Evidence map›Paper›PMID 41711738›Full record

SynthesisESC heart failure2026

Intravenous ferric carboxymaltose in patients with heart failure and iron deficiency: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis.

Mushood Ahmed, Eeshal Zulfiqar, Tallal Mushtaq Hashmi, Rohma Zia, Hadiah Ashraf, Muhammad Abdullah Naveed, Raheel Ahmed, Jamal S Rana, Faizan Ahmed, Stephen J Greene and 3 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Review
  2. 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

13 authors.

Mushood AhmedDepartment of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan.ORCID 0000-0001-9872-8224
Eeshal ZulfiqarDepartment of Cardiology, Dow University of Health Sciences, Karachi, Pakistan.
Tallal Mushtaq HashmiDepartment of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan.
Rohma ZiaDepartment of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan.
Hadiah AshrafDepartment of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan.
Muhammad Abdullah NaveedDepartment of Cardiology, Dow University of Health Sciences, Karachi, Pakistan.
Raheel AhmedDepartment of Cardiology, Royal Brompton Hospital, London  UK.ORCID 0000-0003-2814-7314
Jamal S RanaDivision of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA.
Faizan AhmedDivision of Cardiology, Duke University Medical Center, Durham, NC, USA.
Stephen J GreeneDivision of Cardiology, Duke University Medical Center, Durham, NC, USA.
Marat FudimDivision of Cardiology, Duke University Medical Center, Durham, NC, USA.
Robert J MentzDivision of Cardiology, Duke University Medical Center, Durham, NC, USA.
Gregg C FonarowAhmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIron deficiency (ID) is common among patients with heart failure (HF), and it is associated with poor functional outcomes, increased hospitalizations, and higher mortality. This meta-analysis evaluates the efficacy of intravenous ferric carboxymaltose (FCM) in HF patients with ID.

methodsWe conducted a literature search of major bibliographic databases up to 15 April 2025, to identify randomized controlled trials (RCTs) comparing FCM with placebo or standard care in HF patients with ID. The primary outcome was a composite of recurrent hospitalizations for heart failure (HHF) or cardiovascular (CV) death assessed at 1-year and complete follow-up. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were estimated using a random-effects model.

resultsEleven RCTs enrolling 6493 patients (3329 FCM; 3164 control) were included. The mean age of patients was 66.7 ± 10.6 years, 34.4% were women, mean left ventricular ejection fraction was 33.7 ± 8.8%, mean haemoglobin was 12.4 ± 1.8 g/dL, and mean transferrin saturation was 18.9 ± 10.1%. FCM significantly reduced the composite of recurrent HHF or CV death at 1-year (RR 0.73, 95% CI 0.62-0.85) and over maximum follow-up (RR 0.80, 95% CI 0.68-0.94) compared to control. Recurrent HHF was significantly reduced with FCM administration (1-year RR 0.69, 95% CI 0.57-0.84; complete follow-up RR 0.75, 95% CI 0.60-0.94). FCM demonstrated a trend towards reduced all-cause (RR: 0.86, 95% CI: 0.74-1.00) and CV mortality at 1-year (RR: 0.86, 95% CI: 0.72-1.02), but this effect was attenuated over longer follow-up. FCM significantly improved 6-minute walk test performance (MD 29.19 m, 95% CI 11.95-46.43). The trial sequential analysis confirmed robust evidence for the primary outcome.

conclusionIntravenous FCM in HF patients is associated with reduced risk of adverse cardiovascular events and improved functional capacity. Further trials are needed to clarify its long-term survival impact.

Indexed as

Anemia, Iron-DeficiencyFerric CompoundsHeart FailureIron DeficienciesMaltoseAdministration, IntravenousHumansRandomized Controlled Trials as TopicStroke Volumeferric carboxymaltoseFerric CompoundsMaltoseFerric carboxymaltoseHeart failureIron deficiencyMeta-analysis

Identifiers

PMID41711738
PMCPMC13108314

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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.