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ArticleClinical research in cardiology : official journal of the German Cardiac Society2024

Influence of iron deficiency definition on the efficacy of intravenous iron in heart failure: a meta-analysis of randomized trials.

Pedro Marques, Francisco Vasques-Nóvoa, Paula Matias, Joana T Vieira, Thomas A Mavrakanas, Abhinav Sharma, Fernando Friões, João Pedro Ferreira

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Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Pedro MarquesDepartment of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal. pedro.marques@mail.mcgill.ca.ORCID http://orcid.org/0000-0002-1120-5461
Francisco Vasques-NóvoaDepartment of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal.
Paula MatiasDepartment of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal.
Joana T VieiraDepartment of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal.
Thomas A MavrakanasDivision of Nephrology, McGill University Health Centre, Montreal, QC, Canada.
Abhinav SharmaDivision of Cardiology, DREAM-CV Lab, McGill University Health Centre, Montreal, QC, Canada.
Fernando FriõesDepartment of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal.
João Pedro FerreiraDepartment of Surgery and Physiology, Cardiovascular Research and Development Center (UnIC@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal. jpferreira@med.up.pt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntravenous iron improves symptoms in heart failure (HF) with iron deficiency (ID) but failed to consistently show a benefit in cardiovascular outcomes. The ID definition used may influence the response to intravenous iron. The aim of this meta-analysis is to assess the influence of ID definition on the intravenous iron effect in HF. METHODS/

resultsWe performed a random-effects meta-analysis of randomized controlled trials (RCT) on intravenous iron (vs. placebo or standard of care) in patients with HF and ID that provided data on transferrin saturation (TSAT) and ferritin subgroups on the composite outcome of cardiovascular death (CVD) or HF hospitalizations (HFH). The risk ratio (RR) and 95% confidence intervals (95% CI) were extracted on the TSAT (< 20% and ≥ 20%) and ferritin (< 100 ng/mL and ≥ 100 ng/mL) subgroups. Data from four major RCT was collected including a total of more than 5500 patients. In patients with a TSAT < 20%, intravenous iron reduced the composite outcome of CVD or HFH: RR 0.81, 95%CI 0.69-0.94, while in patients with a TSAT ≥ 20% the effect was neutral: RR 0.98, 95%CI 0.79-1.21, interaction, P = 0.05. On the other hand, ferritin levels did not modify the effect of IV iron: ferritin ≥ 100 ng/mL RR 0.84, 95%CI 0.65-1.09, and ferritin < 100 ng/mL RR 0.85, 95%CI 0.74-0.97; interaction, P = 0.96.

conclusionsOur meta-analysis suggests that the benefit of intravenous iron may be restricted to patients with TSAT < 20% regardless of ferritin levels and supports the single use of TSAT < 20% to identify patients with ID who may benefit from intravenous iron therapy.

Indexed as

FerritinHeart failureIron deficiencyIV ironTransferrin saturation

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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.