Evidence map›Paper›PMID 33755777›Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2021

Intravenous iron for heart failure with evidence of iron deficiency: a meta-analysis of randomised trials.

Fraser J Graham, Pierpaolo Pellicori, Ian Ford, Mark C Petrie, Paul R Kalra, John G F Cleland

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Review
  7. Review
  8. Review
  9. Article
  10. Article
  11. Iron Deficiency in Heart Failure: A Korea-Oriented Review.International journal of heart failure · 2023
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Iron deficiency and cardiovascular disease.European heart journal · 2023
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Fraser J GrahamRobertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK. fraser.graham@glasgow.ac.uk.ORCID http://orcid.org/0000-0001-7539-9958
Pierpaolo PellicoriRobertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK.
Ian FordRobertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK.
Mark C PetrieBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Paul R KalraDepartment of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
John G F ClelandRobertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe recent AFFIRM-AHF trial assessing the effect of intravenous (IV) iron on outcomes in patients hospitalised with worsening heart failure who had iron deficiency (ID) narrowly missed its primary efficacy endpoint of recurrent hospitalisations for heart failure (HHF) or cardiovascular (CV) death. We conducted a meta-analysis to determine whether these results were consistent with previous trials.

methodsWe searched for randomised trials of patients with heart failure investigating the effect of IV iron vs placebo/control groups that reported HHF and CV mortality from 1st January 2000 to 5th December 2020. Seven trials were identified and included in this analysis. A fixed effect model was applied to assess the effects of IV iron on the composite of first HHF or CV mortality and individual components of these.

resultsAltogether, 2,166 patients were included (n = 1168 assigned to IV iron; n = 998 assigned to control). IV iron reduced the composite of HHF or CV mortality substantially [OR 0.73; (95% confidence interval 0.59-0.90); p = 0.003]. Outcomes were consistent for the pooled trials prior to AFFIRM-AHF. Whereas first HHF were reduced substantially [OR 0.67; (0.54-0.85); p = 0.0007], the effect on CV mortality was uncertain but appeared smaller [OR 0.89; (0.66-1.21); p = 0.47].

conclusionAdministration of IV iron to patients with heart failure and ID reduces the risk of the composite outcome of first heart failure hospitalisation or cardiovascular mortality, but this outcome may be driven predominantly by an effect on HHF. At least three more substantial trials of intravenous iron are underway.

Indexed as

Heart FailureHospitalizationHumansInfusions, IntravenousIronIron DeficienciesRandomized Controlled Trials as TopicIronHeart failureIntravenous ironIron deficiencyMeta-analysis

Identifiers

PMID33755777
PMCPMC8318946

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.