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January 24, 2026ESC Heart FailureOpen Access

Intravenous ferric carboxymaltose cuts recurrent HHF or CV death ~27% vs. control at 1 year.

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Why the study?

Iron deficiency is common in heart failure and associated with poor functional outcomes, increased hospitalizations, and higher mortality, motivating an evaluation of intravenous ferric carboxymaltose efficacy.

Does intravenous ferric carboxymaltose reduce recurrent hospitalizations for heart failure or cardiovascular death in patients with heart failure and iron deficiency?

Population

6493 HF patients with iron deficiency across 11 RCTs

Comparison

Intravenous ferric carboxymaltose vs placebo or standard care

Design

Systematic review and meta-analysis of RCTs with trial sequential analysis

Follow-up

1-year and complete follow-up

Key result

Intravenous ferric carboxymaltose reduced recurrent heart failure hospitalizations or cardiovascular death by 27% at 1-year compared to control (RR 0.73).

Authors

MAMushood AhmedEZEeshal ZulfiqarTHTallal Mushtaq Hashmi

Discussion

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Overview

Supports intravenous ferric carboxymaltose in iron-deficient heart failure; confirms benefit on recurrent events in meta-analysis of RCTs.

Key Points

  • This meta-analysis aims to evaluate the efficacy of intravenous ferric carboxymaltose in heart failure patients with iron deficiency.
  • Literature search of major databases for randomized controlled trials comparing FCM with placebo or standard care.
  • Primary outcome measured as composite of recurrent hospitalizations for heart failure and cardiovascular death at 1-year and follow-up.
  • Risk ratios and mean differences were analyzed using a random-effects model.
  • FCM significantly reduced composite recurrent heart failure hospitalizations or cardiovascular death at 1-year (RR 0.73).
  • Recurrent heart failure hospitalizations were significantly reduced with FCM (1-year RR 0.69).
  • FCM improved 6-minute walk test performance with a mean difference of 29.19 meters.

Structured PICO

Does intravenous ferric carboxymaltose reduce recurrent hospitalizations for heart failure or cardiovascular death in patients with heart failure and iron deficiency?

P
Population
11 RCTs pooling 6,493 patients with heart failure and iron deficiency (mean age 66.7, 34.4% women).
I
Intervention
Intravenous ferric carboxymaltose
C
Comparator
Placebo or standard care
O
Outcome
Composite of recurrent hospitalizations for heart failure (HHF) or cardiovascular (CV) death assessed at 1-year and complete follow-upcomposite

Intravenous ferric carboxymaltose significantly reduces the composite of recurrent heart failure hospitalizations or cardiovascular death and improves functional capacity in patients with heart failure and iron deficiency.

Cite This Study

Ahmed et al. (2026) studied this question. Intravenous ferric carboxymaltose reduced recurrent heart failure hospitalizations or cardiovascular death by 27% at 1-year compared to control (RR 0.73).

synapsesocial.com/papers/697460acbb9d90c67120a947https://doi.org/10.1093/eschf/xvaf018
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