Heart failure & cardiomyopathiesMeta-analysis
Meta-Analysis and Metaregression of the Treatment Effect of Intravenous Iron in Iron-Deficient Heart Failure
- Systematic review and meta-analysis of randomised trials
- fixed effect model
- metaregression (mixed effect model)
Authors' conclusion
The totality of data suggests that treatment with intravenous iron reduces both CV death and HF-related events in a broad population with HF. A lower baseline TSAT might be important for the effect on HF-related events.
Study context
- Population
- Heart failure (HF) patients with iron deficiency; RCTs published January 1, 2000, to August 26, 2023
- Participants
- 6,624 patients · 14 RCTs
- Comparison
- IV iron vs placebo
- Intravenous ironn = 3,407
- Placebon = 3,217reference
- Outcome
- Cardiovascular (CV) death; CV death and HF admission; first HF admission; total HF admissions
Pooled result
As reported in the abstract
Intravenous iron vs PlaceboEstimate (95% CI)P value
CV death
OR 0.867(0.755–0.955)
P = 0.0427CV death and HF admission
OR 0.838(0.751–0.936)
P = 0.0015first HF admission
OR 0.855(0.744–0.983)
P = 0.0281total HF admissions
rate ratio 0.739(0.661–0.827)
P < 0.0001Further pooled results
Metaregression by baseline transferrin saturation (TSAT)
- Trials enrolling patients with lower TSAT showed a large effect size on HF-related events
Original publication
Meta-Analysis and Metaregression of the Treatment Effect of Intravenous Iron in Iron-Deficient Heart Failure. JACC Heart Fail. Published 1 December 2023. doi:10.1016/j.jchf.2023.11.006
Summarised from the published abstract; every number is checked against it