PMID- 32843482
OWN - NLM
STAT- MEDLINE
DCOM- 20210907
LR  - 20211204
IS  - 1469-0756 (Electronic)
IS  - 0032-5473 (Linking)
VI  - 96
IP  - 1142
DP  - 2020 Dec
TI  - Efficacy and safety of iron therapy in patients with chronic heart failure and 
      iron deficiency: a systematic review and meta-analysis based on 15 randomised 
      controlled trials.
PG  - 766-776
LID - 10.1136/postgradmedj-2019-137342 [doi]
AB  - Trials studying iron administration in patients with chronic heart failure (CHF) 
      and iron deficiency (ID) have sprung up these years but the results remain 
      inconsistent. The aim of this meta-analysis was to comprehensively evaluate the 
      efficacy and safety of iron therapy in patients with CHF and ID. A literature 
      search was conducted across PubMed, Embase, Cochrane Library, OVID and Web of 
      Science up to 31 July 2019 to search for randomised controlled trials (RCT) 
      comparing iron therapy with placebo in CHF with ID, regardless of presence of 
      anaemia. Published studies reporting data of any of the following outcomes were 
      included: all-cause death, cardiovascular hospitalisation, adverse events, New 
      York Heart Association (NYHA) functional class, left ventricular ejection 
      fraction (LVEF), N-terminal pro b-type natriuretic peptide, peak oxygen 
      consumption, 6 min walking test (6MWT) distance and quality of life (QoL) 
      parameters. 15 RCTs with a total of 1627 patients (911 in iron therapy and 716 in 
      control) were included. Iron therapy was demonstrated to reduce the risk of 
      cardiovascular hospitalisation (OR 0.35, 95% CI 0.12 to 0.99, p=0.049), but was 
      ineffective in reducing all-cause death (OR 0.59, 95% CI 0.33 to 1.06, p=0.078) 
      or cardiovascular death (OR 0.80, 95% CI 0.39 to 1.63, p=0.540). Iron therapy 
      resulted in a reduction in NYHA class (mean difference (MD) -0.73, 95% CI -0.99 
      to -0.47, p<0.001), an increase in LVEF (MD +4.35, 95% CI 0.69 to 8.00, p=0.020), 
      6MWT distance (MD +35.44, 95% CI 11.55 to 59.33, p=0.004) and an improvement in 
      QoL: EQ-5D score (MD +4.07, 95% CI 0.84 to 7.31, p=0.014); Minnesota Living With 
      Heart Failure Questionnaire score (MD -19.47, 95% CI -23.36 to -15.59, p<0.001) 
      and Patients Global Assessment (PGA) scale (MD 0.71, 95% CI 0.32 to 1.10, 
      p<0.001). There was no significant difference in adverse events or serious 
      adverse events between iron treatment group and control group. Iron therapy 
      reduces cardiovascular hospitalisation in patients with CHF with ID, and 
      additionally improves cardiac function, exercise capacity and QoL in patients 
      with CHF with ID and anaemia, without an increase of adverse events.
CI  - (c) Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Zhang, Junyi
AU  - Zhang J
AD  - Department of Cardiology, The First Affilisted Hospital of Soochow University, 
      Suzhou, Jiangsu, China.
FAU - Hu, Shengda
AU  - Hu S
AD  - Department of Cardiology, The First Affilisted Hospital of Soochow University, 
      Suzhou, Jiangsu, China.
FAU - Jiang, Yufeng
AU  - Jiang Y
AD  - Department of Cardiology, The First Affilisted Hospital of Soochow University, 
      Suzhou, Jiangsu, China.
FAU - Zhou, Yafeng
AU  - Zhou Y
AUID- ORCID: 0000-0002-8577-9791
AD  - Department of Cardiology, The First Affilisted Hospital of Soochow University, 
      Suzhou, Jiangsu, China zhouyafeng73@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200825
PL  - England
TA  - Postgrad Med J
JT  - Postgraduate medical journal
JID - 0234135
RN  - 0 (Hematinics)
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - *Anemia, Iron-Deficiency/complications/drug therapy
MH  - *Heart Failure/blood/complications
MH  - Hematinics/pharmacology
MH  - Humans
MH  - *Iron/pharmacology
MH  - Iron Deficiencies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - clinical physiology
OT  - heart failure
OT  - other metabolic (eg, iron, porphyria)
COIS- Competing interests: None declared.
EDAT- 2020/08/28 06:00
MHDA- 2021/09/08 06:00
CRDT- 2020/08/27 06:00
PHST- 2020/03/24 00:00 [received]
PHST- 2020/05/16 00:00 [revised]
PHST- 2020/05/26 00:00 [accepted]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2021/09/08 06:00 [medline]
PHST- 2020/08/27 06:00 [entrez]
AID - postgradmedj-2019-137342 [pii]
AID - 10.1136/postgradmedj-2019-137342 [doi]
PST - ppublish
SO  - Postgrad Med J. 2020 Dec;96(1142):766-776. doi: 10.1136/postgradmedj-2019-137342. 
      Epub 2020 Aug 25.