In HF patients, intravenous iron reduces both CV death and HF-related events

A recent study published in the JACC: Heart Failure analyzed the guidelines that advocate the consideration of intravenous iron to reduce heart failure symptoms which showed positive impact on cardiovascular outcomes. This study was conducted by utilizing systematic review of randomized controlled trials from January 1, 2000, to August 26, 2023 and focused on patients with iron deficiency and heart failure.

This analysis encompassed 14 trials and 6,624 heart failure patients which revealed compelling results. Out of these, 3,407 were treated with intravenous iron while 3,217 received placebo. This comprehensive data unveiled a significant reduction in the risk of combined cardiovascular death and heart failure admission (OR: 0.838 [95% CI: 0.751-0.936]; P = 0.0015), cardiovascular death (OR: 0.867 [95% CI: 0.755-0.955]; P = 0.0427), first heart failure admission (OR: 0.855 [95% CI: 0.744-0.983]; P = 0.0281) and total heart failure admissions (rate ratio: 0.739 [95% CI: 0.661-0.827]; P < 0.0001).

This significance is further underscored by identifying the notable heterogeneity among trial results by concerning first and total heart failure admissions. Metaregression analysis highlighted variations in the baseline transferrin saturation (TSAT) levels which exhibited a more pronounced effect size on heart failure-related events by providing a crucial input into the nuanced relationship between iron status and treatment efficacy.

The observed reduction in cardiovascular death and heart failure-related events suggests a potential shift in the approach to heart failure treatment. Also, the study hints the relevance of baseline TSAT by indicating that patients with lower levels who might particularly benefit from this intervention. This study affirms its strong efficacy and also adds a layer by highlighting the influence of baseline TSAT by paving way for more personalized and effective interventions for heart failure management.

Source:

Martens, P., Augusto, S. N., Jr., Mullens, W., & Tang, W. H. W. (2023). Meta-Analysis and Metaregression of the Treatment Effect of Intravenous Iron in Iron-Deficient Heart Failure. In JACC: Heart Failure. Elsevier BV. https://doi.org/10.1016/j.jchf.2023.11.006