Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure |
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| Institution: | 1. Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China;2. Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China;3. Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, Suzhou, China;1. PGY-4 Gastroenterology, Baylor University Medical Center, Dallas, Tex;2. Precision Family Medicine, Carrolton, Tex;1. Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France;2. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass;3. Harvard Medical School, Boston, Mass;1. Division of Hospital Medicine, Thomas Jefferson University, Philadelphia, Pa;2. Department of Internal Medicine, Internal Medicine Residency Program, University of Arizona College of Medicine, Phoenix;3. Department of Medicine, Loma Linda University School of Medicine, Loma Linda, Calif;4. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio;5. Department of Medicine, University of Virginia, Charlottesville;6. Department of Medicine, Penn State College of Medicine/Penn State Health, Hershey;7. Department of Internal Medicine, Division of Medical Education, Washington University School of Medicine, St. Louis, Mo;8. Department of Medicine, Uniformed Services University of the Health Sciences, Wright-Patterson Medical Center (Cancer Care), Wright-Patterson AFB, Ohio;9. Department of Medicine, Hackensack Meridian School of Medicine at Seton Hall University, St. Francis Medical Center, Trenton, NJ;10. Department of Internal Medicine, Florida State University College of Medicine, Sarasota Memorial Hospital;11. Department of Internal Medicine, Ohio State University College of Medicine, Division of Hematology, Columbus;12. Department of Internal Medicine, Warren Alpert Medical School of Brown University, Division of Hospitalist Medicine, The Miriam Hospital, Providence, RI |
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| Abstract: | BackgroundIron deficiency is prevalent in patients with heart failure. This meta-analysis was performed to evaluate the therapeutic effects of iron in patients with systolic heart failure and iron deficiency.MethodsWe searched PubMed, Embase, and Cochrane databases through March 2018 and included 10 randomized controlled trials involving 1404 heart failure patients who underwent iron or placebo treatment. Odds ratio (OR) and weighted mean differences (WMD) were calculated using fixed- or random-effects models.ResultsOur results showed that iron supplementation significantly reduced hospitalization for worsening heart failure (OR 0.39; 95% confidence interval CI], 0.19-0.80) and the combined endpoint of death and heart failure hospitalization (OR 0.47; 95% CI, 0.32-0.69). In addition, iron treatment was found to improve New York Heart Association class, 6-minute walk distance, left ventricular ejection fraction, and peak oxygen consumption. Iron therapy was also associated with improvements in Patient Global Assessment, Kansas City Cardiomyopathy Questionnaire score, European Quality of Life-5 Dimensions score, and Minnesota Living with Heart Failure Questionnaire score. Moreover, serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were markedly decreased in patients with iron repletion compared with placebo treatment (WMD: − 332.48 pg/mL; 95% CI, − 497.48 to − 167.47; WMD: − 4.64 mg/L; 95% CI, − 6.12 to − 3.17, respectively).ConclusionsOur meta-analysis suggests that iron therapy can reduce heart failure hospitalization, increase cardiac function, improve quality of life, and decrease serum levels of NT-proBNP and CRP in patients with heart failure. |
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