Benefits of intravenous iron supplementation in heart failure

S. Kotit
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Abstract

Introduction: Iron deficiency (ID) is one of the most frequent comorbidities in patients with heart failure (HF) and is estimated to be present in up to 80% of acute patients regardless of their ejection fraction. Randomized controlled trials have shown that supplementary intravenous iron results in improved clinical outcomes; however, the current understanding of the effects of intravenous iron on morbidity and mortality remains limited. Study and results: The meta-analysis pooled individual participant data from three randomized placebo-controlled trials of ferric carboxymaltose (FCM) in adult patients (n=4,501) with heart failure and iron deficiency (CONFIRM-HF, AFFIRM-AHF, and HEART-FID). FCM therapy significantly reduced the co-primary composite endpoint of total cardiovascular hospitalizations and cardiovascular death, with a rate ratio (RR 0.86; 95% CI 0.75 to 0.98; p=0.029). FCM therapy was associated with a 17% relative rate reduction in total cardiovascular hospitalizations (RR 0.83; 95% CI 0.73 to 0.96; p=0.009) and a 16% relative rate reduction in total heart failure hospitalizations (RR 0.84; 95% CI 0.71 to 0.98; p=0.025). Lessons learned: The meta-analysis shows that in iron-deficient patients with heart failure and reduced or mildly reduced left ventricular ejection fraction, intravenous ferric carboxymaltose (FCM) is associated with a reduced risk of total cardiovascular hospitalization...
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心力衰竭患者静脉补铁的益处
导言:缺铁(ID)是心力衰竭(HF)患者最常见的并发症之一,据估计,高达 80% 的急性心力衰竭患者存在缺铁,无论其射血分数如何。随机对照试验表明,静脉补充铁剂可改善临床预后;然而,目前对静脉铁剂对发病率和死亡率影响的了解仍然有限。研究与结果:荟萃分析汇集了三项羧甲基铁(FCM)随机安慰剂对照试验(CONFIRM-HF、AFFIRM-AHF 和 HEART-FID)中的个体参与者数据,这些试验针对心力衰竭和缺铁的成年患者(n=4,501)。FCM疗法大大降低了心血管住院总次数和心血管死亡的共同主要复合终点,比率比(RR 0.86;95% CI 0.75 至 0.98;P=0.029)。FCM疗法可使心血管总住院率相对降低17% (RR 0.83; 95% CI 0.73 to 0.96; p=0.009),使心力衰竭总住院率相对降低16% (RR 0.84; 95% CI 0.71 to 0.98; p=0.025)。经验教训:荟萃分析表明,对于左心室射血分数降低或轻度降低的缺铁性心力衰竭患者,静脉注射羧甲基铁(FCM)可降低心血管疾病的总住院风险...
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