Heart failure & cardiomyopathies
Intravenous Iron in Patients with Heart Failure and Iron Deficiency: An Updated Meta-Analysis
Authors' conclusion
In patients with HF and ID, this meta-analysis suggests that IV iron reduces the risk of HHF but whether this is associated with a reduction in cardiovascular or all-cause mortality remains inconclusive.
Study context
- Population
- Patients with heart failure (HF) and iron deficiency, any clinical setting, any HF phenotype
- Participants
- 3,373 patients10 RCTs
- Comparison
- Intravenous (IV) iron vs standard care/placebo
- IV ironn = 1,759
- Outcome
- Composite of:
- Hospitalizations for heart failure (HHF)
- CV death
Pooled result
As reported in the abstract
IV iron vs Standard care/placeboEstimate (95% CI)P value
Recurrent HHF and CV death
rate ratio 0.75(0.61–0.93)
P < 0.01First HHF or CV death
OR 0.72(0.53–0.99)
P = 0.04Further pooled results
CV mortality
- Effect on CV mortality inconclusive
- OR 0.86, 95% CI 0.70-1.05; p = 0.14
All-cause mortality
- Effect on all-cause mortality inconclusive
- OR 0.93, 95% CI 0.78-1.12; p = 0.47
Analyses confined to first year of follow-up
- Results similar in analyses confined to the first year of follow-up (less disrupted by COVID-19 pandemic)
Primary endpoint, by transferrin saturation (subgroup)
- Transferrin saturation <20%
- OR 0.67, 95% CI 0.49-0.92
- Transferrin saturation ≥20%
- OR 0.99, 95% CI 0.74-1.30
- Little evidence of heterogeneity across subgroups for the primary endpoint
- Heterogeneity p = 0.07
Original publication
Intravenous Iron in Patients with Heart Failure and Iron Deficiency: An Updated Meta-Analysis. Eur J Heart Fail. Published 8 March 2023. doi:10.
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