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Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure - 09/09/19

Doi : 10.1016/j.amjmed.2019.02.018 
Xiang Zhou, MD, PhD a, * , Weiting Xu, MD a, Youjia Xu, MD b, Zhiyuan Qian, MD c
a Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China 
b Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China 
c Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, Suzhou, China 

*Request for reprints should be addressed to Xiang Zhou, MD, PhD, Department of Cardiology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou 215004, China.Department of CardiologyThe Second Affiliated Hospital of Soochow UniversityNo. 1055 Sanxiang RoadSuzhou215004China

Abstract

Background

Iron deficiency is prevalent in patients with heart failure. This meta-analysis was performed to evaluate the therapeutic effects of iron in patients with systolic heart failure and iron deficiency.

Methods

We searched PubMed, Embase, and Cochrane databases through March 2018 and included 10 randomized controlled trials involving 1404 heart failure patients who underwent iron or placebo treatment. Odds ratio (OR) and weighted mean differences (WMD) were calculated using fixed- or random-effects models.

Results

Our results showed that iron supplementation significantly reduced hospitalization for worsening heart failure (OR 0.39; 95% confidence interval [CI], 0.19-0.80) and the combined endpoint of death and heart failure hospitalization (OR 0.47; 95% CI, 0.32-0.69). In addition, iron treatment was found to improve New York Heart Association class, 6-minute walk distance, left ventricular ejection fraction, and peak oxygen consumption. Iron therapy was also associated with improvements in Patient Global Assessment, Kansas City Cardiomyopathy Questionnaire score, European Quality of Life-5 Dimensions score, and Minnesota Living with Heart Failure Questionnaire score. Moreover, serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were markedly decreased in patients with iron repletion compared with placebo treatment (WMD: −332.48 pg/mL; 95% CI, −497.48 to −167.47; WMD: −4.64 mg/L; 95% CI, −6.12 to −3.17, respectively).

Conclusions

Our meta-analysis suggests that iron therapy can reduce heart failure hospitalization, increase cardiac function, improve quality of life, and decrease serum levels of NT-proBNP and CRP in patients with heart failure.

El texto completo de este artículo está disponible en PDF.

Keywords : Heart failure, Iron therapy, Meta-analysis


Esquema


 Funding: This study was financially supported by the National Natural Science Foundation of China (No. 81770370), Scientific Research Program for Young Talents of China National Nuclear Corporation (No. 51001), and Advantage Discipline Group of the Second Affiliated Hospital of Soochow University (No. XKQ2015001).
 Conflict of Interest: The authors had no conflict of interest.
 Authorship: All authors had access to the data and a role in writing the manuscript.


© 2019  Elsevier Inc. Reservados todos los derechos.
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Vol 132 - N° 8

P. 955-963 - août 2019 Regresar al número
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