism","tag-venous-thromboembolism"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/47932","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=47932"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/47932\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=47932"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=47932"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=47932"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}