Effect of iron supplementation in patients with heart failure and iron deficiency: A systematic review and meta-analysis

Department of Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, USA. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan. Department of Medicine, Memorial Healthcare System, Pembroke Pines, USA. Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan. Department of Medicine, Khaja Bandanawaz Institute of Medical Sciences Gulbarga, India. Department of Medicine, Ziauddin Medical University, Karachi, Pakistan. Department of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland. Department of Cardiology, St.Mary Medical Center, Langhorne, PA, USA.

International journal of cardiology. Heart & vasculature. 2021;36:100871
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BACKGROUND The effectiveness of oral and intravenous iron supplementation in reducing the risk of mortality and hospitalizations in HF patients with iron deficiency is not well-established. METHODS A thorough literature search was conducted across 2 electronic databases (Medline and Cochrane Central) from inception through March 2021. RCTs assessing the impact of iron supplementation on clinical outcomes in iron deficient HF patients were considered for inclusion. Primary end-points included all-cause mortality and HF hospitalization. Evaluations were reported as odds ratios (ORs) or risk ratios (RRs) with 95% confidence intervals (CI) and analysis was performed using a random effects model. I(2) index was used to assess heterogeneity. RESULTS From the 2599 articles retrieved from initial search, 10 potentially relevant studies (n = 2187 patients) were included in the final analysis. Both oral (OR: 0.93; 95% CI: 0.08-11.30; p = 0.951) and intravenous (OR: 0.97; 95% CI: 0.73-1.29; p = 0.840) iron supplementation did not significantly reduce all-cause mortality. However, intravenous iron supplementation significantly decreased the rates of overall (OR: 0.52; 95% CI: 0.33-0.81; p = 0.004) and HF (OR: 0.42; 95% CI: 0.22-0.80; p = 0.009) hospitalizations. In addition, intravenous ferric carboxymaltose therapy significantly reduced the time to first HF hospitalization or cardiovascular mortality (RR = 0.70; 95% CI = 0.50-1.00; p = 0.048), but had no effect on time to first cardiovascular death (RR: 0.94; 95% CI: 0.70-1.25; p = 0.655). CONCLUSION Oral or intravenous iron supplementation did not reduce mortality in iron deficient HF patients. However, intravenous iron supplementation was associated with a significant decrease in overall and HF hospitalizations.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine