Heart failure & cardiomyopathies
Effect of Intravenous Iron Replacement on Recurrent Heart Failure Hospitalizations and Cardiovascular Mortality in Patients with Heart Failure and Iron Deficiency: A Bayesian Meta-Analysis
Pooled resultResult — go to the resultRelative risk 0.73 95% CrI 0.48–0.99Authors' conclusion
Treatment of iron-deficient HFrEF patients with intravenous iron - namely with ferric carboxymaltose or ferric derisomaltose - results in significant reduction in recurrent HF hospitalizations and cardiovascular mortality.
Study context
- Population
- Iron-deficient HFrEF patientsFAIR-HF, CONFIRM-HF, AFFIRM-AHF, IRONMAN trials
- Comparison
- IV iron vs placebo
- Outcome
- Recurrent HF hospitalizations and CV mortality
Methodological detailsBayesian random-effects meta-analysis, individual participant data (FAIR-HF, CONFIRM-HF, AFFIRM-AHF) and study level data (IRONMAN), Outcome and subgroup definitions of FAIR-HF (n = 459), CONFIRM-HF (n = 304) and AFFIRM-AHF (n = 1108) matched to IRONMAN (n = 1137)
- Bayesian random-effects meta-analysis
- Individual participant data (FAIR-HF, CONFIRM-HF, AFFIRM-AHF) and study level data (IRONMAN)
- Outcome and subgroup definitions of FAIR-HF (n = 459), CONFIRM-HF (n = 304) and AFFIRM-AHF (n = 1108) matched to IRONMAN (n = 1137)
Pooled result
As reported in the abstract
Relative risk
0.73
95% CrI 0.48–0.99
IV ironvs Placebo
RR 0.73 (95% CrI 0.48–0.99)
Further pooled results
Recurrent heart failure (HF) hospitalizations and CV mortality, by subgroup (ratio of rate ratios)
- No evidence of differential effects by sex: RRR
- 1.49 (95% CrI 0.95-2.37)
- Age <69.4 vs ≥69.4 years: RRR 0.68 (0.40-1.15)
- Ischaemic vs non-ischaemic aetiology: RRR 0.73 (0.42-1.33)
- Transferrin saturation <20% vs ≥20%: RRR 0.75 (0.40-1.34)
- eGFR ≤60 vs >60 ml/min/1.73 m²: RRR 0.97 (0.56-1.68)
- Haemoglobin <11.8 vs ≥11.8: RRR 0.95 (0.53-1.60)
- Ferritin <35 vs ≥35 μg/L: RRR 1.26 (0.72-2.48)
- NYHA class II vs III/IV: RRR 0.91 (0.54-1.56)
- CrI (Bayesian random-effects meta-analysis)
Original publication
Effect of Intravenous Iron Replacement on Recurrent Heart Failure Hospitalizations and Cardiovascular Mortality in Patients with Heart Failure and Iron Deficiency: A Bayesian Meta-Analysis. Eur J Heart Fail. Published 21 May 2023. doi:10.
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