Intravenous iron in heart failure and iron deficiency reduced the composite of heart failure hospitalization or cardiovascular mortality (31.9% vs 45.3%; RR 0.72; 95% CI 0.59-0.88).
Meta-Analysis (n=3,492)
Does intravenous iron administration reduce the composite of HF hospitalization or cardiovascular mortality in patients with heart failure and iron deficiency?
Intravenous iron therapy significantly reduces the composite of heart failure hospitalization or cardiovascular mortality, driven primarily by a reduction in heart failure hospitalizations, in patients with heart failure and iron deficiency.
Effect estimate: RR 0.72 (95% CI 0.59-0.88)
Absolute Event Rate: 31.9% vs 45.3%
Background: Randomized clinical trials (RCTs) evaluating the role of intravenous (IV) iron administration in patients with heart failure (HF) and iron deficiency (ID) have yielded inconsistent results. Methods: Electronic search of MEDLINE, EMBASE and OVID databases was performed until November 2022 for RCTs that evaluated the role of IV iron administration in patients with HF and ID. The main study outcomes were the composite of HF hospitalization or cardiovascular mortality, and individual outcome of HF hospitalization. Summary estimates were evaluated using random effects model. Results: The final analysis included 12 RCTs with 3,492 patients (1,831 patients in the IV iron group and 1,661 patients in the control group). The mean follow-up was 8.3 months. IV iron was associated with a lower incidence in the composite of HF hospitalization or cardiovascular mortality (31.9% vs. 45.3%; relative risk RR 0.72; 95% confidence interval CI 0.59-0.88) and individual outcome of HF hospitalization (28.4% vs. 42.2; RR 0.69; 95% CI 0.57-0.85). There was no significant difference between both groups in cardiovascular mortality (RR 0.88; 95% CI 0.75-1.04) and all-cause mortality (RR 0.95; 95% CI 0.83-1.09). IV iron was associated with lower New York Heart Association class and higher left ventricular ejection fraction (LVEF). Meta-regression analyses showed no effect modification for the main outcomes based on age, hemoglobin level, ferritin level or LVEF. Conclusion: Among patients with HF and ID, IV iron administration was associated with reduction in the composite of HF hospitalization or cardiovascular mortality and driven by a reduction in HF hospitalization.
Hamed et al. (Thu,) conducted a meta-analysis in Heart failure and iron deficiency (n=3,492). Intravenous iron vs. Control was evaluated on Composite of heart failure hospitalization or cardiovascular mortality (RR 0.72, 95% CI 0.59-0.88). Intravenous iron in heart failure and iron deficiency reduced the composite of heart failure hospitalization or cardiovascular mortality (31.9% vs 45.3%; RR 0.72; 95% CI 0.59-0.88).
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