PMID- 22348897
OWN - NLM
STAT- MEDLINE
DCOM- 20120720
LR  - 20201216
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 14
IP  - 4
DP  - 2012 Apr
TI  - Iron supplementation for the treatment of chronic heart failure and iron 
      deficiency: systematic review and meta-analysis.
PG  - 423-9
LID - 10.1093/eurjhf/hfs017 [doi]
AB  - AIMS: Over half of chronic heart failure (CHF) patients are anaemic, and iron 
      deficiency is common. Iron replacement therapy (oral or i.v.) might improve 
      exercise capacity and quality of life (QOL). METHODS AND RESULTS: We carried out 
      a systematic review and meta-analysis of all randomized control trials that 
      compared iron with no therapy for CHF patients with iron deficiency, whether or 
      not they were anaemic. We searched electronic databases as well as haematology 
      and cardiology conferences up to August 2011. The primary outcome was the effect 
      of iron on QOL parameters such as New York Heart Association (NYHA) class and the 
      Minnesota Living With Heart Failure Questionnaire (MLHWFQ). Secondary outcomes 
      included all-cause mortality, mean ejection fraction, 6 min walk distance (6MWD), 
      hospitalizations due to any cause, iron indices, C-reactive protein levels, and 
      adverse events. Four trials performed fulfilled the inclusion criteria. A total 
      of 370 patients were treated with i.v. iron, compared with 224 control patients. 
      There was significant improvement in QOL in the iron arm according to the MLWHFQ 
      score at 26 weeks, with a weighted mean difference of -18.00 (-22.54, -13.46, 
      I(2) = 0%]. The point estimate for improvement in NYHA class was in favour of 
      iron. Iron reduced the number of hospitalizations and C-reactive protein levels, 
      and increased the 6MWD and mean ejection fraction. Iron indices were 
      significantly improved without a change in haemoglobin levels. No increase in the 
      rate of adverse events was found. CONCLUSION: Intravenous iron therapy is 
      associated with improved QOL parameters, reduction in hospitalizations, and 
      increased 6MWD. Treatment with i.v. iron is safe, with no increased rate of 
      adverse events. The results of our analysis are limited by the paucity of trials, 
      and significant heterogeneity between trials.
FAU - Avni, Tomer
AU  - Avni T
AD  - Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, 
      Israel. tomerav@clalit.org.il
FAU - Leibovici, Leonard
AU  - Leibovici L
FAU - Gafter-Gvili, Anat
AU  - Gafter-Gvili A
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20120220
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Iron, Dietary)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Anemia, Iron-Deficiency/*drug therapy
MH  - C-Reactive Protein
MH  - Chi-Square Distribution
MH  - Confidence Intervals
MH  - *Dietary Supplements
MH  - Exercise Tolerance
MH  - Health Status Indicators
MH  - Heart Failure/*drug therapy/psychology
MH  - Humans
MH  - Infusions, Intravenous
MH  - Iron, Dietary/administration & dosage/adverse effects/*therapeutic use
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Quality of Life/psychology
MH  - Surveys and Questionnaires
EDAT- 2012/02/22 06:00
MHDA- 2012/07/21 06:00
CRDT- 2012/02/22 06:00
PHST- 2012/02/22 06:00 [entrez]
PHST- 2012/02/22 06:00 [pubmed]
PHST- 2012/07/21 06:00 [medline]
AID - hfs017 [pii]
AID - 10.1093/eurjhf/hfs017 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2012 Apr;14(4):423-9. doi: 10.1093/eurjhf/hfs017. Epub 2012 Feb 
      20.