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Effects of Intravenous Iron Therapy in Iron-Deficient Patients with Systolic Heart Failure: A Meta-Analysis of Randomized Controlled Trials

Open access
Jankowska, Ewa A., Tkaczyszyn, Michał, Suchocki, Tomasz, Drozd, Marcin, von Haehling, Stephan, Doehner, Wolfram, Banasiak, Waldemar, Filippatos, Gerasimos, Anker, Stefan D., Ponikowski, Piotr·2016·European Journal of Heart Failure

Abstract

Aims: The aim of this study was to assess the net clinical and prognostic effects of intravenous (i.v.) iron therapy in patients with systolic heart failure (HF) and iron deficiency (ID). Methods and results: We performed an aggregate data meta-analysis (random effects model) of randomized controlled trials that evaluated the effects of i.v. iron therapy in iron-deficient patients with systolic HF. We searched electronic databases up to September 2014. We identified five trials which fulfilled the inclusion criteria (509 patients received i.v. iron therapy in comparison with 342 controls). Intravenous iron therapy has been shown to reduce the risk of the combined endpoint of all-cause death or cardiovascular hospitalization [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.30–0.64, P < 0.0001], and the combined endpoint of cardiovascular death or hospitalization for worsening HF (OR 0.39, 95% CI 0.24–0.63, P = 0.0001). Intravenous iron therapy resulted in a reduction in NYHA class (data are reported as a mean net effect with 95% CIs for all continuous variables) (−0.54 class, 95% CI −0.87 to −0.21, P = 0.001); an increase in 6-min walking test distance (+31 m, 95% CI 18–43, P < 0.0001); and an improvement in quality of life [Kansas City Cardiomyopathy Questionnaire (KCCQ) score +5.5 points, 95% CI 2.8–8.3, P < 0.0001; European Quality of Life–5 Dimensions (EQ-5D) score +4.1 points, 95% CI 0.8–7.3, P = 0.01; Minnesota Living With Heart Failure Questionnaire (MLHFQ) score −19 points, 95% CI:–23 to −16, P < 0.0001; and Patient Global Assessment (PGA) +0.70 points, 95% CI 0.31–1.09, P = 0004]. Conclusion: The evidence indicates that i.v. iron therapy in iron-deficient patients with systolic HF improves outcomes, exercise capacity, and quality of life, and alleviates HF symptoms.

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  1. Rector, 1987, Patients’ self-assessment of their congestive heart failure, part 2: content, reliability and validity of a new measure, the Minnesota Living with Heart Failure Questionnaire, Heart Fail, 198–209

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Metadata

Authors
Jankowska, E. A., Tkaczyszyn, M., Suchocki, T., Drozd, M., von Haehling, S., Doehner, W., Banasiak, W., Filippatos, G., Anker, S. D., & Ponikowski, P.
Venue
European Journal of Heart Failure
Published
2016-01-28
Volume
18
Issue
7
Pages
786-795
ISSN
  • 1388-9842 (ISSN-L)
  • 1879-0844
OpenAlex
W2276227009
Cited by
346
References
44
FWCI
9.88
Type
journal article
Language
en
Open access
bronze
Funders
National Science Centre (DEC-2012/05/E/NZ5/00590)

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Jankowska, E. A., Tkaczyszyn, M., Suchocki, T., Drozd, M., von Haehling, S., Doehner, W., Banasiak, W., Filippatos, G., Anker, S. D., & Ponikowski, P. (2016). Effects of Intravenous Iron Therapy in Iron-Deficient Patients with Systolic Heart Failure: A Meta-Analysis of Randomized Controlled Trials. European Journal of Heart Failure. https://doi.org/10.1002/ejhf.473

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