title: Outcomes of patients with chronic heart failure and iron deficiency treated with intravenous iron: a meta-analysis.
abstract: BACKGROUND
  Trials studying iron repletion in patients with chronic heart failure (CHF) and iron deficiency are underpowered to find consistent hard endpoint (mortality and hospitalization) reductions. We conducted a meta-analysis of controlled trials to examine the effects of iron repletion on these parameters.
  
  
  RESULTS
  Pubmed, CENTRAL, EMBASE and NIH Clinical Trials databases were searched for controlled trials utilizing intravenous iron, with or without erythropoietin, in patients with CHF with NYHA class ≥ II, iron deficiency, and left ventricular dysfunction. Data regarding hospitalizations, mortality, adverse events, NYHA class, and ejection fraction were extracted, analyzed for heterogeneity, and pooled using the DerSimonian and Laird random effects model. We identified 5 controlled trials (n = 631 patients). Patients treated with intravenous iron had significant reductions in hospitalizations (OR 0.26, 95% CI 0.08-0.80), adverse events (OR 0.35, 95% CI 0.21-0.60), NYHA class (mean improvement 1.2 classes, 95% CI 0.69-1.78, and LVEF (mean improvement 5.0%, 95% CI 0.13-9.80) but no relationship was found on mortality (OR 0.66, 95% CI 0.30-1.44).
  
  
  CONCLUSIONS
  Treatment of iron deficiency in patients with CHF reduces the risk of hospitalizations without increased adverse events, suggesting its role as a potential therapeutic target in this group of patients.
authors.affiliation: Department of Medicine, Alpert Medical School of Brown University, Rhode Island Hospital, RI 02904, USA. mahim.kapoor@gmail.com
authors.forename: Mahim
authors.initials: M
authors.lastname: Kapoor
authors.forename: Mark D
authors.initials: MD
authors.lastname: Schleinitz
authors.forename: Anthony
authors.initials: A
authors.lastname: Gemignani
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Wu
mesh_terms: D061605:Administration, Intravenous; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D004921:Erythropoietin / Q000008:administration & dosage; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007501:Iron / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D004921:Erythropoietin; D007501:Iron