title: Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials.
abstract: The aim of this study was to assess the net clinical and prognostic effects of intravenous (i.v.) iron therapy in patients with systolic heart failure (HF) and iron deficiency (ID).
  
  
  
  We performed an aggregate data meta-analysis (random effects model) of randomized controlled trials that evaluated the effects of i.v. iron therapy in iron-deficient patients with systolic HF. We searched electronic databases up to September 2014. We identified five trials which fulfilled the inclusion criteria (509 patients received i.v. iron therapy in comparison with 342 controls). Intravenous iron therapy has been shown to reduce the risk of the combined endpoint of all-cause death or cardiovascular hospitalization [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.30-0.64, P < 0.0001], and the combined endpoint of cardiovascular death or hospitalization for worsening HF (OR 0.39, 95% CI 0.24-0.63, P = 0.0001). Intravenous iron therapy resulted in a reduction in NYHA class (data are reported as a mean net effect with 95% CIs for all continuous variables) (-0.54 class, 95% CI -0.87 to -0.21, P = 0.001); an increase in 6-min walking test distance (+31 m, 95% CI 18-43, P < 0.0001); and an improvement in quality of life [Kansas City Cardiomyopathy Questionnaire (KCCQ) score +5.5 points, 95% CI 2.8-8.3, P < 0.0001; European Quality of Life-5 Dimensions (EQ-5D) score +4.1 points, 95% CI 0.8-7.3, P = 0.01; Minnesota Living With Heart Failure Questionnaire (MLHFQ) score -19 points, 95% CI:-23 to -16, P < 0.0001; and Patient Global Assessment (PGA) +0.70 points, 95% CI 0.31-1.09, P = 0004].
  
  
  
  The evidence indicates that i.v. iron therapy in iron-deficient patients with systolic HF improves outcomes, exercise capacity, and quality of life, and alleviates HF symptoms.
authors.affiliation: Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.|Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Ewa A
authors.initials: EA
authors.lastname: Jankowska
authors.affiliation: Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.|Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Tkaczyszyn
authors.affiliation: Biostatistics Group, Department of Genetics, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Suchocki
authors.affiliation: Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.|Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Drozd
authors.affiliation: Division of Innovative Clinical Trials, Department of Cardiology & Pulmonology, University Medicine Göttingen (UMG), Göttingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
authors.affiliation: Department of Cardiology, Virchow Klinikum, Charite - Universitätsmedizin, Berlin, Germany.|Center for Stroke Research Berlin, Charite - Universitätsmedizin, Berlin, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Doehner
authors.affiliation: Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.affiliation: Heart Failure Unit, Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
authors.affiliation: Division of Innovative Clinical Trials, Department of Cardiology & Pulmonology, University Medicine Göttingen (UMG), Göttingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.|Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D061605:Administration, Intravenous; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D003677:Deficiency Diseases / Q000150:complications / Q000188:drug therapy*; D018450:Disease Progression; D017079:Exercise Tolerance; D054143:Heart Failure, Systolic / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D009026:Mortality; D016017:Odds Ratio; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D014131:Trace Elements / Q000627:therapeutic use*; D000070857:Walk Test
chemical_list: D014131:Trace Elements; D007501:Iron
keywords: Anaemia; Heart failure; Intravenous iron; Iron deficiency; Meta-analysis; Outcomes