SynthesisESC heart failure2022
Oral iron supplementation in patients with heart failure: a systematic review and meta-analysis.
Synthesis in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effect of Increasing Red Meat Intake on Iron Status in Adults with Normal and Suboptimal Iron Status: A Systematic Literature Review and Meta-Analysis of Intervention Studies.Nutrition reviews · 2025Pooled it
- Impact of Intravenous Iron in patients with heart failure and Iron Deficiency: an updated Meta-analysis of Randomized controlled trials.BMC cardiovascular disorders · 2024Pooled it
- Oral iron supplementation in patients with heart failure: a systematic review and meta-analysis.ESC heart failure · 2022Pooled it
- Iron Balance and Cardiovascular Health: The Double-Edged Role of Deficiency and Overload.Cardiovascular toxicology · 2026Review
- Iron deficiency and nutritional status in heart failure with reduced ejection fraction: a cross-sectional study.Cardiology journal · 2026Article
- Iron Deficiency Treatment in Heart Failure-Challenges and Therapeutic Solutions.Journal of clinical medicine · 2025Review
- Identification of three mechanistic pathways for iron-deficient heart failure.European heart journal · 2024Review
- Research advances on molecular mechanism and natural product therapy of iron metabolism in heart failure.European journal of medical research · 2024Review
- Killing two birds with one stone: The potential of iron supplementation in Chinese HFrEF patients.Journal of the Chinese Medical Association : JCMA · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThis review aimed to assess whether oral iron supplementation in a chronic heart failure (HF) population with iron deficiency (ID) or mild anaemia is safe and effective according to evidence-based medicine.
methodsWe retrieved 1803 records from the PubMed, Embase, and the Cochrane Library databases from 1 January 1991 to 15 September 2021. The clinical outcome of oral iron supplementation for ID anaemia in patients with HF was the primary endpoint. The primary safety measures included adverse events and all-cause mortality, and efficacy measures included transferrin saturation (Tsat), ferritin levels, and the 6-min walk test (6MWT). The rate ratio (RR) was used to pool the efficacy measures.
resultsFive randomized controlled trials that compared oral iron treatment for patients with the placebo group and included a combined total of 590 participants were analysed. No significant difference was found in all-cause death between oral iron treatment and placebo groups (RR = 0.77; 95% confidence intervals (CI), 0.46-1.29, Z = 0.98; P = 0.33). However, adverse events were not significantly higher in the iron treatment group (RR = 0.83; 95% CI, 0.60-1.16, Z = 1.07; P = 0.28). In addition, ferritin levels and Tsat were slightly increased after iron complex administration in patients with HF but were not statistically significant (ferritin: mean difference [MD] = 2.70, 95% CI, -2.41 to 7.81, Z = 1.04; P = 0.30; Tsat: MD = 27.42, 95% CI, -4.93 to 59.78, Z = 1.66; P = 0.10). No significant difference was found in exercise capacity, as indicated by the 6MWT results (MD = 59.60, 95% CI, -17.89 to 137.08, Z = 1.51; P = 0.13). We also analysed two non-randomized controlled trials with follow-up results showing that oral iron supplementation increased serum iron levels (MD = 28.87, 95% CI, 1.62-56.12, Z = 2.08; P = 0.04).
conclusionsBased on the current findings, oral iron supplementation can increase serum iron levels in patients with HF and ID or mild anaemia but does not improve Tsat and 6MWT. In addition, oral iron supplementation is relatively safe.
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